Asking Youth Questions About Suicide Risk in the Pediatric Emergency Department: Results From a Qualitative Analysis of Patient Opinions

The emergency department (ED) is a promising setting to screen youth for suicide risk. Patient reactions to questions about suicidal thoughts and behaviors during their ED visit have implications for how screening is introduced, developed, and implemented. The current study is a qualitative investigation into patient opinions about screening for suicide risk in the ED. As part of a subset of a multisite study, 165 participants, 10 to 21 years old, were included in this subanalysis. Ninety percent of participants supported suicide risk screening. Reasons youth supported screening included prevention of suicide, detection of at-risk youth, and lack of other social support. Overall, pediatric patients agreed with suicide risk screening in the ED. A small subset of youth (10%) did not support screening for reasons that included a desire to focus on their chief presenting concern and fear of iatrogenic risk. Understanding patient opinions, including those in support of and in opposition to screening, can inform implementation practices. Further education about the importance of suicide risk assessment may be a helpful first step in instituting universal screening efforts.