Teens who decline to answer suicide screening questions may be at risk but hesitant
to seek treatment, researchers found.
The team studied patients ages 12-17 years who presented to the Cincinnati Children’s
Hospital emergency department with non-psychiatric issues. About 3,388 took a voluntary
tablet-based screening that asked four questions: “In the past few weeks, have you
wished you were dead?” “In the past few weeks, have you felt that you or your family
would be better off if you were dead?” “In the past week, have you been having thoughts
about killing yourself?” and “Have you ever tried to kill yourself?” Patients could
answer yes, no or no response to each question.
Researchers focused on 166 who said yes to at least one question and 58 who answered
no response to at least one question. Both groups were evaluated by mental health
Those experts determined 93.4% of the yes group and 84.5% of the no response group
had some level of risk of suicidal ideation. The yes group was significantly more
likely to be at high risk. They suggested mental health referral for 65% of the yes
group and half of the no response group. Many of those who were not referred already
were in treatment or were determined not to have recent suicidal ideation despite
a past attempt.
Researchers also found the no response group was less ready to seek treatment than
the yes group. They noted the value of starting a dialogue with families, especially
since suicidal teens often don’t report their feelings until asked.
“Opportunities to start this conversation with youths are sometimes hard to come by,
and it is important that we begin missing fewer of them; for two-thirds of patients
who complete suicide, there was no previous attempt to serve as a warning,” authors