Patient and Clinical Characteristics Associated With Subsequent Suicide Attempt Among Youth in the Emergency Department With a Positive Suicide Risk Screen.

STUDY

OBJECTIVE

To evaluate sociodemographic and clinical characteristics associated with a subsequent suicide attempt among youth with a positive suicide risk screen in the emergency department (ED).

METHODS

This secondary data analysis used the 2015 to 2019 Pediatric Emergency Care Applied Research Network ED Screen for Teens at Risk for Suicide data set, a prospective cohort of adolescents aged 12 to 17 years in the ED. Adolescents with positive Ask Suicide-Screening Questions, a validated suicide risk screen, were included. Multivariable regression models assessed sociodemographic and clinical characteristics associated with suicide attempt, and mental health-related ED revisit/hospitalization, within 3 months after index ED visit.

RESULTS

Among 2,085 adolescents with a positive Ask Suicide-Screening Questions (40.7% age 14 to 15 years; 65.5% female, 49.0% Non-Hispanic White), 11.6% attempted suicide and 19.9% had an ED revisit/hospitalization within 3 months. Risk factors of suicide attempt included suicide attempt in the past month (adjusted odds ratio [aOR] 2.52, 95% confidence interval [CI] 1.84 to 3.45), prior mental health hospitalization (aOR 1.39, 95% CI 1.02 to 1.90), past nonsuicidal self-injury (aOR 2.06, 95% CI 1.41 to 3.01), and hopelessness (aOR 1.30, 95% CI 1.04 to 1.63). Risk factors of ED revisit/hospitalization within 3 months included prior mental health hospitalization (aOR 2.23, 95% CI 1.74 to 2.84), suicide attempt in the past month (aOR 1.63, 95% CI 1.24 to 2.14), and hopelessness (aOR 1.44, 95% CI 1.21 to 1.72).

CONCLUSION

Among youth with positive suicide risk screens in the ED, multiple sociodemographic and clinical factors were associated with subsequent suicide attempt and mental health-related ED revisits/hospitalizations. Following a positive suicide risk screen, these factors may be important for consideration when assessing risk and determining next steps in care.