Emergency Department Screening for Suicide and Mental Health Risk.
Suicide is the second leading cause of death among youth ages 10-24. An estimated 1.5 million US adolescents receive their primary health care in the emergency department (ED); this is particularly true for low-income and minority youths who often lack a regular source of care. ED visits can provide a window of opportunity to screen and identify youths with suicide and mental health risk, triage youths based on need, and facilitate effective follow-up care. Recently developed brief therapeutic assessment approaches have demonstrated success in improving rates of follow-up care after discharge from the ED. Furthermore, there is some data supporting clinical benefits when youths receive evidence-based outpatient follow-up care. ED screening combined with effective follow-up, therefore, may provide one strategy for improving mental health and reducing health disparities in our nation. This paper reviews the context in which ED screenings occur, available tools and strategies, and evidence for the effectiveness of tested approaches.
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, 90095, USA. kbabeva@mednet.ucla.edu.
Kalina
K
Babeva
Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9119, USA.
Jennifer L
JL
Hughes
Department of Psychiatry and Biobehavioral Sciences, Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, 90095, USA.
Joan
J
Asarnow
D000293:Adolescent; D004636:Emergency Service, Hospital; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology*; D011320:Primary Health Care; D012306:Risk; D013405:Suicide / Q000523:psychology*; D000092864:Suicide Prevention
Assessment; Child and adolescent; Emergency department; Mental health risk; Suicide risk
Am J Epidemiol. 1990 Mar;131(3):538-51
2301363
J Gen Intern Med. 2001 Sep;16(9):606-13
11556941
Psychol Med. 1995 Jul;25(4):739-53
7480451
Arch Gen Psychiatry. 2005 Jun;62(6):593-602
15939837
Pediatrics. 2010 May;125(5):938-44
20385627
Psychiatr Serv. 2007 Dec;58(12):1547-54
18048555
Br J Addict. 1986 Aug;81(4):479-84
3463347
J Consult Clin Psychol. 2015 Apr;83(2):253-64
25622200
J Psychiatr Res. 2015 Dec;71:126-33
26476489
Environ Health Prev Med. 2008 Sep;13(5):243-56
19568911
Arch Suicide Res. 2016 Jul 2;20(3):402-11
26910205
J Child Psychol Psychiatry. 1997 Jul;38(5):581-6
9255702
Psychiatr Serv. 2013 Jun;64(6):554-62
23494079
Arch Pediatr Adolesc Med. 2000 Apr;154(4):361-5
10768673
J Clin Psychiatry. 2011 Jun;72(6):757-64
21733476
Am J Emerg Med. 2008 Jul;26(6):701-5
18606326
Am J Med. 1987 Feb;82(2):231-5
2880504
Br J Psychiatry. 2003 Jul;183:28-33
12835240
Suicide Life Threat Behav. 2014 Feb;44(1):23-33
23889515
Suicide Life Threat Behav. 2012 Dec;42(6):684-98
23072257
Clin Pediatr Emerg Med. 2013 Mar;14(1):20-27
23908599
Arch Gen Psychiatry. 1988 Jun;45(6):581-8
3377645
Psychiatr Q. 2017 May 19;:null
28523431
Arch Gen Psychiatry. 2005 Jan;62(1):66-72
15630074
MMWR Surveill Summ. 2012 Jun 8;61(4):1-162
22673000
J Am Acad Child Adolesc Psychiatry. 1997 Apr;36(4):545-53
9100430
J Consult Clin Psychol. 2000 Dec;68(6):1081-93
11142542
Clin Psychol Rev. 1998 Nov;18(7):765-94
9827321
Pediatr Emerg Care. 2010 Nov;26(11):787-92
