Pediatric Suicide Screening: A Review of the Evidence

Abstract

Background: Suicide rates are increasing for youths and suicide is the second leading cause of death for 10-24 year olds. This evidence-based practice project critically reviews literature regarding the effectiveness of pediatric suicide screening.

Methods: A literature search was guided by the following question: In pediatric patients, does suicide screening at every health encounter compared to an annual screen increase clinician identification of patients at-risk. Ten articles met inclusion criteria and were critically appraised and synthesized.

Findings: Youths had high rates of suicidal ideation (SI), anxiety, and depression. Pediatric universal suicide screening identified SI in youths with both psychiatric and non-psychiatric medical complaints. Patients with chronic health conditions reported higher rates of mental health symptoms and SI. A specific suicide screening instrument should be used as general mental health screens likely miss youths at-risk for SI. The Ask Suicide-Screening Questions tool is an easy to use and highly sensitive instrument for detecting suicide risk in youths.

Discussion: Many youths that screen positive for SI do not have known mental health concerns and would have been missed if not asked directly. Universal screening for SI identifies at-risk youth and allows nurses and other providers to intervene. The need for universal screening across pediatric health care settings using brief, validated screening tools is paramount.

Application to practice: Nurses working in pediatric settings should champion universal screening for SI. Unit-based quality improvement projects using the Plan-Do-Study-Act change cycle provides a model for instituting universal screening for SI.

Keywords: Adolescents; Evidence-based practice; Nursing; Suicidal ideation; Suicide screening; Youths.