Introduction		Depression and suicidality are not uncommon in the adolescent age group. Depression is a major adolescent and adult health issue. Unfortunately, it is often months to years before it is recognized and eventually treated in the adolescent patient. Mental health services are often difficult to secure. It is often difficult to get an appointment with a psychiatrist within 24-48 hours of the emergency. One often needs to refer a patient emergently to an emergency room to gain access to psychiatric care if there is concern for self-harm - specifically suicide. Depression can and should be managed by primary care pediatricians. In this lecture, we will discuss the FDA's new "black-box warnings", which have caused some pediatricians to hesitate in prescribing antidepressant medications. Our goal is to balance the risk of further suicidal ideation against that of the treatment itself and the benefits of treating a child with SSRIs and providing adequate counseling. It is certainly possible for this to be done by the primary care pediatrician. Some of the objectives that I would like you to take away from this talk are: Increased awareness of the prevalence of adolescent depression and suicide Screening techniques used in the office Initial treatment modalities When to refer a child for psychiatric care? The role of the primary care provider in coordinating the care for a depressed youth Return to top of page