The Cost of Universal Suicide Risk Screening for Adolescents in Emergency Departments

• Published in: International journal of environmental research and public health Vol. 20; no. 19; p. 6843
• Main Authors: Grazier, Kyle L, Grupp-Phelan, Jacqueline, Brent, David, Horwitz, Adam, McGuire, Taylor C, Casper, T Charles, Webb, Michael W, King, Cheryl A
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27.09.2023; MDPI
• Subjects: Adolescent; Brief Report; Collaboration; Cost analysis; Electronic health records; Emergency medical care; Emergency Service, Hospital; Humans; Mass Screening; Mental disorders; Mental health; Pandemics; Pediatrics; Suicidal Ideation; Suicide Prevention; Suicide, Attempted - prevention & control; Suicides & suicide attempts; Teenagers; Wages & salaries; Workforce planning; United States > US; adolescent; screening; cost analysis; emergency department; universal screening; suicide
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph20196843

Suicide is the second leading cause of death among adolescents. As nearly 20% of adolescents visit emergency departments (EDs) each year, EDs have an opportunity to identify previously unrecognized suicide risk. A novel Computerized Adaptive Screen for Suicidal Youth (CASSY) was shown in a multisite study to be predictive for suicide attempts within 3 months. This study uses site-specific data to estimate the cost of CASSY implementation with adolescents in general EDs. When used universally with all adolescents who are present and able to participate in the screening, the average cost was USD 5.77 per adolescent. For adolescents presenting with non-behavioral complaints, the average cost was USD 2.60 per adolescent. Costs were driven primarily by time and personnel required for the further evaluation of suicide risk for those screening positive. Thus, universal screening using the CASSY, at very low costs relative to the cost of an ED visit, can facilitate services needed for at-risk adolescents.