Effect of Suicide Screening Assessment Tools in Determining Suicide Risk in Adolescents
Suicide is the second leading cause of death in the United States with the incidence continuing to rise. The U.S. Preventive Services Task Force, American Academy of Pediatrics, and the American Medical Association are among the top organizations that recommend routine screening of adolescents for suicidal thoughts, depression and other risk factors associated with suicide. While screening tools for suicidal ideation, have become available, they are not widely utilized. This integrative review of ten quantitative research articles, examines the value of such tools for evidence-based practice, in the identification of adolescents at risk. This review considered
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(2013), is a retrospective cohort case study that took place in a children’s ED in Washington DC. The associations between screening positive for suicide risk and immediate psychiatric hospitalization or subsequent ED visits within one year, using the RSQ as compared to the SIQ and SIQ-JR. (Ballard et al., 2013).
A convenience sample of 568 patients aged 8–18 years, presenting with psychiatric complaints over a 9 month period to a single urban tertiary care pediatric ED were considered. Final sample size was 442 with mean age of 14, 56% male, 91% African American. There were negligible differences for other demographic data. The number of ED visits by each participant over the year after the baseline visit were obtained from the electronic records, with presenting complaints being psychiatric or non psychiatric in nature (Ballard, et al., 2013).
Univariate regression testing was used for data analysis and positive responses to suicide screening questions were associated with acute hospitalization and repeat ED visits. The RSQ is a valid screening tool and the research found that a 36% of participants were hospitalized as a result of the positive screenings and 29% had one or more ED visits within the following year (Ballard, et al.,
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In fact, these assessment tools are very brief and do not add significant amounts of time to any patient visit (Diamond et al., 2012; Folse et al., 2006).
It has also been stated in the research that parents may not be willing to allow screening for their child due to their age or the belief that the subject of suicide may somehow encourage high risk behavior. There is in fact evidence to the contrary; most parents approached, agreed to the interviews and patients were both willing and forthcoming about their suicidal thoughts and past suicidal behaviors with no evidence of increased ideation as a result of the screening (Diamond et al., 2012; Folse et al., 2006; Horowitz et al., 2010).
RESULTS
Routine use of suicide assessment tools shows compelling evidence of validity for the determination of adolescents at elevated risk for suicide that perhaps would not have been otherwise identified. Using these standardized measures provides important data to assist in treatment recommendations for suicidal patients and guide suicide prevention efforts (Ballard, et al., 2013; Bevans et al., 2013; Folse et al., 2006; Gipson et al., 2015; Horowitz et al., 2010; King et al., 2015; King et al., 2009; Posner et al., 2011; Renaud et al.,
hospitals, psychiatric hospitals, and hospitals claiming “other specialty”. The criteria for the study were previous suicide attempts, drug abuse, and being admitted to a hospital for suicidality. Whether or not the hospitals conducted a mental health assessment was not a requirement for participation in the study, but this factor was considered.
In the United States, suicide is the third-leading cause of death for 10 to 14-year-olds (CDC, 2015) and for 15 to 19-year-olds (Friedman, 2008). In 2013, 17.0% of students grades 9 to 12 in the United States seriously thought about committing suicide; 13.6% made a suicide plan; 8.0% attempted suicide; and 2.7% attempted suicide in which required medical attention (CDC, 2015). These alarming statistics show that there is something wrong with the way suicide is handled in today’s society. In order to alleviate the devastating consequences of teenage suicide, it is important to get at the root of what causes it all: mental illness. According to the Centers for Disease Control and Protection (2013), mental illness is the imbalance of thinking, state of mind, and mood. Approximately 90% of all suicides are committed by people with mental illnesses (NAMI, n.d.). This shows that there is a correlation between mental illness and suicide. If mental illnesses are not treated, deadly consequences could occur. It would make sense that if there is a correlation between mental illness and suicide across all ages, the same should be thought for adolescents. Approximately 21% of all teenagers have a treatable mental illness (Friedman, 2008), although 60% do not receive the help that they need (Horowitz, Ballard, & Pao, 2009). If mental illnesses are not found and treated in teenagers, some of them may pay the ultimate price.
Suicide has been rising at alarming rates; the overall suicide rate for children and adolescents has increased over 300% since the 1950s. (Miller, 2009) Adolescent children are screaming out for our help, are we just ignoring the signs or do we not care? For young people, an average 1,800 take their own lives and 85,000 are hospitalized for attempts nationally (CDC, 2008). With this kind of statistics we need to step in and take some action.
