Variation in Suicide Risk Screening by Pediatricians Across Subspecialties

Area of Science:

• Pediatric Medicine
• Public Health
• Mental Health Screening

Background:

• Pediatricians play a crucial role in identifying and managing mental health issues in children and adolescents.
• Suicide is a significant public health concern among young people, necessitating effective screening protocols.
• Standardized suicide risk screening tools are essential for consistent and accurate identification of at-risk youth.

Purpose of the Study:

• To assess the current practices of general and subspecialty pediatricians regarding standardized suicide risk screening.
• To examine the variation in screening practices across different pediatric subspecialties.
• To determine if awareness of American Academy of Pediatrics (AAP) recommendations influences the adoption of standardized screening.

Main Methods:

• Analysis of survey data from the 2023 American Board of Pediatrics Maintenance of Certification program.
• Survey items focused on the use of standardized suicide risk screening tools, specific tools, universal screening adoption, and knowledge of AAP recommendations.
• Adjusted logistic regression models were employed to analyze associations between clinician characteristics, knowledge of recommendations, and screening practices.

Main Results:

• 36.7% of 5003 analyzed pediatricians reported using standardized suicide risk screening.
• Emergency medicine physicians were more likely to screen than general pediatricians (AOR=2.83).
• Pediatricians knowledgeable about AAP recommendations were more likely to screen (AOR=1.53); 73.1% of those screening used a universal approach for ages 12+.

Conclusions:

• Standardized suicide risk screening is utilized by approximately one-third of pediatricians, with considerable variation among subspecialties.
• Awareness of AAP recommendations is linked to increased screening, suggesting guideline dissemination can improve implementation.
• Enhanced dissemination of AAP guidelines may improve early identification and intervention rates, particularly in subspecialty settings.