Better Medical Screening Could Reduce Adolescent Suicide Rate

While primary care providers are in a unique position to help prevent adolescent suicide, most do not routinely screen their young patients for suicidal behavior or associated mental and physical risk factors, according to researchers at the Johns Hopkins School of Public Health. The study was published in the February 2000 issue of the Archives of Pediatric and Adolescent Medicine.

Suicide is the third leading cause of mortality among persons ages 10 to 19, following motor vehicle crashes and homicide. Senior author Diane Frankenfield, DrPH, stated, "Primary care providers may be the sole source of medical care for this population and thus could serve a 'gatekeeper' role in identifying and referring high-risk youths and families. We recommend that physicians screen their adolescent patients for psychosocial problems at all visits to ensure no missed opportunity." Over 70 percent of young people ages 10 to 19 see a physician at least once a year.

In May 1995, researchers mailed a questionnaire to all currently practicing pediatricians and family physicians on the mailing lists of the Maryland chapters of the American Academy of Pediatrics and the American Academy of Family Physicians. The questions concerned physicians' impressions of the prevalence of adolescent suicidal behavior; whether the physicians screened for individual suicidal risk factors or counseled patients about injury prevention; and whether barriers existed to physician intervention. Sixty-six percent of those surveyed -- 693 physicians -- responded.

"Our most startling findings," according to co-author Susan Baker, MPH, professor at the Center for Injury Research and Policy, Johns Hopkins School of Public Health, "were that 47 percent of these physicians reported that one or more of their adolescent patients had attempted suicide in the previous year, and that only 23 percent screened for risk factors for suicide."

Despite the substantial proportion of primary care providers who had encountered suicidal adolescent patients, over 75 percent of them still did not routinely screen their patients for suicidal behavior and associated risk factors, such as depression, substance abuse, or a history of physical abuse. Seventy-two percent of physicians did report that they were interested in receiving more training on preventing adolescent suicide.

Funding for this study was provided by The Center for Injury Research and Policy.