The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Identification of At-Risk Youth by Suicide Screening in a Pediatric Emergency Department
Open accessAbstract
The pediatric emergency department (ED) is a critical location for the identification of children and adolescents at risk for suicide. Screening instruments that can be easily incorporated into clinical practice in EDs to identify and intervene with patients at increased suicide risk is a promising suicide prevention strategy and patient safety objective. This study is a retrospective review of the implementation of a brief suicide screen for pediatric psychiatric ED patients as standard of care. The Ask Suicide Screening Questions (ASQ) was implemented in an urban pediatric ED for patients with psychiatric presenting complaints. Nursing compliance rates, identification of at-risk patients, and sensitivity for repeated ED visits were evaluated using medical records from 970 patients. The ASQ was implemented with a compliance rate of 79 %. Fifty-three percent of the patients who screened positive (237/448) did not present to the ED with suicide-related complaints. These identified patients were more likely to be male, African American, and have externalizing behavior diagnoses. The ASQ demonstrated a sensitivity of 93 % and specificity of 43 % to predict return ED visits with suicide-related presenting complaints within 6 months of the index visit. Brief suicide screening instruments can be incorporated into standard of care in pediatric ED settings. Such screens can identify patients who do not directly report suicide-related presenting complaints at triage and who may be at particular risk for future suicidal behavior. Results have the potential to inform suicide prevention strategies in pediatric EDs.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Studies show the ASQ has high sensitivity, specificity, and negative predictive validity, and that it can detect patients at risk for suicide that depression screening alone fails to identify.40-42”
From Evidence-based youth suicide prevention and intervention in pediatric primary care settings. (2024) · cites this paper as [41]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Completed Suicide After a Suicide Attempt: A 37-Year Follow-Up Study
Suominen, K., Isometsä, E., Suokas, J., Haukka, J., Achte, K., & Lönnqvist, J. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.3.562 · Cited by 650
Ask Suicide-Screening Questions (ASQ): A Brief Instrument for the Pediatric Emergency Department
Horowitz, L. M., Bridge, J. A., Teach, S. J., Ballard, E., Klima, J., Rosenstein, D. L., Wharff, E. A., Ginnis, K., Cannon, E., Joshi, P., et al. (2012) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpediatrics.2012.1276 · Cited by 593
Self-citationCultural considerations in adolescent suicide prevention and psychosocial treatment.
Goldston, D. B., Molock, S. D., Whitbeck, L. B., Murakami, J. L., Zayas, L. H., & Hall, G. C. N. (2008) · American Psychologist · doi:10.1037/0003-066x.63.1.14 · Cited by 549
A randomized controlled trial of postcrisis suicide prevention.
Motto, J. A., & Bostrom, A. G. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.6.828 · Cited by 517
Candidate endophenotypes for genetic studies of suicidal behavior
Mann, J. J., Arango, V. A., Avenevoli, S., Brent, D. A., Champagne, F. A., Clayton, P., Currier, D., Dougherty, D. M., Haghighi, F., Hodge, S. E., et al. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.11.021 · Cited by 398
161 An evaluation of CDC’s web-based injury statistics query and reporting system (WISQARS)
Ballesteros, M., Thigpen, S. E., Faul, M., Kresnow, M.-J., & Middlebrooks, J. (2016) · doi:10.1136/injuryprev-2016-042156.161 · Cited by 305
Suicide Trends Among Elementary School–Aged Children in the United States From 1993 to 2012
Bridge, J. A., Asti, L., Horowitz, L. M., Greenhouse, J. B., Fontanella, C. A., Sheftall, A. H., Kelleher, K. J., & Campo, J. V. (2015) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2015.0465 · Cited by 303
Self-citationAdolescents Who Use the Emergency Department as Their Usual Source of Care
Wilson, K. M., & Klein, J. D. (2000) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.154.4.361 · Cited by 281
Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008.
