J Multidiscip Healthc. 2026 Sep 1;19:619534. doi: 10.2147/JMDH.S619534. eCollection 2026.
ABSTRACT
BACKGROUND: The World Health Organization estimates that more than 720,000 people die by suicide each year and that suicide is the third leading cause of death among individuals aged 15 to 29 years; in the United States it ranks second among those aged 10 to 24 years. Rising adolescent ideation, planning and attempts have exposed the limits of siloed care.
METHODS: This systematic review was reported according to PRISMA 2020, incorporating scoping elements for guidelines and policy frameworks. Nine databases were searched for English-language literature published between January 2018 and February 2026. Of 7496 records identified and 1680 screened after duplicate removal, 26 sources met the inclusion criteria. Design-appropriate instruments (AMSTAR 2, RoB 2, Newcastle-Ottawa Scale, CASP) were used to appraise quality. Given heterogeneous designs, no meta-analysis was performed; findings were synthesized narratively across five pre-specified domains, with risk determinants organized using the Hierarchical Taxonomy of Psychopathology (HiTOP).
RESULTS: HiTOP dimensions of fear, distress, externalization, thought disorder and traumatic stress organized otherwise disparate risk data. Medically and legally complex subgroups, including adolescents with thalassemia major and justice-involved youth, carried compounded risk requiring cross-sectoral care. In primary care, universal screening and the Safety Planning Intervention with structured follow-up were the best-supported components. Pharmacogenomic testing showed consistent genotype-outcome associations but modest and inconsistent clinical benefit in randomized data, with no adolescent trial reporting suicide outcomes. School programs improved help-seeking and mental health literacy more reliably than they reduced attempts. Digital monitoring achieved high temporal resolution but low positive predictive value. Role ambiguity, non-interoperable records and unmanaged care transitions were the dominant implementation barriers.
CONCLUSION: Coordinated multidisciplinary care is supported, but the strength of evidence differs sharply by component. Care navigation, shared risk registries and integrated behavioral health warrant priority; pharmacogenomic and algorithmic tools require adolescent-specific trials before routine adoption.
PMID:42701793 | PMC:PMC13546003 | DOI:10.2147/JMDH.S619534
