Predictors and correlates of adolescent suicidality: Implications for public health and clinical practice

Adolescent suicide is a significant public health problem. A number of studies indicate dramatic increases in adolescent suicide rates (CDC, 2007, 2008, CDCP, 1998, 2008). According to the WHO, youth are currently the group at highest risk of suicide in one third of all countries (developed and developing). In 2007, suicide was the third leading cause of death in children ages 10 through 24 in the US, exceeded only by unintentional injury and homicide (McIntosh, 2010).

Suicidality in adolescents has been the most significant factor in the majority of Emergency Department (ED) visits for behavioral health concerns (Stewart, Spicer, & Babl, 2006), the most common presenting problem for adolescents subsequently admitted to an inpatient psychiatric unit (Brooker, Ricketts, Bennett, & Lemme, 2007). Suicidal adolescents are at increased risk for boarding; defined as extended stays in a non-psychiatric setting while awaiting psychiatric placement (Mansbach, Wharff, Austin, Ginnis, & Woods, 2003; Wharff, Ginnis, Ross, & Blood, 2011).

In this study, the investigators will explore data from psychiatric ED visits at a pediatric teaching hospital from 2002-2012. The data collected include all patient clinical and demographic characteristics for each Emergency Psychiatry visit during that time period. Bivariate and multivariate analyses will be used to model the relationship between patient characteristics and known clinical and demographic risk factors for suicide. In addition, the authors will examine discharge patterns to determine predictors of psychiatric hospitalization in this population.

Finally, the authors will discuss implications for suicide prevention and mental health care in hospital settings.