Universal Pediatric Suicide Risk Screening in a Health Care System: 90,000 Patient Encounters
Abstract
Background Suicidal behavior is increasing among US youths. Contact with the health care system is common in the months before suicide. Objective To assess the characteristics of suicide risk among youths presenting for health care, universal screening results from a large hospital system were analyzed. Methods A retrospective analysis of the Ask Suicide-Screening Questions tool administered to patients aged 10-17 years in a hospital system including an emergency department, inpatient medical units, and primary care clinics was conducted. Demographic and clinical data from 3 years of encounters were analyzed. Results The sample consisted of 91,580 pediatric encounters, predominantly white Hispanic and women, with one third speaking Spanish. Across health care settings, 2.9% of encounters produced positive suicide risk screens, with the highest rate in the emergency department (8.5%). Acute positive screens, indicating imminent risk for suicidal behavior, accounted for 0.3% of all encounters. Approximately one-fourth (27.6%) of encounters for psychiatric presenting problems screened positive compared with 2.3% for nonpsychiatric encounters. Higher rates of positive screens were present among encounters for psychiatric presenting problems across all settings. Positive screens were less common among preteen (1.8%) than adolescent (3.1%) encounters (χ 2 = 65.50, P Conclusions Universal screening detected suicide risk in approximately 3% of pediatric health care encounters. Screen…
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Self-citation
- Authors
- Roaten, K., Horowitz, L. M., Bridge, J. A., Goans, C. R. R., McKintosh, C., Genzel, R., Johnson, C., & North, C. S.
- Affiliations
- Parkland Health & Hospital System (US)
- National Institutes of Health (US)
- Nationwide Children's Hospital (US)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Roaten, Kimberly
- Venue
- Journal of the Academy of Consultation-Liaison Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 62
- Issue
- 4
- Pages
- 421-429
- ISSN
- 2667-2960 (ISSN-L)
- OpenAlex
- W3134882758
- Cited by
- 67
- References
- 21
- Citations by year
- 2026: 5 · 2025: 18 · 2024: 12 · 2023: 15 · 2022: 14 · 2021: 3
- FWCI
- 7.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the Academy of Consultation-Liaison Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (ZIAMH002922)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Health › Gun Ownership and Violence Research
- Keywords
- suicide risk screening, universal screening, Ask Suicide-Screening Questions, adolescents, preadolescents, emergency department visits, hospital visits, Hispanic patients
- MeSH terms
- Suicide Prevention, Adolescent, Child, Delivery of Health Care, Female, Humans, Mass Screening, Retrospective Studies, 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 ›
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