Screening For Youth Suicide: A Call To Action For Pediatric Therapists

As a pediatric physical or occupational therapist, you dedicate your career to improving children’s quality of life—helping them move, function, and thrive. But your role goes beyond biomechanics, motor function, and sensory integration. You are often a trusted presence in a child’s life, seeing them regularly, developing rapport, and sometimes becoming a safe space where they reveal their struggles. That makes you uniquely positioned to help address one of the most heart-wrenching crises of our time: youth suicide.

This is not an easy topic, but it is an essential one. Youth suicide is one of the leading causes of death for children and adolescents aged 10-18. The statistics are alarming, but they also reveal an opportunity: 80% of children who died by youth suicide had seen their primary care provider in the previous months. Because you, as a pediatric therapist, get even more face time with these children, you can be part of the solution. You can screen. You can ask. You can help keep children safe.

You’ve probably seen how cultural and societal shifts are affecting the behaviors of children. The pressure to achieve, social isolation and stressors, and the mental health stigma, all contribute to this growing crisis.The numbers surrounding youth suicide are staggering:

• Over half of adolescents report suicidal thoughts at some point.
• Suicide attempts are rising, with nearly nine attempts per 100 youth.
• The most common method of suicide among adolescents involves firearms.

But statistics alone don’t tell the whole story. Behind every number is a child—one who might be in your clinic today, masking their pain with a smile. How do you reach them? How do you create a space where they feel safe enough to open up?

Pediatric therapists are often seen as allies—adults who don’t carry the same authority as teachers or parents, yet still offer guidance and care. That gives you a unique ability to notice changes in behavior that others might miss. Maybe a typically engaged child becomes withdrawn. Maybe they stop making eye contact or lose interest in activities they once loved. These could be red flags signaling a deeper struggle.

The hardest part? Asking the right questions. Many therapists worry about bringing up the topic of youth suicide, fearing it might “plant the idea” in a child’s head. Research has repeatedly shown this is not the case. Instead, asking directly about suicidal thoughts can open a door for a child who may feel trapped and alone.

As a pediatric therapist, some things you can do to be better prepared include:

1. Normalize the Conversation
2. Know the Warning Signs
3. Be Willing to Ask
4. Have a Plan
5. Provide Resources

I go into more detail on each of these steps in my online mini-course. Keep reading to learn more.

As pediatric therapists, you often work with children who have complex medical needs, including those with anorectal malformations, chronic constipation, and other pelvic floor dysfunctions. These children frequently experience medical trauma, chronic pain, and social stigma that can contribute to feelings of isolation and hopelessness.

Children with anorectal malformations, in particular, may struggle with fear of social rejection and anxiety surrounding medical procedures. Many of these children undergo multiple surgeries and deal with long-term continence challenges, which can lead to emotional distress and, in some cases, suicidal ideation.

Because you work so closely with these children—often in intimate and vulnerable settings—you have a unique opportunity to screen for youth suicide risk. Recognizing emotional distress, validating their experiences, and connecting them with mental health support can be just as critical as addressing their physical needs. Integrating mental health screening into pelvic floor therapy sessions allows us to provide truly holistic care that supports both physical and emotional well-being.

You are often in a position to detect early signs of distress in children. Because you see your patients regularly, you can spot shifts in mood, behavior, and engagement that others may overlook. Incorporating youth suicide screening into your practice doesn’t mean you take on the role of mental health professionals, but it does mean you become a crucial link in the safety net for at-risk children.

At the core of this conversation is one truth: children need to feel seen, heard, and valued. As a pediatric therapist, you can create an environment where kids know they are not alone. You may not be a mental health professional, but you are their advocate, and sometimes the person a child trusts most. That trust gives you an incredible responsibility—and an incredible opportunity—to make a difference.

If this conversation feels overwhelming, you’re not alone. Many healthcare providers—including therapists—feel unprepared to navigate the topic of youth suicide. That’s why education is key. In my online mini course, we take a deeper dive into recognizing warning signs, asking the right questions, and taking appropriate stepwise action. You don’t have to navigate this alone—together, we can help create safer spaces for our children.