587 - Suicide Risk Among Children in the Emergency Department Patients

Poster Number: 587
Publication Number: 587.2161

Background: Presently, suicide is the second leading cause of death among adolescents, and increasingly, suicidal thoughts and behaviors have become a public health concern among children aged 8-12 years. The emergency department (ED) often serves as the primary contact point for youth to receive psychiatric care for suicidality. However, the severity and time course of clinical outcomes for children remain unclear.

Objective: To (1) characterize the lifetime history of suicidal thoughts and behaviors, and (2) assess rates of suicide events (e.g., attempts, hospitalizations, and ED visits) within 90-days post-discharge among children presenting to the pediatric ED for psychiatric care.

Design/Methods: The study included youth aged 8-12 years presenting to a tertiary care pediatric ED for suicide-related concerns. In this IRB-approved study, participants assented, and guardians provided informed consent. Children and guardians were administered a child-friendly adaptation of the Columbia-Suicide Severity Rating Scale (C-SSRS) to assess suicidal thoughts and behaviors. Additionally, children completed self-report surveys assessing environmental (e.g., adverse stress exposure, parent-child conflict, perceived discrimination), internal (e.g., symptom severity, negative urgency, sleep problems), and developmental factors (e.g., pubertal status, gender identity) At the 90-day follow-up assessment, children and guardians were re-administered the C-SSRS to provide an objective assessment of suicide events during the post-discharge period.

Results: To date, 26 participants completed the baseline and follow-up procedures, and recruitment is ongoing. At baseline, more than two thirds reported a lifetime history of suicide ideation. The majority of children expressed ideation about multiple methods, most frequently involving stabbing (38%) or hanging (19%). Almost half (44%) reported a history of multiple prior suicide attempts (e.g., attempted overdose, jumping from a building, running into traffic, and strangulation). At the 90-day follow-up assessment, 31% either re-presented to the ED or were hospitalized for suicide risk.

Conclusion(s): A rising public health concern is suicide risk among children. These preliminary data suggest that post-discharge, children are at high suicide risk. Future analyses, which will include a larger sample, will clarify risk factors associated with lifetime and post-discharge suicidal thoughts and behaviors.