Session: Screening for Suicide Risk in Medical Settings: Implications for Policy and Practice (Society for Prevention Research 23rd Annual Meeting)

Suicide continues to be a leading cause of death in the United States.  More than 40,000 Americans died by suicide in 2012, the most recent year for which we have national data.  Suicide is also the second leading cause of death for young adults ages 25 to 34.   Suicide rates have not declined in recent years, and suicide has been a challenge to understand, predict and prevent. In 2014, the Research Prioritization Task Force of the National Action Alliance for Suicide Prevention released A Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives. The stated goal of the Research Agenda is to reduce suicides by 20 percent in five years and 40 percent in the next ten, if all recommendations were fully implemented. The Research Agenda bases its recommendations on the magnitude of reduction in the number of suicides possible if targeted interventions were applied to populations of known size. From the work of the task force, it became clear that, in order to improve our capacity to prevent suicide we need more information on the settings in which individuals present before they die and their characteristics so that we may more appropriately target interventions.  Research has shown that a significant proportion of youth and adults who die by suicide have had contact with the health care system in the year preceding their death – either in the form of a primary care or Emergency Department (ED) visit.  As a result, targeted screening and intervention within these settings may be a valuable first step in reducing rates of suicide.  This symposium will highlight three approaches to filling the gaps in the evidence base for risk detection and treatment of suicide risk within medical settings.  The first study examines whether the implementation of universal suicide risk screening protocols in the ED increases the percentage of individuals screened during routine care and improves risk detection.  The second will present the design and methodology for the development of a computerized adaptive screen to identify youth at risk for suicide in the ED and approaches to stratifying youth based on level of risk.  The final paper presents an approach to using data available through electronic medical records within an integrated healthcare system in order to rapidly identify probable suicide attempts.  The studies’ implications for policy and practice will be discussed.