Effectiveness of Two Psychiatric Screening Tools for Adolescent Suicide Risk
Objectives: Emergency departments (EDs) are a gateway for mental health access for adolescents suffering from depression. ED healthcare clinicians do not routinely screen for suicide risk, although screening tools have predictive value in identifying patients warranting psychiatric admission. The purpose of this study was to investigate the use of the Columbia-Suicide Severity Rating Scale (C-SSRS) and the assessment of depression severity using the Patient Health Questionnaire-9 (PHQ-9) modified for teens by healthcare clinicians in identifying adolescents at higher risk for suicidality.
April Hooper Weatherly and Tedra S. Smith
Methods: A pilot study using the C-SSRS and PHQ-9 modified for teens was administered to adolescents aged 14 to 18 years presenting with a psychiatric chief complaint. A comparison appraisal of the results from the PHQ-9 and C-SSRS to the psychiatric consultant disposition was completed.
Results: Thirty adolescents participated; most were female. Screening tools were 62.2% accurate in recognizing adolescents who required inpatient psychiatric treatment. Sixty percent of participants also had a previous psychiatric diagnosis, which is consistent with reports that a coexisting psychiatric diagnosis is typically present with patients exhibiting suicidal behavior.
Conclusion: The increasing number of adolescents presenting to the ED for psychiatric crisis stabilization creates a unique opportunity for ED providers to screen and identify adolescents at higher risk for suicide. Implementing a screening process using the C-SSRS, along with the PHQ-9, creates a time-efficient method for improving adolescent access to appropriate mental health services.
Implications: Limitations of the study include small sample size, convenience sampling, and only one provider administered the tool. The study was also conducted in only one ED.