Self-injurious behavior in an adolescent.

Volume 83, Number 5 www.aafp.org/afp American Family Physician 609 Case Scenario A 16-year-old girl with no remarkable medical history presented to my clinic for a routine well-adolescent appointment. During the visit, I discovered multiple well-healed linear scars on her upper arms and legs. When I questioned her about these lesions, she admitted to cutting herself during the past several months, but denied any suicidal intent or ideation. She said that she cut herself because it was the only way she felt anything and it was a stress release. She further admitted to feeling depressed and to using alcohol over the past year since the divorce of her parents. I was concerned, especially with her cutting behaviors, but unsure what to do next. How do I know if she is at risk of suicide? How should I approach this situation?