Victimization and bullying are potential risk factors for adolescent depression and suicidality. In evaluations of students involved in bullying behavior, it is important to assess depression and suicidality.

HE PRESIDENT'S NEW FREEdom Commission 1 and the Children's Mental Health Screening and Prevention Act 2 recommend increased screening for suicidality and mental illness. The recent enactment of the Garrett Lee Smith Memorial Act 3 further supports the development of youth suicide prevention and intervention programs. Despite the proliferation of screening programs in recent years (eg, Signs of Suicide, 4 Teen-Screen 5 ), the current debate about possible iatrogenic effects of other suicide preventive interventions, 6,7 and the belief that prevention programs may "spur troubled youngsters to try suicide," 8 the potential harm of screening for suicide remains unstudied. 9,10 Screening strategies are based on the valid premise that suicidal adolescents are underidentified [11][12][13][14][15] ; have an active, often treatable, mental illness [16][17][18] ; and exhibit identifiable risk factors. 11 Evidence for the clinical validity and reliability of school-based screening procedures has recently emerged. Use of the Suicidal Ideation Questionnaire (SIQ) in a midwestern US high school yielded a sensitivity ranging from 83% to 100%, with specificity from 49% to 70%. 19 The Suicide Risk Screen's use among 581 students in 7 high schools had a sensitivity ranging from 87% to 100%, with specificity from 54% to 60%. 20 Among 2004 teenagers from 8 New York metropoli-