TY - JOUR
T1 - Five Profiles of Adolescents at Elevated Risk for Suicide Attempts
T2 - Differences in Mental Health Service Use
AU - Pediatric Emergency Care Applied Research Network (PECARN)
AU - King, Cheryl A.
AU - Brent, David
AU - Grupp-Phelan, Jacqueline
AU - Shenoi, Rohit
AU - Page, Kent
AU - Mahabee-Gittens, E. Melinda
AU - Chernick, Lauren S.
AU - Melzer-Lange, Marlene
AU - Rea, Margaret
AU - McGuire, Taylor C.
AU - Littlefield, Andrew
AU - Casper, T. Charles
N1 - Funding Information:
This study was supported by a grant from the National Institute of Mental Health (NIMH), “Emergency Department Screen for Teens at Risk for Suicide” (ED-STARS, U01 MH104311). It was also supported in part by the Health Resources and Services Administration (HRSA), the Maternal and Child Health Bureau (MCHB), the Emergency Medical Services for Children (EMSC) Network Development Demonstration Program under cooperative agreements U03MC00008, U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684, U03MC28845, H3MC26201, and U03MC22685. The information or content and conclusions in this manuscript are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by the NIMH, HRSA, the US Department of Health and Human Services, or the US Government.Disclosure: Dr. King has received support from the NIMH, the American Foundation for Suicide Prevention (AFSP), the National Institute of Child Health and Human Development (NICHD), and the Centers for Disease Control and Prevention. Dr. Brent has received research support from NIMH, AFSP, the Once Upon a Time Foundation, and the Beckwith Foundation; has received royalties from Guilford Press, from the electronic self-rated version of the C-SSRS from eRT, Inc., and from performing duties as an UptoDate Psychiatry Section Editor; and has received consulting fees from Healthwise. Dr. Mahabee-Gittens has received funding from the Ohio Department of Health/AAP and the National Institutes of Health (NIH). Dr. Chernick has received support from the National Center for Advancing Translational Sciences, the NIH, and the NICHD. Drs. Grupp-Phelan, Shenoi, Melzer-Lange, Rea, Littlefield, Casper, Mr. Page, and Ms. McGuire have reported no biomedical financial interests or potential conflicts of interest.
Funding Information:
Disclosure: Dr. King has received support from the NIMH , the American Foundation for Suicide Prevention (AFSP), the National Institute of Child Health and Human Development (NICHD), and the Centers for Disease Control and Prevention . Dr. Brent has received research support from NIMH, AFSP, the Once Upon a Time Foundation, and the Beckwith Foundation; has received royalties from Guilford Press, from the electronic self-rated version of the C-SSRS from eRT, Inc., and from performing duties as an UptoDate Psychiatry Section Editor; and has received consulting fees from Healthwise. Dr. Mahabee-Gittens has received funding from the Ohio Department of Health/AAP and the National Institutes of Health (NIH). Dr. Chernick has received support from the National Center for Advancing Translational Sciences, the NIH, and the NICHD. Drs. Grupp-Phelan, Shenoi, Melzer-Lange, Rea, Littlefield, and Casper, Mr. Page, and Ms. McGuire have reported no biomedical financial interests or potential conflicts of interest.
Funding Information:
This study was supported by a grant from the National Institute of Mental Health (NIMH), “Emergency Department Screen for Teens at Risk for Suicide” (ED-STARS, U01 MH104311 ). It was also supported in part by the Health Resources and Services Administration (HRSA), the Maternal and Child Health Bureau (MCHB), the Emergency Medical Services for Children (EMSC) Network Development Demonstration Program under cooperative agreements U03MC00008 , U03MC00001 , U03MC00003 , U03MC00006 , U03MC00007 , U03MC22684 , U03MC28845 , H3MC26201 , and U03MC22685 . The information or content and conclusions in this manuscript are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by the NIMH, HRSA, the US Department of Health and Human Services, or the US Government.
Publisher Copyright:
© 2019 American Academy of Child and Adolescent Psychiatry
PY - 2020/9
Y1 - 2020/9
N2 - Objective: Adolescents at risk for suicide are highly heterogeneous in terms of psychiatric and social risk factors, yet there has been little systematic research on risk profiles, which would facilitate recognition and the matching of patients to services. Our primary study aims were to identify latent class profiles of adolescents with elevated suicide risk, and to examine the association of these profiles with mental health service use (MHSU). Method: Participants were 1,609 adolescents from the Emergency Department Screen for Teens at Risk for Suicide (ED-STARS) cohort. Participants completed baseline surveys assessing demographics, MHSU, and suicide risk. Telephone follow-up interviews were conducted at 3 months to assess suicide attempts. Participants met pre-established baseline criteria for suicide risk. Results: Using latent class analysis, we derived 5 profiles of elevated suicide risk with differing patterns of eight risk factors: history of multiple suicide attempts, past-month suicidal ideation, depression, alcohol and drug misuse, impulsive-aggression, and sexual and physical abuse. In comparison to adolescents who did not meet baseline criteria for suicide risk, each profile was associated with increased risk of a suicide attempt within 3 months. The MHSU was lowest for adolescents fitting profiles with previous (but no recent) suicidal thoughts and behavior, and for adolescents from racial and ethnic minority groups. Conclusion: Adolescents at elevated risk for suicide present to emergency departments with differing profiles of suicide risk. MHSU varies across these profiles and by race/ethnicity, indicating that targeted risk recognition and treatment linkage efforts may be necessary to reach some adolescents at risk.
AB - Objective: Adolescents at risk for suicide are highly heterogeneous in terms of psychiatric and social risk factors, yet there has been little systematic research on risk profiles, which would facilitate recognition and the matching of patients to services. Our primary study aims were to identify latent class profiles of adolescents with elevated suicide risk, and to examine the association of these profiles with mental health service use (MHSU). Method: Participants were 1,609 adolescents from the Emergency Department Screen for Teens at Risk for Suicide (ED-STARS) cohort. Participants completed baseline surveys assessing demographics, MHSU, and suicide risk. Telephone follow-up interviews were conducted at 3 months to assess suicide attempts. Participants met pre-established baseline criteria for suicide risk. Results: Using latent class analysis, we derived 5 profiles of elevated suicide risk with differing patterns of eight risk factors: history of multiple suicide attempts, past-month suicidal ideation, depression, alcohol and drug misuse, impulsive-aggression, and sexual and physical abuse. In comparison to adolescents who did not meet baseline criteria for suicide risk, each profile was associated with increased risk of a suicide attempt within 3 months. The MHSU was lowest for adolescents fitting profiles with previous (but no recent) suicidal thoughts and behavior, and for adolescents from racial and ethnic minority groups. Conclusion: Adolescents at elevated risk for suicide present to emergency departments with differing profiles of suicide risk. MHSU varies across these profiles and by race/ethnicity, indicating that targeted risk recognition and treatment linkage efforts may be necessary to reach some adolescents at risk.
KW - adolescence
KW - latent class profiles
KW - mental health service use
KW - suicide risk
UR - http://www.scopus.com/inward/record.url?scp=85078614545&partnerID=8YFLogxK
U2 - 10.1016/j.jaac.2019.10.015
DO - 10.1016/j.jaac.2019.10.015
M3 - Article
C2 - 31830523
AN - SCOPUS:85078614545
VL - 59
SP - 1058-1068.e5
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
SN - 0890-8567
IS - 9
ER -