New research highlights that teens reporting good mental health may still be at significant risk of suicide if they experience suicidal ideation, prompting calls for routine screening in healthcare settings.
Adolescents who reported suicidal thoughts were far more likely to have attempted suicide, even when they said their mental health was good, according to research published in the Journal of Pediatric Health Care. The analysis of U.S. high school students found that suicidal ideation carried a strong association with repeated attempts, suggesting that outward signs of wellbeing do not always reflect underlying risk.
The study drew on the 2023 Youth Risk Behaviour Survey and included 14,744 students in grades 9 through 12 from states, tribal governments, territories and local districts. Researchers defined suicidal ideation by asking whether students had seriously considered attempting suicide in the previous year, and grouped mental health by how often it had felt “not good” over the past 30 days.
Overall, 21.7% of students said they had considered suicide in the past 12 months. The CDC has separately reported from the same survey year that 20.4% of students seriously considered attempting suicide and 9.5% made an attempt, underlining how common suicidal thoughts and behaviours remain among teenagers. The new study found that students who always reported good mental health but also had suicidal ideation had dramatically higher odds of multiple suicide attempts than those who always reported poor mental health without suicidal ideation.
The findings add to a wider body of evidence showing that adolescent suicide risk is shaped by more than one factor. Earlier research has linked anxiety and depression symptoms, short sleep, substance use disorders and longer-term rises in suicidal behaviour to greater risk among young people, while public health officials have urged stronger protective factors and earlier intervention. The authors of the new study said the results support routine screening for both mental health and suicide risk in healthcare settings, and they suggested universal suicide screening in paediatric primary care may be worth considering.
The study was led by Ashley E. Barber of Georgia State University and published online on 4 September 2026. It used secondary survey data, which means the findings may not translate neatly to children seen in primary care clinics, but the authors reported no specific funding and no relevant conflicts of interest.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
