Suicide-Risk Identification Across Developmental and Behavioral Pediatric Practices: A DBPNet Study.

Abstract

Background: Identification of suicide risk among individuals with autism and other intellectual/developmental disabilities (IDD) is increasingly required by developmental-behavioral pediatric (DBP), psychology and psychiatry practices that frequently serve these populations. Improved understanding of current practice for risk identification is needed.

Objective: To identify variations in practices, facilitators of and barriers to universal suicide screening of children and adolescents with IDDs in pediatric developmental and behavioral health settings.

Methods: Centers from the Developmental Behavioral Pediatrics Research Network (DBPNet) were invited to describe suicide-screening practices in their developmental-behavioral pediatrics, psychology, and/or psychiatry clinics. A representative per site/specialty was asked to complete surveys (summarized with descriptive statistics) and semi-structured interviews (summarized using thematic analysis) to explore sites' current practices, and barriers/facilitators to screening.

Results: Participants included 34 survey respondents and 21 interviewees.Surveys revealed variation in suicide screening practices across sites; 44.1% of respondents reported that their practice conducts universal screening, but the screening processes varied widely. Interviews identified some facilitators to screening youth with IDD, such as standardizing procedures, training, and having staff available to respond to positive screens. Barriers to universal screening include factors at the patient, family, provider, and system levels. Insufficient mental health care systems, as well as a lack of IDD-specific supports, are significant challenges.

Conclusions: Despite Joint Commission requirements and specific expertise in behavioral health, sites serving patients with IDD vary widely in how suicide screening is implemented and how positive screens are addressed. Findings offer opportunities to standardize procedures to increase suicide risk identification and response.