title: Patients' opinions about suicide screening in a pediatric emergency department.
abstract: OBJECTIVE
  Understanding how children react to suicide screening in an emergency department (ED) can inform implementation strategies. This qualitative study describes pediatric patients' opinions regarding suicide screening in that setting.
  
  
  METHODS
  As part of a multisite instrument validation study, patients 10 to 21 years presenting with both psychiatric and nonpsychiatric complaints to an urban, tertiary care pediatric ED were recruited for suicide screening. Interviews with subjects included the question, "do you think ER nurses should ask kids about suicide/thoughts about hurting themselves...why/why not?" Responses were transcribed verbatim and uploaded into NVivo8.0 qualitative software for coding and content analysis.
  
  
  RESULTS
  Of the 156 patients who participated in the study, 106 (68%) presented to the ED with nonpsychiatric complaints and 50 (32%) presented with psychiatric complaints. The patients' mean (SD) age was 14.6 (2.8) years (range, 10-21 years), and 56% of the sample was female. All patients answered the question of interest, and 149 (96%) of 156 patients supported the idea that nurses should ask youth about suicide in the ED. The 5 most frequently endorsed themes were as follows: (1) identification of youth at risk (31/156, 20%), (2) a desire to feel known and understood by clinicians (31/156, 20%), (3) connection of youth with help and resources (28/156, 18%), (4) prevention of suicidal behavior (25/156, 16%), and (5) lack of other individuals to speak with about these issues (19/156, 12%).
  
  
  CONCLUSIONS
  Pediatric patients in the ED support suicide screening after being asked a number of suicide-related questions. Further work should evaluate the impact of suicide screening on referral practices and link screening efforts with evidence-based interventions.
authors.affiliation: Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD 20892, USA.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Ballard
authors.forename: Abigail
authors.initials: A
authors.lastname: Bosk
authors.forename: Deborah
authors.initials: D
authors.lastname: Snyder
authors.forename: Maryland
authors.initials: M
authors.lastname: Pao
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bridge
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Wharff
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Teach
authors.forename: Lisa
authors.initials: L
authors.lastname: Horowitz
mesh_terms: D000293:Adolescent; D001293:Attitude to Death; D001294:Attitude to Health; D002648:Child; D003953:Diagnosis-Related Groups; D016529:Emergency Nursing; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D010361:Patients / Q000523:psychology*; D010372:Pediatrics; D000297:Psychology, Adolescent; D002666:Psychology, Child; D012306:Risk; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000451:nursing / Q000523:psychology; D059020:Suicidal Ideation; D014342:Truth Disclosure; D055815:Young Adult; D000092864:Suicide Prevention