Screening and Follow-Up Treatment Practices for Suicide Risk in Adolescent Primary Care: A Retrospective Chart Review

Area of Science:

• Adolescent Medicine
• Mental Health Services
• Primary Care Pediatrics

Background:

• Universal depression screening is common in adolescent primary care.
• Screening often includes questions about suicide risk, self-injurious thoughts, and behaviors.
• Effective follow-up protocols are crucial for adolescents endorsing suicidal ideation.

Purpose of the Study:

• To investigate primary care providers' follow-up actions for adolescents screening positive for suicide risk.
• To analyze documentation, further assessment, and referral patterns.
• To understand how clinical judgment influences intervention strategies.

Main Methods:

• Retrospective chart review of well-child visits for adolescents aged 13-17.9.
• Analysis of progress notes for documentation of assessments and actions.
• Categorization of follow-up actions based on depression severity and clinical judgment.

Main Results:

• Over 75% of progress notes indicated further assessment.
• Two-thirds documented same-day actions, including referrals and safety planning.
• Interventions varied by depression severity, with justifications provided for non-interventions.

Conclusions:

• Primary care providers utilize diverse interventions for adolescent suicide risk.
• Clinical judgment is key in tailoring actions to individual patient needs and preferences.
• Standardized guidelines incorporating clinical assessment and individualized planning are proposed.