Preteen Suicide Risk Screening in the Pediatric Outpatient Setting: A Clinical Pathway

Area of Science:

• Child and Adolescent Psychiatry
• Pediatric Healthcare
• Mental Health Services Research

Background:

• Youth face a mental health crisis with rising rates of suicidal ideation and behaviors in preteens.
• Current guidelines recommend universal suicide risk screening for adolescents (12+) but lack systematic approaches for preteens (8-11).
• Pediatric practitioners often lack age-specific tools and clear indications for assessing suicide risk in younger children.

Purpose of the Study:

• To develop an evidence-informed suicide risk screening pathway for pediatric practitioners in outpatient settings.
• To address the need for age-appropriate resources for preteen suicide risk assessment.
• To provide guidance for screening younger children (<8 years) as well.

Main Methods:

• Convened experts in preadolescent suicide, pediatrics, primary care behavioral health, and child development.
• Reviewed empirical literature and existing practice guidelines.
• Iterated on a multi-informant screening pathway involving caregivers and preteens, developing workflow tools and scripts.

Main Results:

• Developed a comprehensive suicide risk screening pathway tailored for preteens (8-11 years).
• Created tools and guidelines for screening workflow, risk determination, and communication with patients and caregivers.
• Included considerations for suicide risk assessment in children under 8 years.

Conclusions:

• The developed pathway provides pediatric practitioners with an age-appropriate, evidence-informed approach to preteen suicide risk screening.
• Implementation of this pathway can improve early identification and intervention for at-risk preteens.
• Standardized screening and clear guidance are crucial for addressing the youth mental health crisis.