Suicide is a prevalent cause of death among America's youth today. Every day more than 1000 teenagers will think about suicide and eighteen will be successful in committing it. It is an ever-growing problem that can be described as unnecessary and uncalled for. Knowledge and understanding are key factors to preventing teenage suicide. The problem will usually originate from a period of depression, either as a medical concern, or simply because of a saddened
In the United States, suicide is the third leading cause of death for 10 to 14-year-olds (CDC, 2015) and for 15 to 19-year-olds (Friedman, 2008). In 2013, 17.0% of students grades 9 to 12 in the United States seriously thought about committing suicide, 13.6% made a suicide plan, 8.0% attempted suicide, and 2.7% attempted suicide in which required medical attention (CDC, 2015). These alarming statistics show that there is something wrong with the way mental illness is handled in today’s society. Also, approximately 21% of all teenagers have a treatable mental illness (Friedman, 2008), although 60% do not receive the help that they need (Horowitz, Ballard, & Pao, 2009).
Teen’s behavior is a major warning sign of suicide or suicidal thoughts. Many factors play into an adolescent's behavior and attitude determining the way they
According to Fowler, Crosby, Parks, and Ivey (2013), suicide and nonfatal suicidal ideations are significant public health concerns for adolescents and young adults. While the onset of suicidal behaviors is observed as young as six years of age, rates of death and nonfatal injury resulting from suicidal behavior are moderately low until 15 years of age (Fowler et al., 2013). According to Fowler et al (2013), the most current available statistics in the United States (U. S.) reported suicide as the third leading cause of death among youth aged 10-14 and 15-19 years, and it was the second leading cause of death among persons aged 20-24 years.
According to the American Association of Suicidology (AAS), 4,822 teens at ages 15 t to 24, died from suicide in 2011 in America. Because of teens suicide facts, it is the third leading cause of death. In 2007, teen suicide was low of 9.6 deaths for every 100,000 adolescence, while the current statistics collected reveal about 14% increase which indicate a 10.9 deaths for every 100,000 adolescence in the years 2011 to 2013. Teen suicide rates increase is unknown, but suicide education, public awareness campaigns, mental illness screening including access to mental health treatment may contribute to rotate the trend of teen suicide (Tracy, 2016). The Illinois Violent Death Reporting System (IVDRS) was created to assist in preventing the deaths
In 2014, suicide was the tenth leading cause of death overall in the United States. According to the National Institute of Mental Health (NIMH, 2015), there were twice as many suicides than there were homicides. Suicidal ideation (SI), defined as an individual thinking about, considering, or planning their suicide, is established before the act of committing suicide. Research suggests that adverse childhood experiences (CDC, 2015) will put an individual at risk for developing a mental illness that could result in SI and suicide attempt (SA). It is important for the psychiatric mental health nurse practitioner (PMHNP) to recognize the signs of SI and SA while assessing their client.
Methods Analysis." Journal of Youth & Adolescence, vol. 46, no. 7, July 2017, pp. 1598-1610.
Suicide is the second leading cause of death among people age 15 to 34 years of age (Center for Disease Control [CDC], 2015). More than 25% of all high school age adolescents in the United States who took part in a youth risk behavior survey felt symptoms of depression almost every day for two or more consecutive weeks (CDC, 2012). Adolescents who are depressed are at higher risk for suicide. Early recognition and treatment is crucial to preventing suicide attempts (King & Vidourek, 2012). Screening for adolescent depression is an important step in implementing the Institute of Medicine (2001) recommendation for improving safety in health care. In addition, the care provided must be patient centered and equitable. This quality improvement project aims to provide screening for adolescent depression for all patients age 12 years and older during routine well-child visits.
Statistics show suicide to be the third leading cause of death among 13-19 year olds, with approximately 6000 suicide deaths each year (Dickinson 1999). Because of statistics like this, the National Institute of Mental Health (NIMH) researchers are vying to find interventions to help prevent suicide among children and adolescents. However, until then, the best prevention appears to lie in early diagnosis
Suicides and attempted suicides have also increased among adolescents at an alarming rate in recent decades. Research findings suggest that the suicidal adolescent has usually had, since childhood, a history of stress and personal problems. Attempts to resolve these problems such as running away from home or an increasing social isolation, withdrawal and acting out, may precipitate an attempted suicide. Early professional help is often needed to prevent this drastic action. Sadly, when the signs are clear it is usually too late.
Studies show a vast number of risk and protective factors in adolescent suicide attempters (Joe, Baser, Breeden, Neighbors, & Jackson, 2006, Nock, 2009). The risk factor I chose to look at is substance use. Some researchers suggest a relationship between substance use and suicidality. (Garlow, Purselle, & Heninger, 2007, Schilling, Aseltine, Glanovsky, James & Jacobs, 2009). In the 2015 National Survey on Drug Use and Health, it was reported that Alcohol and Marijuana had the most
Suicide is the third leading cause of deaths in adolescents in the United States. Teen suicide is also often referred to as a permanent solution to a temporary problem. Teens so often are suicidal and attempt suicide as a call for help from others. They have no intention in dying they are just trying to cry out for help from anyone that will listen. Many reasons cause teen to attempt suicide, varying from bullying to psychological disorders. In fact, psychological disorders accounts for about 90% of teens who attempt or commit suicide. Teenagers are also at higher risk of suicide when they are under