Suicide is the second leading cause of death of youth aged 10-24 years in the US; the COVID-19 pandemic only served to exacerbate the mental health crisis for adolescents and young adults. This crisis prompted the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and the Children’s Hospital Association (CHA) to jointly declare a National State of Emergency in Children’s Mental Health.
In their thoughtful and concise Pediatrics Perspectives being early released this week, “The Case for Universal Screening for Suicidal Risk in Adolescents,” Bridge and colleagues provide one answer to this call (10.1542/peds.2022-061093). In addition to the United States Preventive Services Task Force’s (USPSTF) recommendation for anxiety and depression screening, the authors persuasively argue that universal screening of suicide risk across clinical settings is also required.
Specifically, the authors provide 4 salient arguments in their case for universal screening:
- There are validated measures of suicidal risk
- There are no iatrogenic effects due to screening for suicidal risk
- Screening for depression can also identify youth at risk for suicide
- Universal screening of youth for suicidal risk can be beneficial
Undoubtedly, there is a vital need to identify youth at risk for suicide. Timely identification of individuals at risk is a critical factor in equitable provision of mental health services for all adolescents. Universal screening, as described in this Pediatrics Perspectives, is fully consistent with the AAP, AACAP, CHA declaration to ensure “all families and children… can access evidence-based mental health screening… with particular emphasis on meeting the needs of under-resourced populations.”
As researchers, we strive to advance the evidence base through a thoughtful and measured approach. However, as clinicians caring for youth on a daily basis, it could literally be a tragedy to miss an opportunity to identify a child, adolescent, or young adult at risk for suicide. In the case of adolescent mental health, is the authors’ counterpoint to the USPSTF recommendation pushing the boundaries of existing evidence? Or should universal screening of suicide risk already be considered essential care? I would advocate for the latter.
