Suicide Screening Important in Urban Children With Psychological Distress

Research from Washington University in St. Louis underlines the importance of screening publically insured urban children who are experiencing psychological distress for suicide risk, regardless of ethnicity and age.

“Clinicians need to pay special attention when working with young people in this population who are going through psychiatric crisis,” said lead author Sean Joe, PhD, MSW, an Associate Dean for Faculty and Research and the Benjamin E. Youngdahl Professor of Social Development at Washington University’s George Warren Brown School of Social Work.

The study, “Suicide Risk Among Urban Children,” is scheduled for publication in the September 2016 issue of Children and Youth Services Review.

“This study is one of the few that examines suicidal thoughts and behaviors in a large clinical sample of urban children,” said Dr. Joe. “Our findings indicate that ethnic group identity is not a good indicator of suicide risk, or any health status, without careful consideration for what is actually being captured by the ethnic categorization of human beings, individually and contextually,” he said.

For the study, Dr. Joe and colleagues employed bivariate and binomial logistic regression analyses to examine how socio-demographic and clinical characteristics influence suicide risk among a sample of 951 urban children aged 12 and younger who were presenting for pediatric psychiatric emergency services (PES).

The study team found that about 17.2% of patients had a history of suicidal thoughts and behaviors. Whereas a larger number of African-American children presented for PES when compared with other races/ethnicities, no significant differences were observed in suicide risk across ethnic groups.

Among study participants who presented to PES with suicidality, 65.1% were diagnosed with a behavioral disorder, 26.3% were diagnosed with a mood disorder, 3.8% were diagnosed with a psychotic disorder, and 4.8% were diagnosed with another disorder. Approximately 10% of those who presented with suicidality reported prior child abuse.

“We found that patients admitted to the hospital for suicidality were more likely to be female, to have a mood disorder and to be appropriately discharged to an inpatient setting following initial hospital care,” said Dr. Joe. “Suicide risk should be considered in the context of psychiatric health and gender for more accurate assessment. Regardless of ethnic group membership, urban children expressing intentions to self-harm or exhibiting mood disorder symptoms should be examined for the potential to suicide. Such clinical consideration is a sharp departure from conventional practice wisdom.

“These findings suggest that all children, regardless of ethnic group, should be examined for suicidality when presenting at psychiatric emergency service with known risk factors, and that more study is warranted on this topic.”