Black children brought to an emergency department for behavioral issues appear less likely to report suicidal thoughts than children of other races, suggests a report published today in Psychiatric Services. Additionally, Black children were more likely to be brought to the emergency department by police and to be discharged rather than hospitalized for psychiatric care.
Carol Vidal, M.D., Ph.D., of the Department of Psychiatry and Behavioral Sciences at Johns Hopkins and colleagues analyzed electronic medical record data from 504 patients aged 8 to 12 years visiting a pediatric emergency department (ED) with a psychiatric issue in 2019. This “urban pediatric ED, … located in the Mid-Atlantic region, has an estimated annual census of 35,000 patient visits (60% Black, 21% White, 10% Latino/Latina or Hispanic; approximately 60% had public insurance),” Vidal and colleagues wrote.
The researchers examined youth’s responses to the Ask Suicide-Screening Questions tool (ASQ)—a four-item suicide risk screening instrument completed in the ED. They also compared the youth’s demographic data, mode of arrival to the ED, primary ED clinical impression (for instance, suicidal ideations, oppositional defiant disorder or related problems, or depression and anxiety), and more. A total of 398 youth completed the ASQ; of these, 42% reported wishing they were dead, 32% reported feeling they would be better off dead, and 37% reported thinking of killing themselves in the past week. A previous suicide attempt was reported by 28% of the youth.
When the researchers examined the responses by the race of the youth, they found that there was little difference in the percentage of youth who reported a previous suicide attempt (27% of White youth, 28% of Black youth, and 29% of other/multiracial youth). However, Black youth were less likely to report wishing they were dead (35% vs. 57% in White youth and 50% of other/multiracial youth), feeling that they would be better off dead (27% vs. 38% and 50%), and thinking about killing themselves in the past week (33% vs. 47% and 43%) in the past couple weeks. Further analysis revealed that 35% of Black youth were transported to the ED by police compared with 12% of White youth and 15% of other/multiracial youth.
“[N]on-Black preadolescents were three times as likely as Black children to be admitted to inpatient psychiatric care,” Vidal and colleagues continued. “Although racial differences in admission to inpatient psychiatric care could be related to the lower frequency of self-reported suicidal thoughts among Black preadolescents, other patient, parent, and provider factors likely contribute to this disparity, given that Black preadolescents in our sample who reported thoughts of suicide were still less likely to be hospitalized than were non-Black peers with thoughts of suicide.”
While the authors noted several limitations of the study—including its small sample and focus on a single ED—they wrote that the findings point to the need for more research: “Research to better understand racial disparities in suicide risk among preadolescents can inform prevention efforts.”
For related information, see the Psychiatric News article “Study Investigates Link Between Discrimination, ADHD, Suicide.”
(Image: iStock/MJFelt)
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