Perinatal & Pediatric
Demographic and Clinic Characteristics Associated with Patient’s Declining Universal Suicide Risk Screening in Pediatric Subspecialty Ambulatory Care Imme Kobayashi* Imme Kobayashi Kobayashi Kobayashi Kobayashi New York University
Objective: Suicide is a leading cause of death for children in the US. The American Academy of Pediatrics recommends universal suicide risk screening for youth ages 12 years and older. There is limited knowledge regarding factors impacting patient decisions to accept or decline universal suicide risk screening in clinic settings.
Methods: We analyzed data from electronic health records for 19,053 patients ages 9 years and older attending 26,707 visits from October 2018 to March 2024 at pediatric ambulatory subspecialty care sites at an urban academic medical center. We examined demographic and clinic characteristics related to patient decisions to decline annual universal suicide risk screening.
Results: Patients declining universal suicide risk screening were more likely to be younger, male, and non-Hispanic White compared to patients accepting screening. Declining screening was more common at initial screening compared to screening at subsequent annual visits. There was variation in the prevalence of screen declines by clinic location within the institution. In adjusted models, patients aged 9–11 years were four times more likely (RR 4.2, 95% CI 3.7 – 4.7) to decline screening as compared to patients aged 18–26 years, adjusted for sex, need for interpreter, visit year, maximum number of screen-eligible visits, and clinic location.
Conclusion: Demographic and clinic characteristics appear related to patient decisions to decline universal suicide risk screening in pediatric ambulatory care subspecialty clinics. Understanding factors contributing to patient participation in universal suicide risk screening may inform institutional policies and procedures to maximize screening participation and ultimately ensure patient safety.