Advertisement

Current Psychiatry Reports

, 18:100 | Cite as

Emergency Department Screening for Suicide and Mental Health Risk

  • Kalina Babeva
  • Jennifer L. Hughes
  • Joan Asarnow
Child and Adolescent Disorders (TD Benton, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Child and Adolescent Disorders

Abstract

Suicide is the second leading cause of death among youth ages 10–24. An estimated 1.5 million US adolescents receive their primary health care in the emergency department (ED); this is particularly true for low-income and minority youths who often lack a regular source of care. ED visits can provide a window of opportunity to screen and identify youths with suicide and mental health risk, triage youths based on need, and facilitate effective follow-up care. Recently developed brief therapeutic assessment approaches have demonstrated success in improving rates of follow-up care after discharge from the ED. Furthermore, there is some data supporting clinical benefits when youths receive evidence-based outpatient follow-up care. ED screening combined with effective follow-up, therefore, may provide one strategy for improving mental health and reducing health disparities in our nation. This paper reviews the context in which ED screenings occur, available tools and strategies, and evidence for the effectiveness of tested approaches.

Keywords

Child and adolescent Suicide risk Mental health risk Emergency department Assessment 

Notes

Compliance with Ethical Standards

Conflict of Interest

Kalina Babeva declares no conflict of interest.

Jennifer L. Hughes declares grants from the American Foundation for Suicide Prevention and the National Institute of Mental Health.

