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Declining to answer suicide screening questions may signal risk :

February 14, 2019

Teens who decline to answer suicide screening questions may be at risk but hesitant to seek treatment, researchers found.

The team studied patients ages 12-17 years who presented to the Cincinnati Children’s Hospital emergency department with non-psychiatric issues. About 3,388 took a voluntary tablet-based screening that asked four questions: “In the past few weeks, have you wished you were dead?” “In the past few weeks, have you felt that you or your family would be better off if you were dead?” “In the past week, have you been having thoughts about killing yourself?” and “Have you ever tried to kill yourself?” Patients could answer yes, no or no response to each question.

Researchers focused on 166 who said yes to at least one question and 58 who answered no response to at least one question. Both groups were evaluated by mental health providers.

Those experts determined 93.4% of the yes group and 84.5% of the no response group had some level of risk of suicidal ideation. The yes group was significantly more likely to be at high risk. They suggested mental health referral for 65% of the yes group and half of the no response group. Many of those who were not referred already were in treatment or were determined not to have recent suicidal ideation despite a past attempt.

Researchers also found the no response group was less ready to seek treatment than the yes group. They noted the value of starting a dialogue with families, especially since suicidal teens often don’t report their feelings until asked.

“Opportunities to start this conversation with youths are sometimes hard to come by, and it is important that we begin missing fewer of them; for two-thirds of patients who complete suicide, there was no previous attempt to serve as a warning,” authors wrote.

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