Mitigating Depression and Suicide Risk in Older Adult Trauma Patients

Suicide is a leading cause of death in the United States with over 70% of suicides in adults aged ≥65 y involving firearms. Older adults are at increased risk due to medical, financial, and social stressors, and traumatic injury may further exacerbate depression and suicidality. However, reliance on depression screening alone may fail to identify individuals at risk.

Geri-screen is a multisite survey study conducted across five level I trauma centers assessing depressive symptoms (Patient Health Questionnaire-9, PHQ-9), suicidality (Ask Suicide-Screening Questions, ASQ), and firearm ownership in adults aged ≥55 y. This analysis includes data from a single site collected between May 2023 and July 2024 (n = 100). Depressive symptoms were defined as PHQ-9 scores ≥5, further classified as mild (5-9), moderate (10-14), or severe (≥15). Suicide risk was defined as any positive ASQ response. Participants were defined as high-risk if they had depressive symptoms, a positive ASQ, or both.

Data consisted of 100 participants: firearm owners (19%) and nonfirearm owners (81%). Of 52 participants classified as high-risk, the average PHQ-9 score was 9.54, with little difference between firearm (8.67) and nonfirearm owners (9.72). Notably, four participants screened negative for depressive symptoms but positive for suicidality. Among firearm owners, 47% were high-risk, making up 9% of the study population.

Among older adult trauma patients, approximately half were high-risk, including individuals not identified by depression screening alone. Thus, combined screening for depression, suicidality, and firearm ownership with the Geri-screen tool should be considered as part of any older adult's trauma admission.