title: Coping with suicidal urges among youth seen in a psychiatric emergency department.
abstract: This study of youth seeking psychiatric emergency department (ED) services examined (1) youth self-efficacy to use suicide-specific coping strategies, (2) whether these self-efficacy beliefs varied by demographic and clinical characteristics, (3) and associations of these beliefs with suicide attempts and ED visits 3-5 months later. Participants were 286 psychiatric ED patients (59% Female), ages 13-25. Ratings of self-efficacy to engage in 10 suicide-specific coping behaviors were assessed at index visit. A total of 226 participants (79%) were assessed 3-5 months later. Youth endorsed low-to-moderate self-efficacy for different suicide-specific coping behaviors, with lowest ratings endorsed for limiting access to lethal means and accessing professional resources. More severe baseline psychopathology was associated with lower self-efficacy. Males endorsed higher self-efficacy for coping behaviors not requiring external support. Lower coping self-efficacy for some of the key strategies, and lower confidence that these strategies will be helpful, differentiated those with and without follow-up suicide attempts and ED visits. The generally low-to-moderate confidence in youths' ability to engage in coping behaviors to manage suicidal crises, and its association with follow-up suicidal crises, is concerning because many of these strategies are commonly included as part of discharge recommendations or safety planning. Implications of findings are discussed.
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; The Michigan Institute for Clinical and Health Research and the University of Michigan Injury Center at the University of Michigan, Ann Arbor, MI, USA. Electronic address: ewac@umich.edu.
authors.forename: Ewa K
authors.initials: EK
authors.lastname: Czyz
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Adam G
authors.initials: AG
authors.lastname: Horwitz
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Arango
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Cole-Lewis
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Johnny
authors.initials: J
authors.lastname: Berona
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: King
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010351:Patient Discharge; D061214:Patient Safety; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Coping; Emergency department; Safety planning; Self-efficacy; Suicide attempt; Youth