Joan Asarnow declares grants from the American Foundation for Suicide Prevention, National Institute of Mental Health, and the American Psychological Association (APA) Committee on Division/APA Relations. Dr. Asarnow also receives funding from the Society of Clinical Child and Adolescent Psychology, APA Division 53.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Centers for Disease Control. Fatal injury reports, national and regional, 1999-2014, http://webappa.cdc.gov/sasweb/ncipc/mortrate10_us.html; 2015 [accessed 16 May 12].
  2. 2.
    Bridge JA, Goldstein TR, Brent DA. Adolescent suicide and suicidal behavior. J Child Psychol Psychiatry. 2006;47:372–94. doi: 10.1111/j.1469-7610.2006.01615.x.PubMedCrossRefGoogle Scholar
  3. 3.
    Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, et al. Youth risk behavior surveillance—United States, 2011. Morb Mortal Wkly Report Surveill Summ. 2012;61:1–162.Google Scholar
  4. 4.
    Reinherz HZ, Tanner JL, Berger SR, Beardslee WR, Fitzmaurice GM. Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromised functioning at age 30. Am J Psychiatry. 2006;163:1226–32. doi: 10.1176/appi.ajp.163.7.1226.PubMedCrossRefGoogle Scholar
  5. 5.
    Bridge JA, Horowitz LM, Fontanella CA, Grupp-Phelan J, Campo JV. Prioritizing research to reduce youth suicide and suicidal behavior. Am J Prev Med. 2014;47:S229–34. doi: 10.1016/j.amepre.2014.06.001.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Centers for Disease Control. Trends in the prevalence of suicide-related behavior, National YRBS: 1991-2013, http://www.cdc.gov/healthyyouth/data/yrbs/pdf/trends/us_suicide_trend_yrbs.pdf; 2014 [accessed 16 May 12].
  7. 7.
    Goldston DB, Daniel SS, Erkanli A, Heilbron N, Doyle O, Weller B, et al. Suicide attempts in a longitudinal sample of adolescents followed through adulthood: evidence of escalation. J Consult Clin Psychol. 2015;83:253–64. doi: 10.1037/a0038657.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Forman EM, Berk MS, Henriques GR, Brown GK, Beck AT. History of multiple suicide attempts as a behavioral marker of severe psychopathology. Am J Psychiatry. 2004;161:437–43. doi: 10.1176/appi.ajp.161.3.437.PubMedCrossRefGoogle Scholar
  9. 9.
    Kaslow NJ, Jacobs CH, Young SL, Cook S. Suicidal behavior among low-income African American women: a comparison of first-time and repeat suicide attempters. J Black Psychol. 2006;32:349–65. doi: 10.1177/0095798406290459.CrossRefGoogle Scholar
  10. 10.
    Kandel DB, Raveis VH, Davies M. Suicidal ideation in adolescence: depression, substance use, and other risk factors. J Youth Adolesc. 1991;20:289–309. doi: 10.1007/BF01537613.PubMedCrossRefGoogle Scholar
  11. 11.
    Esposito-Smythers C, Spirito A. Adolescent substance use and suicidal behavior: a review with implications for treatment research. Alcohol Clin Exp Res. 2004;28:77S–88S. doi: 10.1097/01.ALC.0000127417.99752.87.PubMedCrossRefGoogle Scholar
  12. 12.
    Brent DA, Perper JA, Goldstein CE, Kolko DJ, Allan MJ, Allman CJ, et al. Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients. Arch Gen Psychiatry. 1988;45:581–8. doi: 10.1001/archpsyc.1988.01800300079011.PubMedCrossRefGoogle Scholar
  13. 13.
    Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL. Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch Gen Psychiatry. 2005;62:66–72. doi: 10.1001/archpsyc.62.1.66.PubMedCrossRefGoogle Scholar
  14. 14.
    Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity survey replication adolescent supplement. JAMA Psychiatry. 2013;70:300–10. doi: 10.1001/2013.jamapsychiatry.55.PubMedCrossRefGoogle Scholar
  15. 15.
    Harris EC, Barraclough B. Suicide as an outcome for mental disorders: a meta-analysis. Br J Psychiatry. 1997;170:205–28. doi: 10.1192/bjp.170.3.205.PubMedCrossRefGoogle Scholar
  16. 16.
    Yoshimasu K, Kiyohara C, Miyashita K. Suicidal risk factors and completed suicide: meta-analyses based on psychological autopsy studies. Environ Health Prev Med. 2008;13:243–56. doi: 10.1007/s12199-008-0037-x.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602. doi: 10.1001/archpsyc.62.6.593.PubMedCrossRefGoogle Scholar
  18. 18.
    Lewinsohn PM, Rohde P, Seeley JR. Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. Clin Psychol Rev. 1998;18:765–94. doi: 10.1016/S0272-7358(98)00010-5.PubMedCrossRefGoogle Scholar
  19. 19.
    Ahmedani BK, Simon GE, Stewart C, Beck A, Waitzfelder BE, Rossom R, et al. Health care contacts in the year before suicide death. J Gen Intern Med. 2014;29(6):870–7. doi: 10.1007/s11606-014-2767-3.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Wintersteen MB. Standardized screening for suicidal adolescents in primary care. Pediatrics. 2010;125(5):938–44. doi: 10.1542/peds.2009-2458.PubMedCrossRefGoogle Scholar
  21. 21.
