Ontology highlight
ABSTRACT: Objective
To evaluate the effectiveness of adolescent suicide risk screening to increase initiation of mental health services via a secondary analysis using data from the SHIELD (Screening in High Schools to Identify, Evaluate and Lower Depression) randomized clinical trial, which evaluated school-based screening for major depressive disorder (MDD).Study design
Students in 14 Pennsylvania high schools were randomized by grade to either the usual school practice of targeted referral for behavior raising a concern for suicide risk or universal screening using the Patient Health Questionnaire-9 (PHQ-9), with any response >0 to item 9 regarding suicide risk considered positive. Students identified in either arm were referred to the Student Assistance Program (SAP), which is mandated in all Pennsylvania schools. The SAP determined follow-up. Study groups were compared using mixed-effects logistic regression.Results
The participants comprised 12 909 students, with 6473 (50.1%) randomized to universal screening. The study group was 46% female and 43% Hispanic or non-Hispanic Black. Adolescents in the universal screening arm had 7.1-fold greater odds (95% CI, 5.7-8.8) of being identified as at risk for suicide, 7.8-fold greater odds (95% CI, 4.6-13.1) of follow-up needs, and 4.0-fold greater odds (95% CI, 2.0-7.9) of initiating mental health treatment.Conclusions
Although the PHQ-9 is a MDD screening tool, its use in universal screening increased identification and treatment initiation for adolescents at risk for suicide. This confirms the value of universal screening and suggests that a suicide-specific risk assessment would have even greater impact on treatment initiation for identified youth.Trial registration
ClinicalTrials.gov: NCT03716869.
SUBMITTER: Sekhar DL
PROVIDER: S-EPMC10249009 | biostudies-literature | 2022 Dec
REPOSITORIES: biostudies-literature
Sekhar Deepa L DL Batra Erich E Schaefer Eric W EW Walker-Harding Leslie R LR Pattison Krista L KL Molinari Alissa A Rosen Perri P Kraschnewski Jennifer L JL Waxmonsky James G JG
The Journal of pediatrics 20220806
<h4>Objective</h4>To evaluate the effectiveness of adolescent suicide risk screening to increase initiation of mental health services via a secondary analysis using data from the SHIELD (Screening in High Schools to Identify, Evaluate and Lower Depression) randomized clinical trial, which evaluated school-based screening for major depressive disorder (MDD).<h4>Study design</h4>Students in 14 Pennsylvania high schools were randomized by grade to either the usual school practice of targeted referr ...[more]