Joel Stoddard, MD, on youth suicide, firearm access, and universal screening in prevention

New research from pediatric experts at Children’s Hospital Colorado is sharpening the focus on practical suicide prevention strategies for children and adolescents, with particular emphasis on firearm safety counseling and universal suicide risk screening. The findings build on a recent analysis published in the Journal of the American Academy of Child and Adolescent Psychiatry that examined 10 years of national suicide mortality data and identified five distinct classifications of youth who died by suicide.

Watch part 1 of this interview here.

A key takeaway from the research is that nearly half of youth suicide decedents had no documented mental health diagnosis or prior clinical contact, highlighting the limits of prevention approaches that rely solely on psychiatric history. Subsequent discussion with study investigators has focused on how clinicians can act on these insights in everyday practice.

Firearms as a modifiable risk factor

Although asphyxia and ingestion remain common causes of death among youth who die by suicide, investigators emphasized that firearms present a distinct and actionable prevention opportunity. Unlike other means, firearm access can often be identified and modified within the home.

“I think the framing is more important that ligatures are asphyxia. Asphyxia was also a major cause of death,” said Joel Stoddard, MD, MAS, lead author of the study and a child and adolescent psychiatrist at Children’s Hospital Colorado. “But I’d like to highlight that to draw a distinction between firearms, we can identify if firearms are in our house where it’s not really that feasible to manage potential ligatures.”

Stoddard noted that suicide risk in youth can escalate rapidly, sometimes within hours, often during late-night periods with limited supervision. “Sometimes you don’t have that much time between the time that risk develops…and they make their attempt,” he said. Temporarily reducing access to firearms during periods of heightened stress may allow time for emotions to de-escalate and avert irreversible harm.

Firearm safety counseling in routine care

Because firearm use was observed across all identified youth suicide classifications, the researchers recommend integrating counseling on safe firearm storage into routine pediatric and adolescent care. According to Stoddard, these discussions can be brief and practical, using available gun safety devices and clear guidance without placing excessive burden on clinicians or families.

Universal suicide risk screening

The research also reinforces the importance of universal suicide risk screening, including in primary care and other non-psychiatric settings. Many youth who died by suicide would not have been identified using approaches limited to patients with known mental health conditions.

“Be comfortable with your domain, and it’s okay to screen for suicide risk…at least everyone,” Stoddard said. Validated tools, such as the Ask Suicide-Screening Questions toolkit, can support efficient screening and appropriate follow-up, and evidence does not suggest that asking about suicide increases risk.

System-level impact

Encouragingly, the investigators observed lower suicide rates among youth with prior mental health treatment in states with robust crisis response programs and mental health infrastructure. The findings suggest that layered prevention strategies—combining screening, firearm safety counseling, and crisis-oriented systems—may meaningfully reduce youth suicide risk and support earlier intervention.

Disclosure

Stoddard reports no relevant disclosures.

References

Children's Hospital Colorado. Children’s Hospital Colorado research outlines first pediatric classifications for suicide risk in adolescents and kids. Eurekalert. January 13, 2026. Accessed January 23, 2026. https://www.eurekalert.org/news-releases/1112365