Identifying the risk of suicide among adolescents admitted to a children's hospital using the Ask Suicide-Screening Questions.

PROBLEM: Suicides are now the second leading cause of death among teenagers and young adults, 10-24. Many people who die by suicide visit a healthcare provider in the months before their death. Unfortunately, many healthcare clinicians do not routinely screen for mental health concerns such as suicide risk even though the American Academy of Pediatrics recommends screening adolescents for suicide risk. METHODS: The Ask Suicide-Screening Questions (aSQ), a four-question screening instrument, was administered by nurses to all patients, 12 years and older, admitted to the general pediatric wards of a tertiary Children's Hospital. Nursing feedback and comfort levels were assessed before and after the 6-week pilot program. FINDINGS: During the 6 weeks, 152 eligible children were admitted to the general pediatric wards and 67 were screened using the ASQ; 3/67 had a nonacute "positive" screen and received a further psychiatric assessment. CONCLUSIONS: This pilot quality improvement initiative showed that suicide screening is feasible and acceptable to patients and families in a general pediatric inpatient setting. However, nurses would benefit from further teaching and training around asking suicide screening questions.

Evidence-based health promotion programs for schools and communities.

Healthy People 2020 includes an objective to increase the proportion of elementary, middle, and senior high schools that provide comprehensive school health education to prevent health problems in the following areas: unintentional injury; violence; suicide; tobacco use and addiction; alcohol or other drug use; unintended pregnancy, HIV/AIDS, and sexually transmitted infections (STI); unhealthy dietary patterns; and inadequate physical activity. These specific goals are part of the efforts of Healthy People 2020 to increase the proportion of elementary, middle, and senior high schools that have health education goals or objectives that address the knowledge and skills articulated in the National Health Education Standards. A focus on Pre-K through 12 health education is a prerequisite for the implementation of a coordinated, seamless approach to health education as advocated by the Healthy People Curriculum Task Force and incorporated into the Education for Health framework. To help accomplish these goals, this article views the role of education as part of the broader socioecologic model of health. A comprehensive literature review was undertaken to identify evidence-based, peer-reviewed programs, strategies, and resources. The results of this review are presented organized as sexual health, mental and emotional health, injury prevention, tobacco and substance abuse, and exercise and healthy eating. Evidence-based implementation strategies, often considered the missing link, are recommended to help achieve the Healthy People 2020 objective of increasing the prevalence of comprehensive school health education programs designed to reduce health risks for children.