BACKGROUND AND OBJECTIVES: Suicide in elementary school-aged children is not well studied, despite a recent increase in the suicide rate among US black children. The objectives of this study were to describe characteristics and precipitating circumstances of suicide in elementary school-aged children relative to early adolescent decedents and identify potential within-group racial differences.

IMPORTANCE Suicide is a leading cause of death among school-aged children younger than 12 years but little is known about the epidemiology of suicide in this age group. OBJECTIVE To describe trends in suicide among US children younger than 12 years by sociodemographic group and method of death. DESIGN, SETTING, AND PARTICIPANTS Period trend analysis of national mortality data on suicide in children aged 5 to 11 years in the

Objective. To evaluate the impact of rigorous WalkRounds on frontline caregiver assessments of safety climate, and to clarify the steps and implementation of rigorous WalkRounds. Data Sources/Study Setting. Primary outcome variables were baseline and post WalkRounds safety climate scores from the Safety Attitudes Questionnaire (SAQ). Secondary outcomes were safety issues elicited through WalkRounds. Study period was August 2002 to April 2005; seven hospitals in Massachusetts agreed to participate; and the project was implemented in all patient care areas. Study Design. Prospective study of the impact of rigorously applied WalkRounds on frontline caregivers assessments of safety climate in their patient care area. WalkRounds were conducted weekly and according to the seven-step WalkRounds Guide. The SAQ was administered at baseline and approximately 18 months post-WalkRounds implementation to all caregivers in patient care areas. Results. Two of seven hospitals complied with the rigorous WalkRounds approach; hospital A was an academic teaching center and hospital B a community teaching hospital. Of 21 patient care areas, SAQ surveys were received from 62 percent of respondents at baseline and 60 percent post WalkRounds. At baseline, 10 of 21 care areas (48 percent) had safety climate scores below 60 percent, whereas post-WalkRounds three care areas (14 percent) had safety climate scores below 60 percent without improving by 10 points or more. Safety climate scale scores in hospital A were 62 percent at baseline and 77 percent post-WalkRounds (t 5 2.67, p 5 .03), and in hospital B were 46 percent at baseline and 56 percent post WalkRounds (t 5 2.06, p 5 .06). Main safety issues by category were equipment/facility r Health Research and Educational Trust

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Objective To develop a brief screening instrument to assess risk of suicide in pediatric emergency department (ED) patients. Design A prospective, cross-sectional instrument development study which evaluated 17 candidate screening questions assessing suicide risk in young patients. The Suicidal Ideation Questionnaire (SIQ) served as criterion standard. Setting Three urban, pediatric EDs associated with tertiary care teaching hospitals. Patients/Participants A convenience sample of 524 patients aged 10–21 years who presented with either medical/surgical or psychiatric chief complaints to the ED between September 2008–December 2010. Main Exposure Participants answered 17 candidate questions followed by the SIQ. Main Outcome Measures Sensitivity, specificity, predictive values, likelihood ratios, and area under the receiver operating characteristic curves of the best-fitting combinations of screening questions for detecting elevated risk of suicide. Results 524 patients were screened (344 medical/surgical and 180 psychiatric). Fourteen (4%) of the medical/surgical patients and 84 (47%) of the psychiatric patients were at elevated suicide risk on the SIQ. Of the 17 candidate questions, the best-fitting model was comprised of 4 questions assessing: current thoughts of being better off dead, current wish to die, current suicidal ideation, and past suicide attempt. This model had a sensitivity of 96.9% (95% CI, 91.3%–99.4%), specificity of 87.6% (95% CI, 84.0%–90.5%), and a negative predictive value (NPV) of 99.7% (95% CI, 98.2%–99.9%) for medical/surgical patients; 96.9% (95% CI, 89.3%–99.6%) for psychiatric patients. Conclusions A four-question screening instrument, the Ask Suicide-Screening Questions (ASQ), with high sensitivity and NPV, can identify risk of suicide in patients presenting to pediatric EDs.

Purpose of review-Every year, suicide claims the lives of tens of thousands of young people worldwide. Despite its high prevalence and known risk factors, suicidality is often undetected. Early identification of suicide risk may be an important method of mitigating this public health crisis. Screening youth for suicide may be a critical step in suicide prevention. This paper reviews suicide screening in three different settings: schools, primary care clinics and emergency departments (EDs).Recent findings-Unrecognized and thus untreated suicidality leads to substantial morbidity and mortality. With the onus of detection falling on nonmental health professionals, brief screening tools can be used to initiate more in-depth evaluations. Nonetheless, there are serious complexities and implications of screening all children and adolescents for suicide. Recent studies show that managing positive screens is a monumental challenge, including the problem of false positives and the burden subsequently posed on systems of care. Furthermore, nearly 60% of youth in need of mental health services do not receive the care they need, even after suicide attempt. Schools, primary care clinics and EDs are logical settings where screening that leads to intervention can be initiated.Summary-Valid, brief and easy-to-administer screening tools can be utilized to detect risk of suicide in children and adolescents. Targeted suicide screening in schools, and universal suicide screening in primary care clinics and EDs may be the most effective way to recognize and prevent self-harm. These settings must be equipped to manage youth who screen positive with effective and timely interventions. Most importantly, the impact of suicide screening in various settings needs to be further assessed.

A brief 4-item screening tool can be used by nonmental health clinicians to accurately detect suicidality in children and adolescents who visit an ED. Early and accurate identification of suicidality is a critical first step that could lead to better treatment and improved health outcomes for children and adolescents with mental health concerns.

Objective: To estimate the association between the release of the Netflix series 13 Reasons Why and suicide rates in the United States.Method: Using segmented quasi-Poisson regression and Holt-Winters forecasting models, we assessed monthly rates of suicide among individuals aged 10 to 64 years grouped into 3 age categories (