Commentary on: Flores JP, Kahn G, Penfold RB, et al . Adolescents who do not endorse risk via the Patient Health Questionnaire before self-harm or suicide. JAMA Psychiatry . 2024;81(7):717–26 ### Implications for practice and research Self-harm is defined as self-injury or self-poisoning, irrespective of the presence or absence of suicidal intent.1 Self-harm could be divided into the following categories: (1) self-harm with suicidal intent (suicide attempts); (2) self-harm without suicidal intent (non-suicidal self-injury and non-suicidal self-poisoning) and (3) self-harm with undetermined or mixed intent. Self-harm resulting in a presentation to an emergency room is the strongest known predictor of death by suicide.1 The prevalence of self-harm is just under 20%.1 At the peak of the COVID-19 pandemic, …