Ting, S. A., Sullivan, A. F., Boudreaux, E. D., Miller, I., & Camargo, C. A. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.03.020 · Cited by 252
Adolescent suicide, gender, and culture: A rate and risk factor analysis
Langhinrichsen‐Rohling, J., Friend, J., & Powell, A. E. (2009) · Aggression and Violent Behavior · doi:10.1016/j.avb.2009.06.010 · Cited by 232
Suicide screening in schools, primary care and emergency departments
Horowitz, L. M., Ballard, E. D., & Pao, M. (2009) · Current Opinion in Pediatrics · doi:10.1097/mop.0b013e3283307a89 · Cited by 181
Self-citationWhat Do We Know About Suicidality in Autism Spectrum Disorders? A Systematic Review
Segers, M., & Rawana, J. (2014) · Autism Research · doi:10.1002/aur.1375 · Cited by 168
Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents
Molock, S., Puri, R., Matlin, S. L., & Barksdale, C. (2006) · The Journal of Black Psychology · doi:10.1177/0095798406290466 · Cited by 163
Detecting Suicide Risk in a Pediatric Emergency Department: Development of a Brief Screening Tool
Horowitz, L. M., Wang, P. S., Koocher, G. P., Burr, B. H., Smith, M. F., Klavon, S. L., & Cleary, P. D. (2001) · PEDIATRICS · doi:10.1542/peds.107.5.1133 · Cited by 148
Self-citationAsarnow, J. R., Berk, M., Hughes, J. L., & Anderson, N. L. (2015) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.940624 · Cited by 147
Detecting and treating suicide ideation in all settings.
(2016) · PubMed · Cited by 143
Mahajan, P., Alpern, E. R., Grupp-Phelan, J., Chamberlain, J., Dong, L., Holubkov, R., Jacobs, E., Stanley, R. M., Tunik, M. G., Sonnett, M., et al. (2009) · Pediatric Emergency Care · doi:10.1097/pec.0b013e3181bec82f · Cited by 141
Emergency departments are underutilized sites for suicide prevention
Larkin, G. L., & Beautrais, A. L. (2010) · Crisis · doi:10.1027/0227-5910/a000001 · Cited by 133 · cited 4×
“Investigation of the ASQ as a universal screening instrument for all pediatric ED patients may be a promising line of inquiry (Larkin and Beautrais 2010), given that children and adolescents who present to EDs with somatic concerns such as headaches and stomachaches as well as other medical concerns may manifest laten…”
BackgroundInfluentialAdolescent Suicide Risk Screening in the Emergency Department
King, C. A., O’Mara, R. M., Hayward, C. N., & Cunningham, R. M. (2009) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2009.00500.x · Cited by 121
Mental Health Utilization in a Pediatric Emergency Department
Sheridan, D. C., Spiro, D. M., Fu, R., Johnson, K., Sheridan, J. S., Oue, A. A., Wang, W., Nes, R. V., & Hansen, M. L. (2015) · Pediatric Emergency Care · doi:10.1097/pec.0000000000000343 · Cited by 116
Outpatient Care of Young People After Emergency Treatment of Deliberate Self-Harm
Bridge, J. A., Marcus, S. C., & Olfson, M. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.11.002 · Cited by 90
Referral and Resource Use Patterns for Psychiatric-Related Visits to Pediatric Emergency Departments
Grupp‐Phelan, J., Mahajan, P., Foltin, G. L., Jacobs, E., Tunik, M. G., Sonnett, M., Miller, S., & Dayan, P. (2009) · Pediatric Emergency Care · doi:10.1097/pec.0b013e31819e3523 · Cited by 90
King, C. A., Jiang, Q., Czyz, E. K., & Kerr, D. (2013) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-013-9794-0 · Cited by 86
Suicide Risk in Youth with Intellectual Disabilities
Ludi, E. K., Ballard, E. D., Greenbaum, R., Pao, M., Bridge, J. A., Reynolds, W. M., & Horowitz, L. M. (2012) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e3182599295 · Cited by 84
Self-citationDeliberate self‐harm: emergency department nurses’ attitudes, triage and care intentions
McCann, T. V., Clark, E., McConnachie, S., & Harvey, I. (2007) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2006.01555.x · Cited by 76
King, C. A., Gipson, P. Y., Horwitz, A. G., & Opperman, K. J. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201300347 · Cited by 73 · cited 2×
“Sensitivity and specificity analyses highlight the ability of brief suicide risk screening approaches to identify individuals whowill return to the ED for suicide-related reasons, with similar results as other previously published analyses (King et al. 2015a).”