    Kemball RS, Gasgarth R, Johnson B, Patil M, Houry D. Unrecognized suicidal ideation in ED patients: are we missing an opportunity? Am J Emerg Med. 2008;26:701–5. doi: 10.1016/j.ajem.2007.09.006.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Slap GB, Vorters DF, Khalid N, Margulies SR, Forke CM. Adolescent suicide attempters: do physicians recognize them? J Adolesc Heal. 1992;13:286–92. doi: 10.1016/1054-139X(92)90161-4.CrossRefGoogle Scholar
  23. 23.
    Wilson KM, Klein JD. Adolescents who use the emergency department as their usual source of care. Arch Pediatr Adolesc Med. 2000;154:361–5. doi: 10.1001/archpedi.154.4.361.PubMedCrossRefGoogle Scholar
  24. 24.
    Gairin I, House A, Owens D. Attendance at the accident and emergency department in the year before suicide: retrospective study. Br J Psychiatry. 2003;183:28–33. doi: 10.1192/bjp.183.1.28.PubMedCrossRefGoogle Scholar
  25. 25.
    Downey LV, Zun LS, Burke T. Undiagnosed mental illness in the emergency department. J Emerg Med. 2012;43:876–82. doi: 10.1016/j.jemermed.2011.06.055.PubMedCrossRefGoogle Scholar
  26. 26.
    Horowitz LM, Ballard E, Teach SJ, Bosk A, Rosenstein DL, Joshi P, et al. Feasibility of screening patients with nonpsychiatric complaints for suicide risk in a pediatric emergency department: a good time to talk? Pediatr Emerg Care. 2010;26:787–92. doi: 10.1097/PEC.0b013e3181fa8568.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    King CA, O’Mara RM, Hayward CN, Cunningham RM. Adolescent suicide risk screening in the emergency department. Acad Emerg Med. 2009;16:1234–41. doi: 10.1111/j.1553-2712.2009.00500.x.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Baraff LJ, Janowicz N, Asarnow JR. Survey of California emergency departments about practices for management of suicidal patients and resources available for their care. Ann Emerg Med. 2006;48:452–8. doi: 10.1016/j.annemergmed.2006.06.026.PubMedCrossRefGoogle Scholar
  29. 29.
    The Joint Commission. National patient safety goals effective January 1, 2015. Oakbrook Terrace: The Joint Commission; 2015.Google Scholar
  30. 30.
    Williams JR, Ho ML, Grupp-Phelan J. The acceptability of mental health screening in a pediatric emergency department. Pediatr Emerg Care. 2011;27:611–5. doi: 10.1097/PEC.0b013e318222554e.PubMedCrossRefGoogle Scholar
  31. 31.
    Ballard ED, Stanley IH, Horowitz LM, Cannon EA, Pao M, Bridge JA. Asking youth questions about suicide risk in the pediatric emergency department: results from a qualitative analysis of patient opinions. Clin Pediatr Emerg Med. 2013;14:20–7. doi: 10.1016/j.cpem.2013.01.001.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Gould MS, Marrocco FA, Kleinman M, Thomas JG, Mostkoff K, Cote J, et al. Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial. JAMA. 2005;293:1635–43. doi: 10.1001/jama.293.13.1635.PubMedCrossRefGoogle Scholar
  33. 33.•
    O’Mara RM, Hill RM, Cunningham RM, King CA. Adolescent and parent attitudes toward screening for suicide risk and mental health problems in the pediatric emergency department. Pediatr Emerg Care. 2012;28:626–32. doi: 10.1097/PEC.0b013e31825cfb10. This study examining the attitudes of adolescent and their parents toward screening youth for mental health and suicidality risk in the ED documents overall support of screening by both groups. Suicide risk and drug/alcohol abuse were rated as the most important domains for screening, with mothers and female adolescents being more strongly in favor of suicide and mental health risk screening in the ED compared to fathers and male youth.
  34. 34.
    Nadeem E, Lange JM, Edge D, Fongwa M, Belin T, Miranda J. Does stigma keep poor young immigrant and U.S.-born Black and Latina women from seeking mental health care? Psychiat Serv. 2007;58:1547–54. doi: 10.1176/ps.2007.58.12.1547.CrossRefGoogle Scholar
  35. 35.
    Kranke D, Floersch J, Townsend L, Munson M. Stigma experience among adolescents taking psychiatric medication. Child Youth Serv Rev. 2010;32:496–505. doi: 10.1016/j.childyouth.2009.11.002.CrossRefGoogle Scholar
  36. 36.
    Asarnow JR, Baraff LJ, Berk M, Grob C, Devich-Navarro M, Suddath R, et al. Pediatric emergency department suicidal patients: two-site evaluation of suicide ideators, single attempters, and repeat attempters. J Am Acad Child Adolesc Psychiatry. 2008;47:958–66. doi: 10.1097/CHI.0b013e3181799ee8.PubMedCrossRefGoogle Scholar
  37. 37.
    National Institute of Mental Health. Personalized screen to ID suicidal teens in 14 ERs [press release], http://www.nimh.nih.gov/news/science-news/2014/personalized-screen-to-id-suicidal-teens-in-14-ers.shtml; 2014 [accessed 16 May 11].
  38. 38.
    Asarnow JR, McArthur D, Hughes J, Barbery V, Berk M. Suicide attempt risk in youths: utility of the Harkavy-Asnis suicide scale for monitoring risk levels. Suicide Life-Threatening Behav. 2012;42:684–98. doi: 10.1111/j.1943-278X.2012.00122.x.CrossRefGoogle Scholar
  39. 39.
