The Urgent Need to Recognize and Reduce Risk of Suicide for Children in the Welfare System.

* Abbreviations: CWS — : child welfare system ED — : emergency department Youth suicide is a global public health crisis. The National Action Alliance for Suicide Prevention and the National Institute of Mental Health aim to reduce the suicide rate 20% by 2025.1 To reach this goal, it will be important to implement universal policies and programs and tailor suicide prevention strategies to ensure mental health professionals are meeting the needs of groups at highest risk. In this issue of Pediatrics , Ruch et al2 present data on an understudied, high-risk population of abused and neglected youth. This is the first study in which authors characterize youth in the child welfare system (CWS) who die by suicide and compare them with living CWS controls. These results have potential to inform proactive and integrated approaches to suicide prevention in the CWS, a boundaried setting that serves youth at 3.5-fold higher risk for suicide than the general youth population.3 There is minimal suicide research on youth served in the CWS, a “protected” population, hindering our ability to identify the unique needs and opportunities for suicide prevention in this population. The Ruch et al2 study was a retrospective matched case-control design that included 120 suicide … Address correspondence to Lisa M. Horowitz, PhD, MPH, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, 10 CRC, Room 6-5362, 10 Center Dr, Bethesda, MD 20892-1276. E-mail: horowitzl{at}mail.nih.gov