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Year : 2022  |  Volume : 4  |  Issue : 2  |  Page : 164-173

Systematic Youth Suicide Screening in a General Hospital Setting: Process and Initial Results

1 Division of Child and Adolescent Psychiatry, University of Florida College of Medicine, Gainesville, Florida, USA
2 Department of Psychiatry, Tower Health Reading Hospital, Reading, Pennsylvania, USA
3 Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida, USA

Correspondence Address:
Andres Julio Pumariega
Division of Child and Adolescent Psychiatry UF Health Springhill 2, 8491 N.W. 39th Avenue, Gainesville32606, FL
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wsp.wsp_15_22

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Objectives: Adolescent suicide rates have been rising since 1999, and efforts to identify youth at risk with systematic approaches are important in secondary prevention. The Columbia Suicide Severity Rating Scale (C-SSRS) screener is a tool that has demonstrated predictive validity in identifying youth at risk of attempting suicide. Health care settings are key venues where at-risk youth can be identified effectively. Methods: A tertiary hospital in the Northeast U.S. developed a suicide risk protocol, consisting of systematic screening of patients for suicidal ideation/behavior with a screening version of the C-SSRS and a response algorithm based on risk levels derived from the screen. A total of 840 nurses were trained on the C-SSRS Screener, with a response protocol addressing environmental safety and psychiatric consultation. Results: This report focuses on the screening results for adolescents (ages 12–17) within this cohort, occurring over a 11-year period. Posttraining inter-rater reliability on the C-SSRS Screener definitions of ideation and behavior were high and independent of level of education or mental health experience. Of 6126 patients screened in this age group, 9.6% were in the highest risk category, as compared to 0.93% of adults during a 12-month period. Middle adolescents, females, African American and Latino patients, patients with psychiatric diagnoses, and patients with some medical diagnoses were at significant risk. Conclusions: These findings suggest that a systematic screening and clinical response protocol using the C-SSRS screener can potentially enhance the ability to identify suicide risk in the adolescent population in medical surgical hospitals and can focus services on patients with the most need.

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