    Prinstein MJ, Nock MK, Spirito A, Grapentine WL. Multimethod assessment of suicidality in adolescent psychiatric inpatients: preliminary results. J Am Acad Child Adolesc Psychiatry. 2001;40:1053–61. doi: 10.1097/00004583-200109000-00014.PubMedCrossRefGoogle Scholar
  40. 40.
    Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49:980–9. doi: 10.1016/j.jaac.2010.05.017.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Horowitz LM, Bridge JA, Teach SJ, Ballard E, Klima J, Rosenstein DL, et al. Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Arch Pediatr Adolesc Med. 2012;166:1170–6. doi: 10.1001/archpediatrics.2012.1276.PubMedCrossRefGoogle Scholar
  42. 42.
    Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168:1266–77. doi: 10.1176/appi.ajp.2011.10111704.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Columbia University Medical Center. Scales - Public health settings, http://www.cssrs.columbia.edu/scales_practice_cssrs.html; [accessed 16 May 12].
  44. 44.•
    Gipson PY, Agarwala P, Opperman KJ, Horwitz A, King CA. Columbia-Suicide Severity Rating Scale: predictive validity with adolescent psychiatric emergency patients. Pediatr Emerg Care. 2015;31:88–94. doi: 10.1097/PEC.0000000000000225. This is a longitudinal ED study examining the ability of the Columbia-Suicide Severity Rating Scale (C-SSRS) and other medical data (e.g., NSSI) to predict future ED visits and SAs among adolescent (13 to 17 year-old) patients. Approximately one third of the sample had one or more return ED visits in the year following the baseline visit, and lifetime NSSI and the C-SSRS intensity scale predicted SA at return visit.
  45. 45.
    United States Food and Drug Administration. Guidance for industry—suicidality: prospective assessment of occurrence in clinical trials, draft guidance. Silver Spring: United States Food and Drug Administration; 2012.Google Scholar
  46. 46.
    Sher L, Zalsman G. Alcohol and adolescent suicide. Int J Adolesc Med Health. 2005;17:197–203. doi: 10.1515/IJAMH.2005.17.3.197.PubMedGoogle Scholar
  47. 47.
    McManama O’Brien KH, Becker SJ, Spirito A, Simon V, Prinstein MJ. Differentiating adolescent suicide attempters from ideators: examining the interaction between depression severity and alcohol use. Suicide Life-Threatening Behav. 2014;44:23–33. doi: 10.1111/sltb.12050.CrossRefGoogle Scholar
  48. 48.•
    Fein JA, Pailler ME, Barg FK, Wintersteen MB, Hayes K, Tien AY, et al. Feasibility and effects of a Web-based adolescent psychiatric assessment administered by clinical staff in the pediatric emergency department. Arch Pediatr Adolesc Med. 2010;164:1112–7. doi: 10.1001/archpediatrics.2010.213. Evaluating a computerized, self-administered Behavioral Health Screening–Emergency Department (BHS-ED) system for youth (14 to 18 years old) presenting without psychiatric symptoms to a pediatric ED, this study provides evidence for the feasibility and utility of this approach. Specifically, rates of the identification of psychiatric concerns (e.g., depression, SI, posttraumatic stress, substance use) and resulting assessments by a mental health professional increased significantly following the implementation of BHS-ED.
  49. 49.
    Gadomski AM, Fothergill KE, Larson S, Wissow LS, Winegrad H, Nagykaldi ZJ, et al. Integrating mental health into adolescent annual visits: impact of previsit comprehensive screening on within-visit processes. J Adolesc Heal. 2015;56:267–73. doi: 10.1016/j.jadohealth.2014.11.011.CrossRefGoogle Scholar
  50. 50.
    Mundt JC, Greist JH, Jefferson JW, Federico M, Mann JJ, Posner K. Prediction of suicidal behavior in clinical research by lifetime suicidal ideation and behavior ascertained by the electronic Columbia-Suicide Severity Rating Scale. J Clin Psychiatry. 2013;74:887–93. doi: 10.4088/JCP.13m08398.PubMedCrossRefGoogle Scholar
  51. 51.
    Chisolm DJ, Gardner W, Julian T, Kelleher KJ. Adolescent satisfaction with computer-assisted behavioural risk screening in primary care. Child Adolesc Ment Health. 2008;13:163–8. doi: 10.1111/j.1475-3588.2007.00474.x.PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    Olson AL, Gaffney CA, Hedberg VA, Gladstone GR. Use of inexpensive technology to enhance adolescent health screening and counseling. Arch Pediatr Adolesc Med. 2009;163:172–7. doi: 10.1001/archpediatrics.2008.533.PubMedCrossRefGoogle Scholar
  53. 53.
    Choo EK, Ranney ML, Aggarwal N, Boudreaux ED. A systematic review of emergency department technology-based behavioral health interventions. Academic Emergency Medicine. 2012;19:318–28. doi: 10.1111/j.1553-2712.2012.01299.x.PubMedCrossRefGoogle Scholar
  54. 54.
    Kurth AE, Martin DP, Golden MR, Weiss NS, Heagerty PJ, Spielberg F, et al. A comparison between audio computer-assisted self-interviews and clinician interviews for obtaining the sexual history. Sex Transm Dis. 2004;31:719–26. doi: 10.1097/01.olq.0000145855.36181.13.PubMedCrossRefGoogle Scholar
