A Qualitative Study Exploring Adolescent and Caregiver Perspectives of Electronic Suicide Screening in the Emergency Department - 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 |
Screening for suicide risk at medical encounters is an essential step in suicide prevention. Electronic devices have been used for screening in emergency departments (EDs) for sensitive health topics, including mental health. This study explored adolescent and caregiver perspectives of privacy, autonomy, and honesty when completing suicide screening on an electronic device in the ED.
Methods |
This was a qualitative study of adolescents and/or their caregiver who completed suicide screening using an electronic modality in the ED between October 2023 and June 2024. Our institution performs screening with the Ask Suicide-Screening Questions (ASQ) for all ED patients aged 10 years and older. We conducted semistructured interviews with adolescents (ages 13 to 17 years) and/or caregivers of patients ages 10 to 17 years who had a “nonacute positive” ASQ. Interviews that occurred after ED discharge were audio-recorded and transcribed. Content analysis was performed to develop themes.
Results |
Of 41 eligible adolescents and caregivers approached in the ED, 34 consented, and 17 (8 adolescents; 9 caregivers) completed interviews. The following 4 primary themes emerged: (1) ED suicide screening provides an opportunity for connection and intervention; (2) electronic screening promotes adolescent autonomy; (3) electronic screening improves privacy, but data security concerns may limit adolescent honesty; and (4) optimizing communication before screening may quell existing concerns.
Conclusion |
In this study, participants highlighted an opportunity for connection during ED suicide screening. Electronic screening in the ED improved autonomy and privacy, facilitating honest responses. Future work should engage adolescents in identifying ideal communication strategies to engender trust and enhance ED suicide screening practices.
Le texte complet de cet article est disponible en PDF.Keywords : Pediatric suicide screening, Qualitative research, Perspectives on privacy, Autonomy, Honesty
Plan
| Please see page 406 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Lois K. Lee, MD, MPH. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Author contributions: RC, BA, BD, and SO conceptualized and designed the study. RC obtained research funding. RC, 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 under the supervision of BD. RC drafted the manuscript, and all authors contributed substantially to its revision. RC takes responsibility for the paper as a whole. |
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| 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 on reasonable request from the date of article publication by contacting Rachel Cafferty, MD [Rachel.Cafferty@childrenscolorado.org]. |
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| 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. |
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| Funding and support: 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). 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. The other authors have stated that no such relationships exist. |
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| Presentation information: This work was accepted for presentation at the Pediatric Academic Societies (PAS) Annual Conference April 26, 2025, Honolulu, Hawaii. |
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Vol 86 - N° 4
P. 405-414 - octobre 2025 Retour au numéro
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