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Screening and Risk Algorithms for Detecting Pediatric Suicide Risk in the Emergency Department.

Robert H Aseltine^1,2, Shane J Sacco^2,3, Steven Rogers^2,4,5

¹Division of Behavioral Sciences and Community Health, UConn Health, Farmington, Connecticut.

JAMA Network Open

|September 24, 2025

Summary

This summary is machine-generated.

A new risk algorithm outperformed standard screening methods in identifying suicide attempts among pediatric emergency department patients. This tool can help healthcare organizations meet patient safety goals for suicide prevention.

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Area of Science:

Pediatric emergency medicine
Mental health research
Clinical risk assessment

Background:

Hospitals must identify at-risk patients per Joint Commission National Patient Safety Goal 15.01.01.
Suicide risk algorithms and in-person screening are used, but comparative data in children is limited.

Purpose of the Study:

To compare the performance of suicide risk screening tools and a risk algorithm in identifying suicide attempts among pediatric emergency department patients.

Main Methods:

Retrospective cohort study of 19,653 youths aged 10-18 in a northeastern US emergency department.
Utilized Ask Suicide-Screening Questions and Columbia-Brief Suicide Severity Rating Scale for screening.
Developed and validated a risk algorithm using electronic health records, with follow-up for suicide attempts.

Main Results:

The risk algorithm identified 50.7% of suicide attempts compared to 36.5% for screening.
The algorithm uniquely identified 127% more youths who attempted suicide than screening.
Among screened patients, 8.1% tested positive for suicide risk.

Conclusions:

The risk algorithm demonstrated superior performance across all metrics compared to standard screening.
The algorithm can significantly aid healthcare organizations in meeting suicide prevention safety goals.
This study highlights the potential of advanced algorithms in pediatric suicide risk assessment.