  55. 55.
    Viguera AC, Milano N, Laurel R, Thompson NR, Griffith SD, Baldessarini RJ, et al. Comparison of electronic screening for suicidal risk with the Patient Health Questionnaire Item 9 and the Columbia Suicide Severity Rating Scale in an outpatient psychiatric clinic. Psychosomatics. 2015;56:460–9. doi: 10.1016/j.psym.2015.04.005.PubMedCrossRefGoogle Scholar
  56. 56.
    Hankin A, Haley L, Baugher A, Colbert K, Houry D. Kiosk versus in-person screening for alcohol and drug use in the emergency department: patient preferences and disclosure. West J Emerg Med. 2015;16:220–8. doi: 10.5811/westjem.2015.1.24121.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Fothergill KE, Gadomski A, Solomon BS, Olson AL, Gaffney CA, Dosreis S, et al. Assessing the impact of a web-based comprehensive somatic and mental health screening tool in pediatric primary care. Acad Pediatr. 2013;13:340–7. doi: 10.1016/j.acap.2013.04.005.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Asarnow JR, Baraff LJ, Berk M, Grob CS, Devich-Navarro M, Suddath R, et al. An emergency department intervention for linking pediatric suicidal patients to follow-up mental health treatment. Psychiatr Serv. 2011;62:1303–9. doi: 10.1176/appi.ps.62.11.1303.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Rotheram-Borus MJ, Bradley J. Triage model for suicidal runaways. Am J Orthopsychiatry. 1991;61:122–7. doi: 10.1037/h0079228.PubMedCrossRefGoogle Scholar
  60. 60.
    Rotheram-Borus MJ, Piacentini J, Cantwell C, Belin TR, Song J. The 18-month impact of an emergency room intervention for adolescent female suicide attempters. J Consult Clin Psychol. 2000;68:1081–93. doi: 10.1037/0022-006X.68.6.1081.PubMedCrossRefGoogle Scholar
  61. 61.
    Cwik MF, Tingey L, Wilkinson R, Goklish N, Larzelere-Hinton F, Barlow A. Suicide prevention gatekeeper training: Can they advance prevention in Indian country? Arch Suicide Res 2016:1–10. doi:10.1080/13811118.2015.1033122Google Scholar
  62. 62.
    Mullany B, Barlow A, Goklish N, Larzelere-Hinton F, Cwik M, Craig M, et al. Toward understanding suicide among youths: results from the White Mountain Apache tribally mandated suicide surveillance system, 2001-2006. Am J Public Health. 2009;99:1840–8. doi: 10.2105/AJPH.2008.154880.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Asarnow JR, Berk MS, Baraff LJ. Family intervention for suicide prevention: a specialized emergency department intervention for suicidal youths. Prof Psychol Res Pract. 2009;40:118–25. doi: 10.1037/a0012599.CrossRefGoogle Scholar
  64. 64.
    Johnson RM, Frank EM, Ciocca M, Barber CW. Training mental healthcare providers to reduce at-risk patients’ access to lethal means of suicide: evaluation of the CALM Project. Arch Suicide Res. 2011;15(3):259–64.PubMedCrossRefGoogle Scholar
  65. 65.
    Substance Abuse and Mental Health Services Administration. Evidence Based Programs/NREPP, http://www.samhsa.gov/data/evidence-based-programs-nrepp; 2014 [accessed 16.05.11].
  66. 66.•
    Ougrin D, Zundel T, Ng A, Banarsee R, Bottle A, Taylor E. Trial of therapeutic assessment in London: randomised controlled trial of therapeutic assessment versus standard psychosocial assessment in adolescents presenting with self-harm. Arch Dis Child. 2011;96:148–53. doi: 10.1136/adc.2010.188755. This British RCT tests a therapeutic assessment (TA) approach, which incorporates a 30-min cognitive-behavioral intervention into a standard assessment done for self-harming/suicidal adolescents (12 to 18 years old) as a means of increasing engagement in follow-up outpatient care. Results suggest that TA was feasible to administer and, compared to assessment as usual, TA leads to significantly improved engagement, as measured by increased likelihood of attending the first follow-up mental health appointment post-discharge and at least four treatment sessions. However, no differences were found in ratings of overall functioning between the TA and assessment as usual groups at 3 months post-assessment.
  67. 67.•
    Grupp-Phelan J, McGuire L, Husky MM, Olfson M. A randomized controlled trial to engage in care of adolescent emergency department patients with mental health problems that increase suicide risk. Pediatr Emerg Care. 2012;28:1263–8. doi: 10.1097/PEC.0b013e3182767ac8. This RCT evaluates the effectiveness of a brief, pediatric ED-based risk screening plus mental health service engagement intervention in improving linkage to outpatient mental health services. Adolescents (12 to 17 years old), presenting to ED with non-psychiatric complaint and not currently receiving services, who screened positive for suicide risk factors (SI in conjunction with alcohol abuse, impairment in functioning and/or depression), were randomized to receive the intervention or a standard referral practice. The intervention was rated as more helpful by teens than the standard referral and increased the likelihood of attending a mental health appointment in the 2 months following the ED visit.PubMedCrossRefGoogle Scholar
