Factors Associated With Persistent Positive Suicide Screens in the Pediatric Emergency Department

Area of Science:

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

Background:

• Suicide is a leading cause of death in youth aged 10-24.
• The Ask Suicide-Screening Questions (ASQ) tool identifies suicide risk in emergency departments (EDs).
• Limited research exists on factors associated with persistent positive ASQ screens during repeat ED visits.

Purpose of the Study:

• To identify sociodemographic and visit-related factors associated with persistent positive ASQ screening in pediatric patients.
• To understand predictors of ongoing suicide risk identification in youth.
• To inform targeted suicide prevention strategies in the ED setting.

Main Methods:

• Retrospective chart review of pediatric patients (11-18 years) with a positive ASQ at index visit and subsequent ED visit (>30 days later).
• Inclusion criteria: positive ASQ at index visit and at least one subsequent ED visit.
• Bivariate analyses and multivariable logistic regression were used to identify associated factors.

Main Results:

• 31% of encounters showed persistent positive ASQ responses.
• Females had higher odds of persistent positivity (OR = 2.84).
• Transfer to another facility (OR = 7.70) and prior mental health follow-up visits (OR = 2.30) were associated with persistent positivity.

Conclusions:

• Persistent positive ASQ screening suggests current interventions may be inadequate.
• Improving continuity of care and reducing systemic barriers are crucial.
• Targeted strategies for high-risk youth are warranted to enhance suicide prevention efforts.