Hospital-Based Pediatric Suicide Risk Screening Outcomes Vary by Demographic and Clinical Characteristics

Area of Science:

• Pediatric mental health
• Public health surveillance
• Health equity research

Background:

• Suicide is a significant cause of mortality in adolescents and young adults.
• Understanding disparities in suicide and depression screening is crucial for effective intervention.
• Universal screening tools aim to identify at-risk youth, but demographic variations in outcomes are not well-understood.

Purpose of the Study:

• To investigate the associations between demographic and clinical characteristics and responses to universal suicide risk and depression screening tools.
• To analyze screening outcomes from the Ask Suicide-Screening Questions (ASQ) and Patient Health Questionnaire-9 (PHQ-9) in a pediatric hospital setting.
• To identify potential inequities in screening practices across diverse patient groups.

Main Methods:

• Retrospective cohort study of 66,225 patients aged 10-26 years.
• Utilized data from emergency, urgent care, and inpatient settings.
• Analyzed screening responses from ASQ and PHQ-9 against demographic and clinical data using frequency and association tests.

Main Results:

• Overall positive screening rate was 8.5% (1.9% acute positive) for ASQ.
• Higher positive rates observed in older youth and those assigned female at birth.
• Hispanic/Latino ethnicity and private insurance were associated with lower rates; military insurance and higher Area Deprivation Index scores were linked to increased risk. Depression symptoms were more common than suicidal ideation.

Conclusions:

• Demographic and clinical factors significantly correlate with suicide and depression screening outcomes.
• Findings suggest disparities in screening tool performance across different patient populations.
• Opportunities exist to enhance screening equity and improve mental health support for vulnerable youth.