Sociodemographic Influences on Suicide Risk Screening and Management in Hospitalized Youths.

Abstract

Background: Characterizing the relationship between sociodemographic factors and youth suicide risk is crucial for developing prevention strategies and targeted interventions.

Objective: We aimed to describe the relationship between hospital-based suicide-risk screening and sociodemographics (race and ethnicity, sex, age, and neighborhood socioeconomic status), discharge disposition, and reuse rates in those with positive screens.

Methods: This is a retrospective study of patients aged 10 to 17 years hospitalized between May 2021 and May 2022 at a freestanding children's hospital in Milwaukee, Wisconsin. Screening rates and results were compared across groups using chi-square tests and logistic regression.

Results: Five thousand two hundred sixty-one encounters were included, and 83.2% (4375/5261) received suicide-risk screening. Of those screened, 19.3% (843/4375) had positive suicide-risk results. Screening rates were significantly higher among Black or African American patients (P < .001), girls (P = .01), and those aged 13 to 17 years (P < .001). Positive suicide-risk results were most frequent among Hispanic/Latino/Latinx patients (P = .01) and girls (P < .001). Patients aged 10 to 12 years were screened less frequently and had fewer positive suicide-risk results (P < .001). There were no differences based on neighborhood socioeconomic status. Black or African American patients were discharged home more often than white patients (P < .001). Patients with positive suicide-risk screens discharged home had a 6.1% emergency department revisit rate within 7 days of discharge compared with 2.4% of those transferred to inpatient psychiatry (P = .05).

Conclusion: We found differences in screening incidence and result (Black or African American and Latinx, sex, and preteens), discharge disposition (Black or African American), and hospital reuse (discharge home) after a positive suicide-risk screen. Our findings call for increased consideration of social determinants when caring for hospitalized youth.