Feasability of Utilizing a Rapid Screening Tool for Suicide and Major Depressive Disorder in Appalachian Acute Care Settings

Abstract

INTRODUCTION Patients who commit suicide will often visit the emergency department (ED) shortly before death for reasons other than those related to the suicide. These visits may be a prime opportunity to identify patients with symptoms of major depressive disorder (MDD) that contribute to suicidal ideation. This pilot study investigated the feasibility of a recently developed tool, the CAD-MDD-S, a combination of the Computerized Adaptive Diagnostic Screening Tool for Major Depressive Disorder (CAD-MDD) and four screening questions from the Columbia-Suicide Severity Rating Scale (C-SSRS),to identify patients with suicidal thoughts, intent, plans, and behaviors, and/or MDD. METHOD CAD-MDD-S was administered to ambulatory adult patients (18+ years) who presented at an academic ED or student health services clinic for non-mental health concerns. The goal was to study the feasibility and efficiency of the screening tool, assessing the potential impact the tool may have in identifying at risk patients in these clinical settings. RESULTS From August 2015 to November 2016, 345 patients agreed to complete the screening tool (89% agree rate), with 76 screening positive for MDD, 13 for risk of suicide, and 7 for both. The median screening time to completion was six minutes, with 87% of patients taking less than 10 minutes. CONCLUSIONS This pilot study demonstrated that the ad- ministration of the CAD-MDD-S diagnostic screening tool was feasible and efficient in emergency settings, and the time to completion did not present a substantial burden to the patient. Future studies are needed to confirm these findings in other populations with larger samples.