Rates of suicide and self-harm have risen significantly in youth populations over the past 12 years (Murphy et al., Natl Vital Stat Rep 66:1–75, 2015). Suicide is also the 2nd leading cause of death in youth aged 10–24, and non-suicidal self-injury (NSSI) is prevalent in adolescents and young adults (Murphy et al., Natl Vital Stat Rep 66:1–75, 2015). Many families are unfamiliar with navigating the mental health system, and most turn to their primary care clinician with behavioral health concerns. As such, PCPs must be prepared to assess youth for suicidal thoughts and behaviors (STB) and NSSI, develop a treatment plan, and refer them to the appropriate level of care. Common risk factors include existing psychiatric disorders, prior suicide attempts or knowing someone who has attempted/completed suicide, substance use, and general environmental factors (e.g., trauma, family dynamics, bullying, academic culture). In pediatric populations, it is impossible to ignore the role of the digital revolution: youth are often unable to experience any sort of break from life stressors, which in turn intensifies negative feelings and exacerbates pre-existing symptoms.