@article{ref1,
title="Adolescent suicide risk screening: a secondary analysis of the SHIELD randomized clinical trial",
journal="Journal of pediatrics",
year="2022",
author="Sekhar, Deepa L. and Batra, Erich and Schaefer, Eric W. and Walker-Harding, Leslie R. and Pattison, Krista L. and Molinari, Alissa and Rosen, Perri and Kraschnewski, Jennifer L. and Waxmonsky, James G.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To evaluate the effectiveness of adolescent suicide risk screening to increase initiation of mental health services via a secondary analysis using data from the SHIELD randomized clinical trial, which evaluated school-based screening for major depressive disorder (MDD). STUDY DESIGN: Students in 14 Pennsylvania high schools were randomized by grade to either: usual school practice of targeted referral for behavior raising concern for suicide risk, or universal screening using the Patient Health Questionnaire-9 (PHQ-9) with any response >0 to item #9 regarding suicide risk considered positive. Students identified in either arm were referred to the Student Assistance Program (SAP), which is mandated in all Pennsylvania schools. SAP determined follow-up. Study groups were compared using mixed effects logistic regression. <br><br>RESULTS: Participants included 12,909 students with 6,473 (50.1%) randomized to universal screening. Students were 46% female and 43% Hispanic or non-Hispanic Black. Adolescents in the universal screening arm had 7.1 times higher odds (95% CI 5.7-8.8) of being identified as at risk for suicide, 7.8 times higher odds (95% CI 4.6-13.1) of follow-up needs, and 4.0 times higher odds (95% CI 2.0-7.9) of initiating mental health treatment. <br><br>CONCLUSIONS: Although the PHQ-9 is a MDD screening tool, its use in universal screening increased identification and treatment initiation for adolescents at risk for suicide. This confirms the value of universal screening, and suggests a suicide-specific risk assessment would have even greater impact on treatment initiation for identified youth.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2022.07.036",
url="http://dx.doi.org/10.1016/j.jpeds.2022.07.036"
}