20944511
Arch Pediatr Adolesc Med. 2012 Dec;166(12):1170-6
23027429
Assessment. 2001 Dec;8(4):443-54
11785588
Ann Emerg Med. 2006 Oct;48(4):452-8, 458.e1-2
16997683
JAMA. 2005 Apr 6;293(13):1635-43
15811983
J Adolesc Health. 1992 Jun;13(4):286-92
1610844
J Am Acad Child Adolesc Psychiatry. 2000 Jan;39(1):28-38
10638065
Alcohol Clin Exp Res. 2004 May;28(5 Suppl):77S-88S
15166639
J Consult Clin Psychol. 1979 Apr;47(2):343-52
469082
J Clin Psychiatry. 2010 Mar;71(3):313-26
20331933
Psychiatr Serv. 2011 Nov;62(11):1303-9
22211209
Psychopharmacol Bull. 1985;21(4):995-8
4089116
Am J Public Health. 2009 Oct;99(10):1840-8
19696377
Acad Pediatr. 2013 Jul-Aug;13(4):340-7
23830020
Annu Rev Clin Psychol. 2014;10:275-303
24437432
Br J Psychiatry. 1997 Mar;170:205-28
9229027
Addiction. 2010 Mar;105(3):452-65
20402989
Am J Psychiatry. 2006 Jul;163(7):1226-32
16816228
Acad Emerg Med. 2012 Mar;19(3):318-28
22435865
J Clin Psychiatry. 2013 Sep;74(9):887-93
24107762
West J Emerg Med. 2015 Mar;16(2):220-8
25834660
Pediatr Emerg Care. 2011 Jul;27(7):611-5
21712750
J Child Psychol Psychiatry. 2006 Mar-Apr;47(3-4):372-94
16492264
J Emerg Med. 2012 Nov;43(5):876-82
21871769
Child Adolesc Ment Health. 2008 Nov 1;13(4):163-168
19779573
J Am Acad Child Adolesc Psychiatry. 2000 Jan;39(1):76-84
10638070
J Am Acad Child Adolesc Psychiatry. 1997 Jul;36(7):980-8
9204677
J Consult Clin Psychol. 1985 Aug;53(4):491-9
4031204
J Clin Epidemiol. 2010 Nov;63(11):1179-94
20685078
J Subst Abuse Treat. 1995 May-Jun;12(3):181-93
7474026
Am J Psychiatry. 2011 Dec;168(12):1266-77
22193671
J Adolesc Health. 2015 Mar;56(3):267-73
25586231
J Am Acad Child Adolesc Psychiatry. 2001 Sep;40(9):1053-61
11556629
J Am Acad Child Adolesc Psychiatry. 2000 Jan;39(1):59-66
10638068
Int J Adolesc Med Health. 2005 Jul-Sep;17(3):197-203
16231470
Am J Prev Med. 2014 Sep;47(3 Suppl 2):S229-34
25145744
J Pers Assess. 2001 Dec;77(3):475-90
11781034
J Am Acad Child Adolesc Psychiatry. 2000 Jan;39(1):67-75
10638069
Psychosomatics. 2015 Sep-Oct;56(5):460-9
26278339
J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9
20855043
Arch Pediatr Adolesc Med. 1999 Jun;153(6):591-6
10357299
Arch Suicide Res. 2011;15(3):259-64
21827315
J Am Acad Child Adolesc Psychiatry. 1997 Apr;36(4):554-65
9100431
J Am Acad Child Adolesc Psychiatry. 2008 Aug;47(8):958-66
18596552
Rand Health Q. 2013 Jun 1;3(2):3
28083290
Psychol Assess. 2007 Sep;19(3):309-17
17845122
J Youth Adolesc. 1991 Apr;20(2):289-309
24265011
J Child Psychol Psychiatry. 1981 Jan;22(1):73-88
7451588
J Pediatr. 1988 Feb;112(2):201-9
3339501
Am J Orthopsychiatry. 1991 Jan;61(1):122-7
2006668
JAMA Psychiatry. 2013 Mar;70(3):300-10
23303463
J Child Adolesc Psychopharmacol. 2002 Summer;12(2):113-26
12188980
Curr Psychiatry Rep. 2004 Apr;6(2):96-100
15038911
Sex Transm Dis. 2004 Dec;31(12):719-26
15608586
Acad Emerg Med. 2009 Nov;16(11):1234-41
19845554
J Abnorm Child Psychol. 1978 Jun;6(2):271-80
670592
Arch Pediatr Adolesc Med. 2009 Feb;163(2):172-7
19188650
Am J Psychiatry. 2004 Mar;161(3):437-43
14992968
Int J Methods Psychiatr Res. 2010 Dec;19(4):185-94
20683845
Pediatr Emerg Care. 2012 Dec;28(12):1263-8
23187979
J Gen Intern Med. 2014 Jun;29(6):870-7
24567199