Given the importance of depression as a risk factor for suicide, the recognition and treatment of depression in male adolescents is critical in reducing the risk for suicide. The Columbia Suicide Screen in particular has proven useful in identifying youths with untreated mental health problem. Once depressed youths are identified, however, they must be able to access treatment and remain in treatment. For youth who have been depressed, prevention intervention should also focus on enhancing social skills, social problem-solving ability, and social integration. A review of epidemiological and case-control evidence supports age-related changes in substance use as a major contributor to the age-related pattern in suicide among adolescent males. Changes in rates of depression also play a role. Also, a general increased capacity for lethal violence from ages 11 to 21 may also contribute to suicide among adolescent males. An examination of the relationship between suicide, substance-use disorders, and depression from a developmental perspective concludes that stressful life events preceding suicide do not occur spontaneously, but rather often conclude a maladaptive developmental trajectory. Further, substance abuse and depression both contribute to and are exacerbated by difficulties in managing age-related events and experiences. 137 references