Understanding adolescents’ perspectives on suicide risk screening in primary care: Implications and insights for implementation and practice

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Abstract
Suicide is a pervasive public health concern with risk increasing during adolescence. Universal suicide screening for youth ages 12 years and older has been deemed an important component of suicide prevention. However, little is known about how adolescents feel about screening. This study aimed to better understand how adolescents perceive current suicide risk screening practices in primary care (PC). Purposive sampling identified adolescents with histories of suicidal thoughts or behaviors (STB) who saw a doctor in urban, suburban, or rural pediatric PC clinics at least yearly. Twenty 12–18-year-old adolescents completed semi-structured interviews exploring their views of suicide screening in PC. Interviews were recorded, transcribed, and analyzed using thematic analysis. Themes were compared by geographic setting and described across clinics as a whole. Results were similar across settings and highlight five main themes: (1) asking about STB in PC is important and shows providers care, (2) some adolescents expressed discomfort with the language used in suicide risk screeners and how questions about STB are asked, (3) provider-patient interactions and relationships can either facilitate or hinder STB disclosure, (4) mental health stigma makes disclosing STB feel uncomfortable, and (5) adolescents fear how parents/caregivers will react and potential consequences of disclosing STB (e.g., losing autonomy). Participants overwhelmingly reported that asking adolescents about STB in PC is important. However, several challenges were identified that make it difficult for adolescents to answer questions about STB honestly. Participants suggested several areas for improvement to enhance screening practices and improve adolescent disclosure.
Funding Information
  • National Institute of Mental Health (K23MH134229)

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