New Onset of Suicidal Ideation in Children With Neurologic, Developmental, and Behavioral Disorders From Longitudinal Universal Suicide Risk Screening.

Abstract

Objective: This naturalistic, observational study aimed to assess the frequency and timing of new and recent suicidal ideation (SI) in youth with neurologic, developmental, and behavioral disorders (NDBDs) after an initial negative suicide risk screening within medical and behavioral health settings.

Method: A total of 5030 children aged 8 to 17 years were included, all of whom received at least 2 routine suicide risk screenings between July 2019 and February 2024 as part of their larger clinical care appointments (N = 20,177 total screenings). Screenings were conducted using the Ask Suicide-Screening Questions tool. Analyses examined the interval between an initial negative screening and the emergence of new SI, with stratification by clinic type and age group. Predictors of new onset of SI were also examined.

Results: Overall, a significant proportion of children screened positive for new SI after an initial negative screening (8.4%). Rates were higher in behavioral health clinics (11.3%) compared with medical clinics (5.4%), with a median interval of 5 to 6 months to the first positive screening for both settings. Females were more likely to report new SI, as were those in seen in behavioral health as compared with medical clinics.

Conclusion: The findings highlight the importance of repeated suicide risk screening in children with NDBDs as a significant proportion of new SI is reported in the months after an initial negative screening. Screening only annually appears likely to underdetect risk, underscoring the need for more frequent screening particularly within the first year of care to improve early detection and intervention opportunities.