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Evaluation ViewAttendees 8

Spotlight Research Presentations

Suicide and Self-Injury

Spotlight Research 10 - Detecting and Managing Youth at Risk for Suicide: From Research to Clinical Practice

Saturday, November 16, 2024
12:30 PM – 1:30 PM EST
Location: Grand Ballroom F, Level 5, Downtown Marriott
Earn 1 Credit
Keywords: Suicide, Adolescents, Implementation
Recommended Readings: Horowitz, L. M., Bridge, J. A., Teach, S. J., Ballard, E., Klima, J., Rosenstein, D. L., Wharff, E. A., Ginnis, K., Cannon, E., Joshi, P., & Pao, M. (2012). Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Archives of pediatrics & adolescent medicine, 166(12), 1170–1176. https://doi.org/10.1001/archpediatrics.2012.1276,   Brahmbhatt, K., Kurtz, B. P., Afzal, K. I., Giles, L. L., Kowal, E. D., Johnson, K. P., Lanzillo, E., Pao, M., Plioplys, S., Horowitz, L. M., & PaCC Workgroup (2019). Suicide Risk Screening in Pediatric Hospitals: Clinical Pathways to Address a Global Health Crisis. Psychosomatics, 60(1), 1–9. https://doi.org/10.1016/j.psym.2018.09.003,   Lowry, N. J., Goger, P., Hands Ruz, M., Ye, F., & Cha, C. B. (2024). Suicide Risk Screening Tools for Pediatric Patients: A Systematic Review of Test Accuracy. Pediatrics, 153(3), e2023064172. https://doi.org/10.1542/peds.2023-064172,   ,  

    Chair(s)

  • Nathan Lowry, B.A.

    Doctoral Fellow
    Columbia University
    New York, New York, United States

    • Panelist(s)

  • Lisa M. Horowitz, M.P.H., Ph.D.

    Senior Associate Scientist / Pediatric Psychologist
    National Institute of Mental Health, NIH
    Bethesda, Maryland, United States

Suicide is the second leading cause of death for youth aged 10-24 years old. Early detection of youth at risk is a critical prevention strategy that can be achieved by screening with evidence-based tools. Since the majority of youth who die by suicide have contact with a healthcare provider weeks before their death, the medical setting is an ideal venue to detect risk and connect youth to mental health care. However, healthcare providers often lack training in managing suicide risk and could benefit from guidance from mental health clinicians. The Ask Suicide-Screening Questions (ASQ) tool is a brief screening tool developed in pediatric emergency departments and validated in various medical settings. This presentation will describe how universal suicide risk screening and evidence-based clinical pathways can be used effectively to identify at risk youth.

Current research on suicide risk screening and management of patients who screen positive will be presented. Additionally, development of an adaptable three-tiered clinical pathway, consisting of an initial screen, followed by a brief suicide safety assessment for all patients who screen positive to determine disposition will be presented. Lessons learned from real-world adaptations of the ASQ in urban and rural healthcare settings highlighting the significance of cultural responsivity will be discussed. New research on the recency of a past attempt, false positives, and pitfalls of using depression screeners for detecting suicide risk will be presented as examples of adapting research into practice.

Universal suicide risk screening can help achieve health equity and can be feasibly integrated into healthcare settings without overburdening busy workflows. Incorporating brief suicide safety assessments as part of an adaptable clinical pathway is a key strategy for effective management of patients that screen positive. Pilot trials in multiple cultures/languages reveal the importance of cultural responsivity. Mental health clinicians trained in the use of suicide risk screening and assessment tools can play a critical role in partnering with providers across all behavioral and medical settings to reduce youth suicide.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Gain knowledge on a brief epidemiology of youth suicide and its application to the medical setting.
  2. Describe the development of the Ask Suicide-Screening Questions (ASQ) ol and examples of how research has changed implementation practices.
  3. Describe how screening as part of a 3-tiered clinical pathway makes management feasible in busy healthcare settings.
  4. Describe the importance of mental health clinicians as valuable partners in screening and management of patients at risk for suicide.
  5. Explain cultural considerations when working with underserved populations.