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Major depressive disorder with suicide risk — RACP Paediatrics MCQ

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HardSafeguarding, development, mental healthMajor depressive disorder with suicide riskRACP Paediatrics

A 15-year-old reports two months of low mood, insomnia, loss of interest and declining school attendance. He has been searching online for lethal medication doses and has written a goodbye message. He denies current substance use but cannot agree to a safety plan. What is the most appropriate management?

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Correct answer: D — Urgent mental health assessment with safety supervision and crisis planning

Active suicidal preparation and inability to agree to safety planning require urgent mental health assessment and supervised safety measures. Outpatient referral alone is insufficient when imminent risk markers are present. Management should involve family or carers where safe, with attention to confidentiality and safeguarding.

Reference: RACP Knowledge Guides; Australian child and adolescent mental health guidance