BackgroundResultSuicide Risk Screening and Assessment
Boudreaux, E. D., & Horowitz, L. M. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.06.005 · Cited by 68
Self-citationPena, J. B., Matthieu, M. M., Zayas, L. H., Masyn, K. E., & Caine, E. D. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0322-z · Cited by 62
Identifying adolescents at highly elevated risk for suicidal behavior in the emergency department
King, C. A., Berona, J., Czyz, E., Horwitz, A. G., & Gipson, P. Y. (2015) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2014.0049 · Cited by 54
Suicide in children and young adolescents: A 25-year database on suicides from Northern Finland
Lahti, A., Harju, A., Hakko, H. H., Riala, K., & Räsänen, P. K. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.07.020 · Cited by 50
(2010) · PubMed · Cited by 35
Suicide Risk Screening in an Emergency Department
Folse, V. N., & Hahn, R. L. (2009) · Clinical Nursing Research · doi:10.1177/1054773809335296 · Cited by 35
Trauma and mental health in US inner-city populations
Breslau, N. (2009) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2009.07.001 · Cited by 27
Physician Management of Pediatric Mental Health Patients in the Emergency Department
Cappelli, M., Glennie, J. E., Cloutier, P., Kennedy, A., Vloet, M., Newton, A. S., Zemek, R. L., & Gray, C. (2012) · Pediatric Emergency Care · doi:10.1097/pec.0b013e31826764fd · Cited by 21
Research works printed but not linked: 3
- Knesper, D. J. (2010). Continuity of care for suicide prevention and research: Suicide attempts and suicide deaths subsequent to discharge from the emergency department or psychiatry inpatient unit. In American Association of Suicidology, & Suicide Prevention Resource Center. Newton: Education Development Center, Inc.
- National Action Alliance for Suicide Prevention Research Prioritization Task Force. (2014). A prioritized research agenda for suicide prevention: an action plan to save lives. Rockville: National Institute of Mental Health and the Research Prioritization Task Force.
- Reynolds, W. M. (1987). Suicidal Ideation Questionnaire (SIQ): Professional manual. Odessa: Psychological Assessment Resources.
Cited by
Sorted by citations
Turecki, G., Brent, D. A., Gunnell, D., O’Connor, R. C., Oquendo, M. A., Pirkis, J., & Stanley, B. H. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0121-0 · Cited by 1,074
Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US
Kalb, L. G., Stapp, E. K., Ballard, E. D., Holingue, C., Keefer, A., & Riley, A. (2019) · Pediatrics · doi:10.1542/peds.2018-2192 · Cited by 285
Self-citationAn Integrated Public Health Approach to Interpersonal Violence and Suicide Prevention and Response
Decker, M. R., Wilcox, H. C., Holliday, C. N., & Webster, D. W. (2018) · Public Health Reports® · doi:10.1177/0033354918800019 · Cited by 115
Self-citationAssessment of selective and universal screening for suicide risk in a pediatric emergency department
DeVylder, J. E., Ryan, T. C., Cwik, M., Wilson, M. E., Jay, S., Nestadt, P. S., Goldstein, M., & Wilcox, H. C. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.14070 · Cited by 109
Self-citationEmerging trends in adolescent suicide prevention research
King, C. A., Arango, A., & Foster, C. E. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.08.037 · Cited by 85
Metadata
- Authors
- Ballard, E. D., Cwik, M., Van Eck, K., Goldstein, M., Alfes, C., Wilson, M. E., Virden, J. M., Horowitz, L. M., & Wilcox, H. C.
- Affiliations
- National Institutes of Health (US)
- Johns Hopkins University (US)
- Corresponding author
- Ballard, Elizabeth D.
- Venue
- Prevention Science
- Published
- 2016-09-27
- Volume
- 18
- Issue
- 2
- Pages
- 174-182
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC5247314
- OpenAlex
- W2524022793
- Cited by
- 123
- References
- 34
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 17 · 2023: 20 · 2022: 16 · 2021: 19 · 2020: 14 · 2019: 13 · 2018: 3 · 2017: 3
- FWCI
- 8.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Substance Abuse and Mental Health Services Administration (U79SM061751)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Keywords
- suicide risk screening, pediatric emergency department, at-risk youth, suicide prevention, Ask Suicide-Screening Questions, nursing compliance, screening sensitivity and specificity, psychiatric patients, externalizing disorders, African American adolescents, suicide risk identification
- MeSH terms
- Suicide Prevention, Adolescent, Emergency Service, Hospital, Female, Hospitals, Pediatric, Humans, Male, Retrospective Studies, Risk Assessment, Young Adult, Suicidal Ideation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review