Universal Suicide Screening in the Hospital Setting: Risk and Implications

Suicide risk screening is a pivotal step in improving hospital safety and quality of care, with the potential to prevent suicide and facilitate mental health intervention. The Ask Suicide-Screening Questions (ASQ) is a brief, validated tool for pediatric and adult populations. This retrospective cross-sectional study sought to identify prevalence rates of suicide risk among pediatric and adult patients at an academic medical center in the Southeastern United States, examine demographic factors associated with ASQ outcomes, and compare suicide risk rates across presenting medical diagnoses. The ASQ was administered to patients 12 years and older upon admission to the ED or inpatient unit. Partial proportional odds modeling was used to examine associations between demographic factors and suicide risk. Chi-square analyses were used to identify differences in suicide risk across medical diagnoses. On the ASQ, 5% of pediatric patients (12-24 years) and 1% of adults (25-113 years) screened as potential risk, and 1% of both samples screened as imminent risk. Higher-risk groups included early adolescents (12-14 years), young adults (25-34 years), pediatric females, adult males, and adult patients with government insurance or no insurance The psychiatric/substance use category had significantly higher rates of suicide risk compared to other diagnostic categories. Among non-psychiatric pediatric patients, neurological, chronic condition, and general medical diagnoses exhibited higher potential risk than women's health, trauma, and orthopedic diagnoses. Results highlight need for universal suicide risk screening in hospital settings and indicate elevated risk among younger adolescents, young adults, and adults with government insurance or no insurance.