Clifton Richelle L, Beemer Kate, Camacho Marybelle, Adrian Molly C
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, WA, USA.
Am J Prev Med. 2025 Jun 16:107945. doi: 10.1016/j.amepre.2025.107945.
Youth suicide is a critical public health issue. Universal screening in healthcare settings can provide clinical pathways for early identification of suicide risk by assessing suicidal thoughts and behaviors and connection to care. This study aimed to examine whether participation in universal suicide risk screening varies by demographic factors, including race/ethnicity, given documented disparities in suicide rates across racial/ethnic groups.
Patient responses on the Ask Suicide-Screening Questions (ASQ), demographics, and service use factor data were drawn from patient medical records for ambulatory and acute care visits within a large children's hospital system between 6/1/21, and 9/12/23, for patients aged 10 and above who presented for in-person visits in an eligible clinic and were asked to complete a suicide risk screening.
160,228 visits for patients between ages 10-25 (M=14.35) were included in final analyses. Screening was accepted in 76.95% of visits, and of those screens, 15.87% were positive. After controlling for within-patient correlations, race/ethnicity, sex, and age were significant predictors of screening acceptance and result. White and Latine youth were more likely to accept screening, whereas youth of other races/ethnicities, including Asian and Black youth, were less likely to accept screening. White and Multiracial youth were more likely to screen positive, whereas Latine, Asian, and Pacific Islander youth were less likely to screen positive.
Racial/ethnic differences in screening acceptance and results indicate disparities in suicide risk identification among youth. More work is needed to understand factors impacting engagement in screening and to ensure equitable suicide risk identification.
青少年自杀是一个关键的公共卫生问题。在医疗机构中进行普遍筛查，可以通过评估自杀想法和行为以及与护理的联系，为早期识别自杀风险提供临床途径。鉴于不同种族/族裔群体的自杀率存在差异，本研究旨在探讨参与普遍自杀风险筛查是否因人口统计学因素（包括种族/族裔）而异。
患者对自杀筛查问题（ASQ）的回答、人口统计学信息以及服务使用因素数据，取自2021年6月1日至2023年9月12日期间，一家大型儿童医院系统内门诊和急症护理就诊的患者病历，这些患者年龄在10岁及以上，在符合条件的诊所进行面对面就诊，并被要求完成自杀风险筛查。
最终分析纳入了160228例10 - 25岁患者的就诊情况（平均年龄M = 14.35岁）。76.95%的就诊接受了筛查，其中15.87%的筛查结果为阳性。在控制了患者内部的相关性后，种族/族裔、性别和年龄是筛查接受度和结果的显著预测因素。白人和拉丁裔青少年更有可能接受筛查，而其他种族/族裔的青少年，包括亚裔和黑人青少年，接受筛查的可能性较小。白人和多种族青少年筛查呈阳性的可能性更大，而拉丁裔、亚裔和太平洋岛民青少年筛查呈阳性的可能性较小。
筛查接受度和结果方面的种族/族裔差异表明，青少年自杀风险识别存在差异。需要开展更多工作来了解影响参与筛查的因素，并确保公平地识别自杀风险。
