title: Suicide Risk Screening in Healthcare Settings: Identifying Males and Females at Risk.
abstract: Suicide is the tenth leading cause of death in the United States, accounting for more than 42,000 deaths in 2014. Although this tragedy cuts across groups defined by age, gender, race/ethnicity, and geographic location, it is striking that nearly four times as many males as females die by suicide in the U.S. We describe the current regulations and recommendations for suicide risk screening in healthcare systems and also describe the aspirational goal of "Zero Suicide," put forth by the National Action Alliance for Suicide Prevention. We then provide information about suicide risk screening tools and steps to take when a patient screens positive for suicide risk. Given the substantially higher suicide rate among males than females, we argue that it is important to consider how we could optimize suicide risk screening strategies to identify males at risk and females at risk. Further research is needed to accomplish this goal. It is recommended that we consider multi-factorial suicide risk screens that incorporate risk factors known to be particularly important for males as well as computerized, adaptive screens that are tailored for the specific risk considerations of the individual patient, male or female. These strategies are not mutually exclusive. Finally, universal suicide risk screening in healthcare settings, especially primary care, specialty medical care, and emergency department settings, is recommended.
authors.affiliation: Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA. kingca@med.umich.edu.
authors.forename: Cheryl A
authors.identifier: http://orcid.org/0000-0002-9903-6278
authors.initials: CA
authors.lastname: King
authors.affiliation: Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Horwitz
authors.affiliation: Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA.
authors.forename: Ewa
authors.initials: E
authors.lastname: Czyz
authors.affiliation: Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lindsay
mesh_terms: D003695:Delivery of Health Care / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D011320:Primary Health Care / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors; D000092864:Suicide Prevention
keywords: Adolescent suicide risk; Safety planning; Suicide risk; Suicide risk screening; Zero suicide initiative