A rapid review of emergency department interventions for children and young people presenting with suicidal ideation

Abstract

Background Suicidal ideation is an increasingly common presentation to the paediatric emergency department. The presence of suicidal ideation is linked to acute psychiatric hospital admission and increased risk of suicide. The paediatric emergency department plays a critical role in reducing risk of suicide, strengthening protective factors and encouraging patient engagement with ongoing care. Aims This rapid review aims to synthesise evidence on interventions that can be implemented in the paediatric emergency department for children and adolescents presenting with suicidal ideation. Method Six electronic databases were searched for studies published since January 2010: PubMed, Web of Science, Medline, PsycINFO, CINAHL and Cochrane. Outcomes of interest included suicidal ideation, engagement with out-patient services, incidence of depressive symptoms, hopelessness, family empowerment, hospital admission and feasibility of interventions. The Cochrane risk-of-bias tool was used to evaluate the quality of studies. Results Six studies of paediatric emergency department-initiated family-based (n = 4) and motivational interviewing interventions (n = 2) were narratively reviewed. The studies were mainly small and of varying quality. The evidence synthesis suggests that both types of intervention, when initiated by the paediatric emergency department, reduce suicidal ideation and improve patient engagement with out-patient services. Family-based interventions also showed a reduction in suicidality and improvement in family empowerment, hopelessness and depressive symptoms. Conclusions Paediatric emergency department-initiated interventions are crucial to reduce suicidal ideation and risk of suicide, and to enhance ongoing engagement with out-patient services. Further research is needed; however, family-based and motivational interviewing interventions could be feasibly and effectively implemented in the paediatric emergency department setting.

Association between suicidal behavior and symptoms of other mental health problems in Mexican adolescents

“…42 The mental health problems associated in both models are consistent with those of previous literature. [20][21][22]43 One finding that was different from those previously reported in the literature were anxiety and psychosomatic symptoms as predictors of suicidal behaviors, including suicide attempts, since, in other analyses, they had only been associated with suicidal ideation. 26,29,31,44 A probable explanation for this change is related to the context the survey was applied in, during the COVID-19 pandemic.…”

Asociación entre conducta suicida y síntomas de otros problemas de salud mental en adolescentes mexicanos

“…42 Los problemas de salud mental asociados en ambos modelos coinciden con los de la literatura previa. [20][21][22]43 Un hallazgo distinto a los reportados previamente en la literatura fueron los síntomas de ansiedad y síntomas psicosomáticos como predictores de las conductas suicidas, incluidos los intentos de suicidio, porque en otros análisis solo se habían relacionado con ideación suicida. 26,29,31,44 Una probable explicación para este cambio está relacionada con el contexto de aplicación de la encuesta durante la pandemia de COVID-19.…”

Validity and reliability of a Chinese language suicide screening questionnaire-observer rating (CL-SSQ-OR) assessment for children/adolescents

“…Moreover, due to lack of a useful assessment tool, suicide risk screening and suicide prevention efforts are limited. Among suicide deaths, those involving adolescents and children represent a large proportion ( 12 – 15 ). In particular, since adolescents and children are generally not proactive in reporting their suicide risk, their guardians often underestimate or neglect the potential suicide risk of their children.…”