“Our findings underscore the importance of screening all adolescents who present to the ED for suicide risk and access to firearms,” said lead author Samaa Kemal, MD, MPH, Pediatric Emergency Medicine Fellow at Ann & Robert H. Lurie Children’s Hospital of Chicago. “This is even more critical now that we are in the midst of a youth mental health crisis.”
Currently, the Joint Commission mandates that all children over 12 years old should be screened for suicide risk, and if this risk is identified, screening for access to lethal means is recommended. However, screening for firearm access tends to be inconsistent in the ED.
Suicide Risk Among Teenagers
Suicide is the second leading cause of death among adolescents in the United States, and adolescent suicide death rates have almost doubled over the past 10 years.
Dr. Kemal and colleagues analyzed data from over 15,000 patients ages 14 to 18 years seen at a tertiary children’s hospital ED between June 2013 and March 2020. 14% of the overall sample reported access to a firearm in the home or ability to access one within the next 24 hours.
A history of sexual assault significantly increased the odds of a participant reporting a prior suicide attempt. Participants reporting verbal bullying, intimate partner violence, and/or abuse by a caregiver also had significantly increased odds of reporting current suicidal ideation and prior suicide attempt.
“Universal mental health screening of adolescents is particularly important in the wake of the COVID-19 pandemic, which has led to both increased firearm availability and worsening indicators of youth mental health,” said Dr. Kemal.
“Proper screening for both suicidality and firearm access can create the opportunity to offer effective firearm safety counseling, such as keeping all firearms locked, unloaded and separate from ammunition, as well as linkage to mental health resources. We must do everything possible to prevent tragic deaths among teens who are struggling.”