  68. 68.•
    King CA, Gipson PY, Horwitz AG, Opperman KJ. Teen options for change: an intervention for young emergency patients who screen positive for suicide risk. Psychiatr Serv. 2015;66:97–100. doi: 10.1176/appi.ps.201300347. This study is an RTC testing the effectiveness of Teen Options for Change (TOC), a brief motivational interviewing-based intervention focusing on youths’ values, goals, and development of an action plan for behavior change. TOC was administered to adolescents (14 to 19 years old) presenting to the ED with non-psychiatric concerns but screening positive for suicide risk. Rates of use of mental health services post- ED visit did not differ between the two groups at the 2-month follow-up; however, compared to ED treatment as usual, patients receiving TOC experienced a greater decrease in depression symptoms.
  69. 69.
    Barnett NP, Apodaca TR, Magill M, Colby SM, Gwaltney C, Rohsenow DJ, et al. Moderators and mediators of two brief interventions for alcohol in the emergency department. Addiction. 2010;105:452–65. doi: 10.1111/j.1360-0443.2009.02814.x.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.•
    Bernstein E, Edwards E, Dorfman D, Heeren T, Bliss C, Bernstein J. Screening and brief intervention to reduce marijuana use among youth and young adults in a pediatric emergency department. Acad Emerg Med. 2009;16:1174–85. doi: 10.1111/j.1553-2712.2009.00490.x. This RCT examines the effects of screening and brief intervention administered to adolescents (14 to 21 years old) presenting to a pediatric ED on marijuana usage up to 12 months later. The motivational interviewing-based intervention included a 20-min structured conversation conducted by an older peer and a 10-day booster telephone call. Results demonstrate a decrease in 30-day abstinence rate and in number of days of marijuana usage as well as an increase in referrals as compared to the standard assessment group.
  71. 71.•
    Cunningham RM, Chermack ST, Ehrlich PF, Carter PM, Booth BM, Blow FC, et al. Alcohol interventions among underage drinkers in the ED: a randomized controlled trial. Pediatrics. 2015;136:e783–93. doi: 10.1542/peds.2015-1260. This is an RCT study of the efficacy of screening for risky drinking and brief (15–20 min) intervention administered via computer or by a mental health professional to teens (14 to 20 years old) in the ED. The interventions both used motivational interviewing techniques to target alcohol use and participants were followed for 12 months after their ED visit. Compared to usual ED care, the computer- and therapist-administered interventions were both found to be effective in decreasing alcohol consumption at 3 months, negative consequences stemming from alcohol use at 3 and 12 months, and prescription drug use at 12 months.
  72. 72.
    Bowersox NW, Bohnert ASB, Ganoczy D, Pfeiffer PN. Inpatient psychiatric care experience and its relationship to posthospitalization treatment participation. Psychiatr Serv. 2013;64:554–62. doi: 10.1176/appi.ps.002342012.PubMedCrossRefGoogle Scholar
  73. 73.
    Asarnow JR, Miranda J. Improving care for depression and suicide risk in adolescents: innovative strategies for bringing treatments to community settings. Annu Rev Clin Psychol. 2014;10:275–303. doi: 10.1146/annurev-clinpsy-032813-153742.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    U.S. Department of Health and Human Services. Mental health: culture, race, and ethnicity—a supplement to mental health: a report of the surgeon general. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2001.CrossRefGoogle Scholar
  75. 75.
    Substance Abuse and Mental Health Services Administration. Mental health, United States, 2010. HHS Publication No. (SMA) 12-4681. Rockville: Substance Abuse and Mental Health Services Administration; 2012.Google Scholar
  76. 76.
    Morganti KG, Bauhoff S, Blanchard JC, Abir M, Iyer N, Smith AC, et al. The evolving role of emergency departments in the United States. Santa Monica: RAND Corporation; 2013.Google Scholar
  77. 77.
    Angold A, Prendergast M, Cox A, Harrington R, Simonoff E, Rutter M. The Child and Adolescent Psychiatric Assessment (CAPA). Psychol Med. 1995;25:739–53.PubMedCrossRefGoogle Scholar
  78. 78.
    Weller EB, Weller RA, Fristad MA, Rooney MT, Schecter J. Children’s Interview for Psychiatric Syndromes (ChIPS). J Am Acad Child Adolesc Psychiatry. 2000;39:76–84. doi: 10.1097/00004583-200001000-00019.PubMedCrossRefGoogle Scholar
  79. 79.
    Reich W. Diagnostic Interview for Children and Adolescents (DICA). J Am Acad Child Adolesc Psychiatry. 2000;39:59–66. doi: 10.1097/00004583-200001000-00017.PubMedCrossRefGoogle Scholar
  80. 80.
