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Year : 2020  |  Volume : 2  |  Issue : 1  |  Page : 31-42

Systematic Suicide Screening in a General Hospital Setting: Process and Initial Results

1 Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Florida, Gainesville, FL, USA
2 Department of Nursing, Psychiatry, and Information Management Systems, The Reading Hospital and Medical Center, Reading, PA, USA
3 Department of Psychiatry, Suicide Prevention Center, School of Medicine, Columbia University, New York, NY, USA
4 Complete Statistical Services, Macungie, PA, USA
5 Department of Psychology, University of Maryland, College Park MD, USA

Correspondence Address:
Prof. Andres J Pumariega
Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Florida, Gainesville, FL
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/WSP.WSP_26_19

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Background: Suicide is one of the leading causes of death across all age groups globally and poses a significant public health burden. In response to the United States Joint Commission National Patient Safety Goals, a tertiary hospital in the Northeast U.S. developed a suicide risk assessment and response protocol, consisting of systematic screening of patients for suicidal ideation/behavior with a screening version of the Columbia Suicide Severity Rating Scale (C-SSRS) and a response algorithm based on risk levels derived from the screen. Methods: A total of 837 nurses were trained and 24,168 patients ages 12 and above were screened with the C-SSRS Screener. Results: Posttraining interrater reliability on the C-SSRS Screener definitions of ideation and behavior was high and independent of level of education or mental health experience. Of the patients screened, only 144 patients (0.93%) were in the highest risk category, and they were assigned patient safety monitors until a follow-up consultation. The highest risk levels from the C-SSRS Screener reasonably identified subsequent attempts at self-injurious behavior during hospitalization. Screening resulted in lower burden due to reduction in the rate of psychiatric consultations and one-to-one observation shifts. Conclusions: These findings suggest that a systematic screening and clinical response protocol using the C-SSRS Screener can potentially enhance the ability to identify suicide risk in the general hospital population and focus services on patients with the most need.

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