Lowering the Age Limit in Suicide Risk Screening: Clinical Differences and Screening Form Predictive Ability

Area of Science:

• Pediatric Emergency Medicine
• Child and Adolescent Psychiatry
• Public Health

Background:

• Emergency departments (EDs) are critical points for identifying mental health concerns in children.
• The Ask Suicide-Screening Questions (ASQ) tool was implemented in a pediatric ED for patients aged 8-21 presenting with behavioral or mental health issues.
• This study retrospectively analyzed data from 2,466 patient visits to assess suicide risk screening in younger children.

Discussion:

• Younger children (8-9 years) screened for suicide risk in the ED showed distinct clinical presentations compared to older adolescents.
• Externalizing symptoms and hallucinations were more common in younger positive screeners.
• A notable proportion of younger children screening positive did not initially present with suicidal ideation or attempt, highlighting the importance of universal screening.

Key Insights:

• 36% of 8- and 9-year-old patients presenting with behavioral/mental health concerns screened positive for suicide risk.
• Younger patients (8-9 years) screening positive were less likely to report suicidal ideation or attempts than older patients.
• Over 71% of 8- to 9-year-olds who screened positive did not present with suicidal ideation or attempt, underscoring the need for broad screening.

Outlook:

• These findings support the expansion of suicide risk screening to younger pediatric populations in ED settings.
• Further research should explore the specific needs and interventions for young children identified through screening.
• Implementing validated screening tools like the ASQ can improve early identification and intervention for at-risk youth.