    Shaffer D, Fisher P, Lucas CP, Dulcan MK, Schwab-Stone ME. NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry. 2000;39:28–38. doi: 10.1097/00004583-200001000-00014.PubMedCrossRefGoogle Scholar
  81. 81.
    Sherrill JT, Kovacs M. Interview Schedule for Children and Adolescents (ISCA). J Am Acad Child Adolesc Psychiatry. 2000;39:67–75. doi: 10.1097/00004583-200001000-00018.PubMedCrossRefGoogle Scholar
  82. 82.
    Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36:980–8. doi: 10.1097/00004583-199707000-00021.PubMedCrossRefGoogle Scholar
  83. 83.
    Sheehan DV, Sheehan KH, Shytle RD, Janavs J, Bannon Y, Rogers JE, et al. Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). J Clin Psychiatry. 2010;71:313–26. doi: 10.4088/JCP.09m05305whi.PubMedCrossRefGoogle Scholar
  84. 84.
    Beck AT, Steer RA. Manual for Beck Scale for suicidal ideation. New York: Psychological Corporation; 1991.Google Scholar
  85. 85.
    Trivedi MH, Wisniewski SR, Morris DW, Fava M, Gollan JK, Warden D, et al. Concise health risk tracking scale: a brief self-report and clinician rating of suicidal risk. J Clin Psychiatry. 2011;72:757–64. doi: 10.4088/JCP.11m06837.PubMedCrossRefGoogle Scholar
  86. 86.
    Ostacher MJ, Nierenberg AA, Rabideau D, Reilly-Harrington NA, Sylvia LG, Gold AK, et al. A clinical measure of suicidal ideation, suicidal behavior, and associated symptoms in bipolar disorder: psychometric properties of the Concise Health Risk Tracking Self-Report (CHRT-SR). J Psychiatr Res. 2015;71:126–33. doi: 10.1016/j.jpsychires.2015.10.004.PubMedCrossRefGoogle Scholar
  87. 87.
    Harkavy Friedman JM, Asnis GM. Assessment of suicidal behavior: a new instrument. Psychiatr Ann. 1989;19:382–7. doi: 10.3928/0048-5713-19890701-11.CrossRefGoogle Scholar
  88. 88.
    Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol. 1979;47:343–52. doi: 10.1037/0022-006X.47.2.343.PubMedCrossRefGoogle Scholar
  89. 89.
    Reynolds WM. Development of a semistructured clinical interview for suicidal behaviors in adolescents. Psychol Assess. 1990;2:382–90. doi: 10.1037/1040-3590.2.4.382.CrossRefGoogle Scholar
  90. 90.
    Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX. The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001;8:443–54. doi: 10.1177/107319110100800409.PubMedCrossRefGoogle Scholar
  91. 91.
    Reynolds WM. Suicidal ideation questionnaire: professional manual. Odessa: Psychological Assessment Resources; 1988.Google Scholar
  92. 92.
    Reynolds WM. Suicidal Ideation Questionnaire-Junior. Odessa: Psychological Assessment Resources; 1987.Google Scholar
  93. 93.
    Cull JG, Gill WS. Suicide Probability Scale (SPS) manual. Los Angeles: Western Psychological Services; 1988.Google Scholar
  94. 94.
    Gratz KL. Measurement of deliberate self-harm: preliminary data on the deliberate self-harm inventory. J Psychopathol Behav Assess. 2001;23:253–63. doi: 10.1023/A:1012779403943.CrossRefGoogle Scholar
  95. 95.
    Lloyd E, Kelley ML, Hope T. Self-mutilation in a community sample of adolescents: descriptive characteristics and provisional prevalence rates. New Orleans: Poster presented at the Annual Meeting of the Society for Behavioural Medicine; 1997.Google Scholar
  96. 96.
    Gutierrez PM, Osman A, Barrios FX, Kopper BA. Development and initial validation of the self-harm behavior questionnaire. J Pers Assess. 2001;77:475–90. doi: 10.1207/S15327752JPA7703_08.PubMedCrossRefGoogle Scholar
  97. 97.
    Nock MK, Holmberg EB, Photos VI, Michel BD. Self-injurious thoughts and behaviors interview: development, reliability, and validity in an adolescent sample. Psychol Assess. 2007;19:309–17. doi: 10.1037/1040-3590.19.3.309.PubMedCrossRefGoogle Scholar
  98. 98.
    Beck AT, Beck J, Jolly J, Steer RA. Beck youth inventories. 2nd ed. San Antonio: Harcourt Assessment; 2005.Google Scholar
  99. 99.
    March JS, Parker JD, Sullivan K, Stallings P, Conners CK. The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry. 1997;36:554–65. doi: 10.1097/00004583-199704000-00019.PubMedCrossRefGoogle Scholar
  100. 100.
    Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, et al. The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. J Clin Epidemiol. 2010;63:1179–94. doi: 10.1016/j.jclinepi.2010.04.011.PubMedPubMedCentralCrossRefGoogle Scholar
  101. 101.
    Reynolds CR, Richmond BO. What I think and feel: a revised measure of children’s manifest anxiety. J Abnorm Child Psychol. 1978;6:271–80. doi: 10.1007/BF00919131.PubMedCrossRefGoogle Scholar
  102. 102.
    Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, et al. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36:545–53. doi: 10.1097/00004583-199704000-00018.PubMedCrossRefGoogle Scholar
  103. 103.
    Beck AT, Steer RA, Brown GK. Beck Depression Inventory-II. San Antonio: Psychological Corporation; 1996.Google Scholar
  104. 104.
