New Guidance for Universal Suicide Risk Screening in Health Care Settings

Risk screening could help address the rising rate of youth suicide in the U.S., where more than 6,000 youth died by suicide in 2016.

Photo:  IMAGE: FAT CAMERA/ISTOCK

A new report, authored in part by researchers at NIMH, provides guidance on how to implement universal suicide risk screening of youth in medical settings. The report describes a way for hospitals to address the rising suicide rate in a way that is flexible and mindful of limited resources.

In 2016 alone, more than 6,000 youth in the United States under the age of 25 died by suicide, according to the Centers for Disease Control and Prevention. Studies have found that a majority of youth who died by suicide visited a health care provider or medical setting in the month prior to killing themselves. The interactions of these youth with the health care system make medical settings an ideal place for positioning suicide intervention efforts.

“Suicide is a major public health concern and early detection is a critical prevention strategy,” said NIMH director Dr. Joshua Gordon. “Part of NIMH’s suicide prevention research portfolio focuses primarily on testing and implementing effective strategies for identifying individuals at risk of suicide. Results from these research efforts are poised to make a real difference and help save lives.”

In 2007, The Joint Commission (TJC) released a National Patient Safety Goal requiring that all behavioral health patients who present to psychiatric and general hospitals be screened for suicide risk. However, upon examining their data, they discovered that over a quarter of hospital suicides occur on non-behavioral health units, and at-risk patients were passing through emergency departments, inpatient medical units and outpatient clinics undetected. This realization led TJC, in 2016, to recommend that all patients presenting to medical settings be screened for suicide risk.

While good practice, universal screening can present a strain on the resources of hospitals and other health care facilities. The report, published in Psychosomatics, presents a new three-tiered clinical pathway system as a flexible and resource-conscious way to implement universal suicide risk screening within pediatric health care settings.