A Qualitative Study Exploring Adolescent and Caregiver Perspectives of Emergency Department Response After a Positive Suicide Screen - 18/09/25
, Anastasia Klott, MD b, Ashley Dafoe, MA c, Chloe Glaros, MPH, MSW c, Brooke Dorsey, PhD, MA c, Maya Haasz, MD a, Bruno J. Anthony, PhD b, Sean T. O’Leary, MD, MPH c, dAbstract |
Study objective |
As a safety net for adolescents, the emergency department (ED) is considered an opportune setting for suicide screening and response (ie, safety assessments, brief interventions, and referrals). This study explored adolescent and caregiver perspectives on the ED’s response when nonacute suicide risk was identified during universal screening.
Methods |
This was a qualitative study of adolescents who completed the Ask Suicide-Screening Questions (ASQ) in the ED and/or their caregiver. Our institution performs universal suicide screening with the ASQ for all ED patients aged 10 or more years. We conducted semistructured interviews with adolescents (13 to 17 years) who had a “nonacute positive” ASQ (defined as “yes” to questions 1 to 4 on the ASQ without current thoughts of suicide), and/or their caregiver. Interviews were scheduled after ED discharge and occurred from October 2023 to June 2024. Interviews were audio-recorded, transcribed, and coded in ATLAS.ti. Content analysis was used to identify salient themes. The analytic team diagrammed each participant’s story to augment the analysis.
Results |
We completed 17 interviews (8 adolescents and 9 caregivers). Three primary themes were identified: (1) responses by ED clinicians are lacking, confusing, and inconsistent; (2) ED responses should be tailored, well timed, private, and autonomous; and (3) resources provided by the ED should empower adolescents and caregivers moving forward. Participants recommended resources that overcome barriers to care and standardized ED interventions to better support patients and families.
Conclusion |
In this study, the ED response to nonacute suicide risk was described as inadequate. Participants recommended additional resources to safely manage suicidal thoughts and navigate mental health treatment.
Le texte complet de cet article est disponible en PDF.Keywords : Suicide screening, Mental health, ED screening, Adolescent health
Plan
| Please see page 392 for the Editor’s Capsule Summary of this article. |
|
| Supervising editor: Lois K. Lee, MD, MPH. Specific detailed information about possible conflicts of interest for individual editors is available at editors. |
|
| Author contributions: RC, BA, BD, and SO conceptualized and designed the study. RC obtained research funding. RC, AK, AD, and CG developed the interview guide, with oversight from BD. RC and MH approached individuals in the ED for informed consent. AD and CG contacted consented individuals to schedule interviews and arrange gift card compensation after completion. AK conducted adolescent interviews. RC and AD conducted caregiver interviews. Data analysis was performed by RC, AD, and CG with supervision from BD. RC drafted the manuscript, and all authors contributed substantially to its revision. RC takes responsibility for the paper as a whole. |
|
| Data sharing statement: To protect patient anonymity/confidentiality, interview transcripts and identifying information will not be publicly available. The codebook and query summaries will be available upon reasonable request from the date of article publication by contacting Rachel Cafferty, MD (Rachel.Cafferty@childrenscolorado.org). |
|
| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
|
| Funding andsupport: By Annals’ policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. Dr. Cafferty received funding from Partners for Children’s Mental Health, established by Children's Hospital Colorado and the University of Colorado School of Medicine, to support this work. |
|
| Presentation information: This work was accepted for presentation at the Pediatric Academic Societies (PAS) Annual Conference April 28, 2025, Honolulu, Hawaii. |
|
| Readers: click on the link to go directly to a survey in which you can provide H829VRJ to Annals on this particular article. |
|
| A podcast for this article is available at www.annemergmed.com. |
Vol 86 - N° 4
P. 391-401 - octobre 2025 Retour au numéro
Article précédent
- Adoption of Boarding in Inpatient Hallways During Emergency Department Crowding
- Brian J. Franklin, Sam H. Shen, Vikas I. Parekh, Gabor D. Kelen, Heidi High, Maame Yaa A.B. Yiadom, Moon O. Lee, Ryan Ribeira, Neel Kapadia, Jamie S. Newman, Maralyssa Bann, Robert L. Fogerty, Xinhang Wang, Ariadna Garcia, Eric Goralnick
- Universal Suicide Screening in the Emergency Department: What Next?
- Joyce Li, Mohsen Saidinejad
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?