Ask Suicide-Screening Questionnaire (ASQ): Rapid Suicide Risk Screening for Hospitalized Patients

Article type
Authors
Clinton K1, Britt J1, Karlson C1, Barrier K1, Murray A1
1University Of Mississippi Medical Center, Jackson, MS, United States
Abstract
Background:

Suicide is a global public health concern. Suicide has become a leading cause of death among age groups worldwide. In the US, suicide is the second leading cause of death in ages 10-14 and 20-34. Early screening and detection are crucial for prevention.

Objective:

Determine the prevalence and characteristics of suicide risk among patients admitted to an academic medical center.

Methods:

The ASQ screening questions (4-items) were administered to all patients ages 12 and above upon admission or presentation to the Emergency Department (ED) at the University of Mississippi Medical Center. A total of 29,019 patients were screened, of which 4,563 were pediatrics patients and 24,456 were adult patients. Screenings were completed in the ED, Medical-Surgical (Med-Surg), Behavioral, Psychiatry, Operating Room, Intensive Care Unit (ICU), Labor and delivery, and Obstetrics and Gynecology Emergency units. 75% patients are admitted through the ED resulting in 52.3% of screening occurring in the ED unless the patient was unconscious on arrival.

Results:

Across all pediatric patients, 11% (n=502) screened positive and 1.84% (n=84) screened acutely positive. Pediatric patients screened in the Behavioral unit (81.25%) and ICU (13.04%) had a higher percentage of positive screenings compared to other units. Regarding acutely positive screenings, the pediatric Med-Surg (2.83%) and Behavioral (25.00%) units had the highest percentages. Across all adult patients, 3.33% (n=814) screened positive and 1.70% (n=416) screened acutely positive. Adult patients admitted to Psychiatry had a higher percentage of positive screenings (52.37%) and acute positive screenings (34.09%) compared to other adult units. All other adult units had a low percentage of both positive (range = 0.00 to 2.63%) and acute positive (range = 0.00 to 1.39%) suicide screenings.

Conclusion:

Alarmingly, pediatric patients had a relatively high number of positive suicide screens, with higher than anticipated numbers in the ICU and Med-Surg units. This investigation highlights the relative risk of suicide in pediatric and adult patients and emphasizes the importance of universal suicide screening in the medical setting.

Relevance:

Patients admitted to the hospital, regardless of reason for admission, may experience suicidal ideation requiring mental health intervention in addition to treatment for a physical diagnosis