School-based screening for suicide risk: balancing costs and benefits.

American Journal of Public Health
Michelle ScottDavid Shaffer

Abstract

We examined the effects of a scoring algorithm change on the burden and sensitivity of a screen for adolescent suicide risk. The Columbia Suicide Screen was used to screen 641 high school students for high suicide risk (recent ideation or lifetime attempt and depression, or anxiety, or substance use), determined by subsequent blind assessment with the Diagnostic Interview Schedule for Children. We compared the accuracy of different screen algorithms in identifying high-risk cases. A screen algorithm comprising recent ideation or lifetime attempt or depression, anxiety, or substance-use problems set at moderate-severity level classed 35% of students as positive and identified 96% of high-risk students. Increasing the algorithm's threshold reduced the proportion identified to 24% and identified 92% of high-risk cases. Asking only about recent suicidal ideation or lifetime suicide attempt identified 17% of the students and 89% of high-risk cases. The proportion of nonsuicidal diagnosis-bearing students found with the 3 algorithms was 62%, 34%, and 12%, respectively. The Columbia Suicide Screen threshold can be altered to reduce the screen-positive population, saving costs and time while identifying almost all students at high risk...Continue Reading

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Citations

Oct 14, 2011·Issues in Mental Health Nursing·Gregory D CooperKaryn Holt
Sep 17, 2013·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Richard LowryLaura Kann
Sep 1, 2015·Suicide & Life-threatening Behavior·Geoffrey L Ream
Sep 12, 2015·The Lancet. Psychiatry·Yaron FinkelsteinUNKNOWN Canadian Drug Safety and Effectiveness Research Network (CDSERN)
May 11, 2016·European Child & Adolescent Psychiatry·Gil ZalsmanAlan Apter
May 18, 2016·JMIR Mental Health·Scott R BraithwaiteCarl Lee Hanson
Apr 24, 2012·Clinical Pediatrics·John RauschKaren Soren

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