More than half of suicidal adolescents have already received some mental health treatment, according to a new study published in the journal JAMA Psychiatry.
The study evaluated nearly 6,500 young people ages 13 to 18, and found that more than 55 percent of suicidal teens received treatment prior to having suicidal thoughts, planning their suicide or killing themselves, suggesting the treatment was unsuccessful.
Critically, the vast majority of suicidal teens have a preexisting mental disorder, according to the study — a powerful predictor of future suicidal thoughts and actions, the researchers concluded. The study also suggests that, in addition to mental health disorder such as depression and anxiety, additional behavioral disorders may factor prominently in the emergence of behaviors like suicide ideation.
“The disorders most powerfully predicting ideation, though, are different from those most powerfully predicting conditional transitions from ideation to plans and attempts,” the conclusion of the report reads. “These differences suggest that distinct prediction and prevention strategies are needed for ideation, plans among ideators, planned attempts and unplanned attempts.”
According to researchers, suicide is the third leading cause of death among adolescents in the United States, with an estimated one-third of adolescents with persistent thoughts of suicide eventually making attempts to end their own lives. More than 12 percent of teens have suicidal thoughts at some point.
However, a separate study, also published in JAMA Psychiatry, found that using a four-item questionnaire to screen young patients for suicide risks during emergency department (ED) visits could significantly increase the number of young people identified with potentially suicidal behaviors.
Currently, younger patients are often not screened for suicide risks by ED nurses or physicians if they present with routine physical ailments.
Beginning with 17 questions given to more than 500 patients ages 10 to 21, the researchers narrowed the survey form to the four questions that most accurately predicted risk of suicide.
Of the 524 patients who responded to the questions, 98 were identified as at-risk for suicide.
“With high sensitivity and negative predictive value,” the report reads, the four-question screening instrument, referred to as the Ask Suicide-Screening Questions (ASQ), “can identify the risk for suicide in patients presenting to pediatric emergency departments.”
Dr. Lisa Horowitz, the study’s lead author, said that because emergency departments are often the only healthcare avenues for some families, implementation of the Ask Suicide-Screening Questions during ED visits may prove crucial in uncovering possible suicide ideations that may otherwise go undetected.
“Most people don’t show up to the emergency department and say ‘I want to kill myself,’” Horowitz said. “Rather they show up with physical complaints and do not discuss their suicidal thoughts. But studies have shown that if you ask directly, the majority will tell you.”