The Role of Suicide Risk Assessment Screening in the Pediatric Orthopaedic Clinic.

Background: Suicide is the second leading cause of death for youth 12-18 years of age. Identification of adolescents with suicidal ideation can help facilitate early interventions. This study evaluates the use of a PSS-3 Suicide Risk Screener (SRA), given to patients presenting to a specialty pediatric orthopaedic clinic (SCC), to identify suicide risk and interventions performed for these patients.

Methods: We conducted a retrospective cohort study of the 1920 patients that presented to the SCC in 2022. Every patient that entered the clinic was given a SRA to complete. We determined the frequency of positive screens, negative screens, and incomplete screens and the demographics of the patients in the positive group. We also determined the frequencies of the interventions performed for patients that did have a positive screen.

Results: Of the 1920 patients that presented in the SCC in 2022, 319 patients had an incomplete screen and were excluded from the analysis. One patient was incorrectly coded to have a positive screen in the SCC clinic and was excluded. Of the 1600 patients that had a complete screen, 3% (48) had a positive SRA screen. Of the patients with a positive screen, the mean age was 13.6 years (1.27), 54.2% (26) female, and 89.8% (43) had public insurance. Of note, 23% (11) of those with a positive screen met with a social worker and were admitted to an inpatient facility.

Conclusions: The addition of the PSS-3 Suicide Risk Screener in this pediatric orthopaedic clinic screened 83% of patients presenting to the clinic and found a 3% positivity rate for patients that completed the screen. In 2022, 1 in every 180 patients who visited the SCC were admitted to an inpatient facility for suicidality. The implementation of a suicide risk assessment helped us to identify a need for intervention in patients originally presenting for musculoskeletal complaints. There is a role for suicide risk screening in pediatric orthopaedic clinics.

Key concepts: (1)Utility of suicide screening questionnaires in orthopaedic clinics is poorly understood.(2)This study sought to investigate the risk of suicidality in pediatric orthopaedic patients.(3)Suicide risk screening in pediatric populations can identify patients at risk.(4)Early intervention to address suicide risk in pediatric orthopaedic patients can significantly improve outcome.(5)Suicide risk screening in pediatric orthopaedic clinics has a strong role in better promoting overall health.

Level of evidence: Level III.