Effective Treatment of Adolescents With Suicidal and Self-Harming Behaviors: What Are the Knowledge Gaps?

Youth suicide and self-harm constitute ongoing and unsolved major public health challenges in most regions of the world. Many risk factors, such as mental illness, substance abuse, emotional dysregulation, and recurrent traumatic exposure, have long been well known, whereas our knowledge of other factors, such as the role of negative social media exposure, easier access to cannabis, and reduced sleep time, has increased in recent years.1 Over the past 1 to 2 decades, a range of randomized controlled trials (RCTs) of clinical interventions for adolescents with self-harming behavior have demonstrated statistically significant larger reductions in self-harm compared with active control treatments, as we have previously summarized.1 So far, dialectical behavior therapy (DBT) is the only treatment that has been shown to be effective in more than 1 RCT, but given that only 1 to 2 decades ago no known effective treatment for self-harm in adolescents existed, major progress has been made.