@article{ref1,
title="Zero suicide quality improvement: developmental and pandemic-related patterns in youth at risk for suicide attempts",
journal="Evidence-based practice in child and adolescent mental health",
year="2023",
author="Asarnow, Joan R. and Clarke, Greg N. and Miranda, Jeanne M. and Edelmann, Anna C. and Sheppler, Christina R. and Firemark, Alison J. and Zhang, Lily and Babeva, Kalina and Venables, Chase and Comulada, Scott",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="The Zero Suicide (ZS) approach to health system quality improvement (QI) aspires to reduce/eliminate suicides through enhancing risk detection and suicide prevention services. This first report from our randomized trial evaluating a stepped care for suicide prevention intervention within a health system conducting ZS-QI describes (1) our screening and case identification process, (2) variation among adolescents versus young adults, and (3) pandemic-related patterns during the first COVID-19 pandemic year. Between April 2017 and January 2021, youths aged 12-24 years with elevated suicide risk were identified through an electronic health record (EHR) case-finding algorithm followed by direct assessment screening to confirm risk. Eligible/enrolled youth were evaluated for suicidality, self-harm, and risk/protective factors. Case finding, screening, and enrollment yielded 301 participants showing suicide risk indicators: 97% past-year suicidal ideation, 83% past suicidal behavior; and 90% past non-suicidal self-injury (NSSI). Compared to young adults, adolescents reported more past-year suicide attempts (47% vs. 21%, p <.001) and NSSI (past 6 months, 64% vs. 39%, p <.001); less depression, anxiety, posttraumatic stress, and substance use; and greater social connectedness. Pandemic onset was associated with lower participation of racial-ethnic minority youths (18% vs. 33%, p <.015) and lower past-month suicidal ideation and behavior. <br><br>RESULTS support the value of EHR case-finding algorithms for identifying youths with potentially elevated risk who could benefit from suicide prevention services, which merit adaptation for adolescents versus young adults. Lower racial-ethnic minority participation after the COVID-19 pandemic onset underscores challenges for services to enhance health equity during a period with restricted in-person health care, social distancing, school closures, and diverse stresses.<p /> <p>Language: en</p>",
language="en",
issn="2379-4925",
doi="10.1080/23794925.2023.2208382",
url="http://dx.doi.org/10.1080/23794925.2023.2208382"
}