Adolescent and Parent Attitudes Toward Screening for Suicide Risk and Mental Health Problems in the Pediatric Emergency Department

Abstract

Objective The objective of this study was to investigate adolescent and parent attitudes toward screening adolescents for suicide risk and other mental health problems in the emergency department (ED). Methods Two hundred ninety-four adolescents and 300 parents completed questionnaires about the importance of screening for suicide risk and other mental health problems in the ED, what would be helpful if the screen was positive, their concerns about screening in the ED, whether they believe screening should be a routine part of an ED visit, and whether they would complete a screening during the current visit if offered the opportunity. Results Overall, parents and adolescents reported positive attitudes toward screening for suicide risk and other mental health problems in the ED, with the majority responding that it should be a routine part of ED care. Suicide risk and drug and alcohol misuse were rated as more important to screen for than any of the other mental health problems by both parents and adolescents. Adolescent females and mothers were more supportive of screening for suicide risk and mental health problems in the ED than male adolescents and fathers. Descriptive data regarding screening concerns and follow-up preferences are reported. Conclusions Study results suggest overall positive support for screening for suicide risk and other mental health problems in the ED, with some important preferences, concerns, and parent versus adolescent and male versus female differences.

Asking Youth Questions About Suicide Risk in the Pediatric Emergency Department: Results From a Qualitative Analysis of Patient Opinions

“…Lastly, participants had already assented or consented to take part in a study on suicide risk screening, so they may have been predisposed to agree with suicide risk screening efforts. Nevertheless, these findings mirror results from other ED patient samples,(12–13) which did not have similar recruitment biases, suggesting that such screening is generally supported by pediatric ED patients.…”

“…Other patients stated that they did not want to be asked about suicide if they were in the ED for nonpsychiatric reason, describing the experience of being screened as potentially uncomfortable and “irritating.” The comments echo other ED research studies,(12) in which a minority of patients and parents raised concerns about screening, including privacy, added time, non-psychiatric reasons (e.g., asthma, abrasions, or vomiting) for their ED visit, or that mental health screening is potentially upsetting. (13) Such responses further highlight the need for thoughtful planning and careful implementation in order to mitigate discomfort and irritation associated with screening.…”

“…(11–12) In a separate study of patients and their parents, participants supported screening for suicidal thoughts and behaviors, with adolescents rating suicide risk screening as significantly more important than screening for other mental health problems. (13)…”

Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

“…Teenagers and parents both report favorable attitudes toward mental health screening during an ED visit. 153,154 In this study, suicide and drug and alcohol screening rated as more important than other mental health problems. Female adolescents and their parents, more than male adolescents, expressed positive views on screening.…”

Suicide Risk Screening in Healthcare Settings: Identifying Males and Females at Risk

“…Although much smaller in scope, studies also have documented the feasibility of ED-based suicide risk screening for adolescents (Horowitz et al, 2010; King et al, 2009) as well as the acceptability of ED-based suicide risk screening to adolescents and parents (O’Mara, Hill, Cunningham, & King, 2012). Studies also support the feasibility and concurrent validity of ED-based suicide risk screening for adolescents, as well as its ability to identify males and females at risk who were not previously identified and were receiving no services (King et al, 2009); and its potential for pairing with a promising brief intervention (King, Gipson, Horwitz, & Opperman, 2015).…”