Suicide Screening in a Large Pediatric Emergency Department Results, Feasibility, and Lessons Learned

Suicide is a leading cause of death among children and adolescents, and research has shown a significant increase in the rates of emergency department (ED) visits because of suicide ideation and attempts for children younger than 18 years. Objective This study examined the feasibility of screening all patients entering the ED using the Columbia-Suicide Severity Rating Scale as well as examining the rates of suicide ideation and attempts endorsed by adolescents who present at the ED. Methods This study used a sample of 12,113 patients between the ages of 11 and 19 years. Results Results revealed that 13.5% of the participants endorsed passive suicide ideation in the month leading up to their ED visit and 11.3% of the participants reported active ideation in the prior month. Results also revealed that patients whose chief complaints were coded as psychiatric or medical trauma were more likely to endorse either active or passive suicidal ideation than other presenting problems. Patients with a psychiatric or medical trauma chief complaint were also more likely to report lifetime suicidal behavior and suicidal behavior 3 months before the ED visit. Conclusions In addition to findings, implications, feasibility, and lessons learned are discussed for other institutions or departments considering implementation of a widespread screening. Highlights: center dot Suicide screenings were implemented in a large pediatric emergency department. center dot One in 5 endorsed suicidal ideation or behavior regardless of presenting problem. center dot Feasibility and lessons learned are discussed for others hoping to implement a widespread screening.