    Fendrich M, Weissman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol. 1990;131:538–51.PubMedGoogle Scholar
  105. 105.
    Kovacs M. The Children’s Depression, Inventory (CDI). Psychopharmacol Bull. 1985;21:995–8. doi: 10.3724/SP.J.1041.2015.01004.PubMedGoogle Scholar
  106. 106.
    Asarnow JR, Carlson G. Depression self-rating scale: utility with child psychiatric inpatients. J Consult Clin Psychol. 1985;53:491–9. doi: 10.1037/0022-006X.53.4.491.PubMedCrossRefGoogle Scholar
  107. 107.
    Birleson P. The validity of depressive disorder in childhood and the development of a self-rating scale: a research report. J Child Psychol Psychiatry. 1981;22:73–88. doi: 10.1111/j.1469-7610.1981.tb00533.x.PubMedCrossRefGoogle Scholar
  108. 108.
    LeBlanc JC, Almudevar A, Brooks SJ, Kutcher S. Screening for adolescent depression: comparison of the Kutcher adolescent depression scale with the Beck depression inventory. J Child Adolesc Psychopharmacol. 2002;12:113–26. doi: 10.1089/104454602760219153.PubMedCrossRefGoogle Scholar
  109. 109.
    Angold A, Costello EJ, Messer SC, Pickles A, Winder F, Silver D. Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int J Methods Psychiatr Res. 1995;5:237–49.Google Scholar
  110. 110.
    Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13. doi: 10.1046/j.1525-1497.2001.016009606.x.PubMedPubMedCentralCrossRefGoogle Scholar
  111. 111.
    Bernstein IH, Rush AJ, Trivedi MH, Hughes CW, Macleod L, Witte BP, et al. Psychometric properties of the quick inventory of depressive symptomatology in adolescents. Int J Methods Psychiatr Res. 2010;19:185–94. doi: 10.1002/mpr.321.PubMedPubMedCentralCrossRefGoogle Scholar
  112. 112.
    Bush B, Shaw S, Cleary P, Delbanco TL, Aronson MD. Screening for alcohol abuse using the CAGE questionnaire. Am J Med. 1987;82:231–5. doi: 10.1016/0002-9343(87)90061-1.PubMedCrossRefGoogle Scholar
  113. 113.
    Meyers K, McLellan AT, Jaeger JL, Pettinati HM. The development of the Comprehensive Addiction Severity Index for Adolescents (CASI-A): an interview for assessing multiple problems of adolescents. J Subst Abuse Treat. 1995;12:181–93. doi: 10.1016/0740-5472(95)00009-T.PubMedCrossRefGoogle Scholar
  114. 114.
    Knight JR, Shrier LA, Bravender TD, Farrell M, Vander Bilt J, Shaffer HJ. A new brief screen for adolescent substance abuse. Arch Pediatr Adolesc Med. 1999;153:591–6. doi: 10.1001/archpedi.153.6.591.PubMedGoogle Scholar
  115. 115.
    Skinner HA, Goldberg AE. Evidence for a drug dependence syndrome among narcotic users. Br J Addict. 1986;81:479–84. doi: 10.1111/j.1360-0443.1986.tb00359.x.PubMedCrossRefGoogle Scholar
  116. 116.
    Tarter RE, Laird SB, Bukstein OG, Kaminer Y. Validation of the adolescent drug use screening inventory: preliminary findings. Psychol Addict Behav. 1992;6:233–6. doi: 10.1037/h0080632.CrossRefGoogle Scholar
  117. 117.
    Foa EB, Cashman L, Jaycox L, Perry K. The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychol Assess. 1997;9:445–51. doi: 10.1037/1040-3590.9.4.445.CrossRefGoogle Scholar
  118. 118.
    Briere J. Trauma symptom checklist for children. Odessa: Psychological Assessment Resources; 1996.Google Scholar
  119. 119.
    Steinberg AM, Brymer M, Decker K, Pynoos RS. The UCLA PTSD Reaction Index. Curr Psychiatry Rep. 2004;6:96–100.PubMedCrossRefGoogle Scholar
  120. 120.
    Achenbach TM. Manual for the Youth Self-Report and 1991 profile. Burlington: Department of Psychiatry, University of Vermont; 1991.Google Scholar
  121. 121.
    Reynolds CR, Kamphaus RW. Behavior Assessment System for Children, Third Edition (BASC-3). Bloomington: Pearson Assessments; 2015.Google Scholar
  122. 122.
    American Psychiatric Association. DSM-5 self-rated level 1 cross-cutting symptom measure—child age 11–17. Arlington: American Psychiatric Association; 2013.Google Scholar
  123. 123.
    Jellinek MS, Murphy JM, Robinson J, Feins A, Lamb S, Fenton T. Pediatric Symptom Checklist: screening school-age children for psychosocial dysfunction. J Pediatr. 1988;112:201–9. doi: 10.1016/S0022-3476(88)80056-8.PubMedCrossRefGoogle Scholar
  124. 124.
    Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38:581–6. doi: 10.1111/j.1469-7610.1997.tb01545.x.PubMedCrossRefGoogle Scholar
  125. 125.
    Burlingame GM, Mosier JI, Wells MG, Atkin QG, Lambert MJ, Whoolery M, et al. Tracking the influence of mental health treatment: the development of the Youth Outcome Questionnaire. Clin Psychol Psychother. 2001;8:361–79. doi: 10.1002/cpp.315.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kalina Babeva
    • 1
  • Jennifer L. Hughes
    • 2
  • Joan Asarnow
    • 3
  1. 1.Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesUSA
  2. 2.Center for Depression Research and Clinical CareUT Southwestern Medical CenterDallasUSA
  3. 3.Department of Psychiatry and Biobehavioral Sciences, Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesUSA

Personalised recommendations