Office of the Clinical Director, National Institute of Mental Health, Bethesda (LM Horowitz, MV Tipton, AM Mournet, DJ Snyder, EC Lanzillo, D Powell, and M Pao), Md.
The Abigail Wexner Research Institute at Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus (JA Bridge), Ohio.
Acad Pediatr. 2022 Mar;22(2):217-226. doi: 10.1016/j.acap.2021.10.012.
To describe the methodological development and feasibility of real-world implementation of suicide risk screening into a pediatric primary care setting.
A suicide risk screening quality improvement project (QIP) was implemented by medical leadership from a suburban-based pediatric (ages 12-25 years) primary care practice in collaboration with a National Institute of Mental Health (NIMH) suicide prevention research team. A pilot phase to acclimate office staff to screening procedures preceded data collection. A convenience sample of 271 pediatric medical outpatients was screened for suicide risk. Patients, their parents, and medical staff reported their experiences and opinions of the screening procedures.
Thirty-one (11.4%) patients screened positive for suicide risk, with 1 patient endorsing imminent suicide risk (3% of positive screens; 0.4% of total sample). Over half of the patients who screened positive reported a past suicide attempt. Most patients, parents, and medical staff supported the implementation of suicide risk screening procedures into standard care. A mental health clinical pathway for suicide risk screening in outpatient settings was developed to provide outpatient medical settings with guidance for screening.
Screening for suicide risk in pediatric primary care is feasible and acceptable to patients, their families, and medical staff. A clinical pathway used as guidance for pediatric health care providers to implement screening programs can aid with efficiently detecting and managing patients who are at risk for suicide.
描述在儿科初级保健环境中实施自杀风险筛查的方法学发展和实施可行性。
一项自杀风险筛查质量改进项目（QIP）由来自郊区儿科（12-25 岁）初级保健实践的医学领导与国家心理健康研究所（NIMH）自杀预防研究团队合作实施。在收集数据之前，先进行了一个试点阶段，使办公室工作人员适应筛查程序。对 271 名儿科门诊患者进行了自杀风险筛查。患者、其父母和医务人员报告了他们对筛查程序的经验和意见。
31 名（11.4%）患者筛查出自杀风险阳性，其中 1 名患者有自杀风险（3%的阳性筛查率；0.4%的总样本率）。超过一半的筛查阳性患者报告过去有自杀企图。大多数患者、家长和医务人员都支持将自杀风险筛查程序纳入标准护理。为在门诊环境中进行自杀风险筛查制定了心理健康临床路径，为门诊医疗环境提供了筛查指导。
在儿科初级保健中筛查自杀风险是可行的，并且可以被患者、其家人和医务人员接受。作为指导儿科保健提供者实施筛查计划的临床路径可以帮助有效地发现和管理有自杀风险的患者。
