Screening Young People for Suicide Risk

An analysis of screening data from more than 2,500 primary care patients ages 14 to 24 found that a web-based screening tool assessing risk behaviors, social stressors, and psychiatric syndromes could be used to identify youth at high risk for suicide. The data were taken from a convenience sample of primary care patients in Northeastern Pennsylvania and were not meant to represent the general population.

Using the Behavioral Health Screen (BHS), researchers were able to identify two groups of adolescents based on their probability of reporting stressors and risk factors: (1) a low-risk group and (2) a high-risk group. Members of the high-risk group were more likely to report stressors and risk factors such as substance use and a sexual assault history. These adolescents were “11 times more likely to have made a suicide attempt, 5 times more likely to report a history of suicidal ideation and behavior, and 3 times more likely to report recent suicidal ideation and behavior” than those in the low-risk group.

Differences in suicide risk between the two groups remained after controlling for depression, age, and gender. The authors suggested that this finding demonstrates the limitations of assessing suicide risk based solely on the presence of depression or other symptoms without considering “the broader context of risk behavior and social stress.”

The seven characteristics most associated with suicide risk were current marijuana use, being physically forced into sex by an adult at home, sex with a same-sex partner, being physically or sexually hurt by a romantic partner, being physically forced to have sex, unsafe sex, and current alcohol use. Since most of the young people found to be at high risk of suicide reported only one or two of these risk factors, the authors recommended that young people reporting any one of these risk factors during a primary care visit should be assessed for suicide risk.

Diamond, G. S., Herres, J. L., Krauthamer Ewing, E. S., Atte, T. O., Scott, S. W., Wintersteen, M. B., & Gallop, R. J. (2017). Comprehensive screening for suicide risk in primary care. American Journal of Preventive Medicine, 53(1), 48–54.