by Christine Yu Moutier, MD: For Complete Post, Click Here…
We can all play a role in identifying at-risk kids.
With increasing rates of suicide and mental health issues among U.S. youth, and with suicide as the second leading cause of death among people ages 10 to 34, the state of youth mental health has reached crisis proportions. For this reason, I’m gravely concerned about the impact of the recent draft recommendations of the U.S. Preventive Services Task Force (USPSTF) that found insufficient evidence for implementing screening for suicide risk among youth.
The USPSTF’s methodology may be mismatched with the real-world implementation science and the scope of the problem concerning youth suicide. Clinicians and mental health professionals must have a clear understanding of the USPSTF’s guidelines for reviewing evidence and arriving at a recommendation, as their approach is out of touch with recent expert recommendations on screening for youth suicide risk. The USPSTF findings may cast doubt among healthcare providers on the importance of suicide screening and preventive care.
In collaboration with our partner organization on the Blueprint for Youth Suicide Prevention, the American Academy of Pediatrics, and experts from the National Institute of Mental Health, we have identified three key weaknesses of the USPSTF draft report.
Suicide Screening Can Be Done Safely
The USPSTF calls for screening asymptomatic adolescents ages 12 to 18 years for major depressive disorder, and youth between the ages of 8 and 18 for anxiety, saying there would be a moderate benefit to each. We support this recommendation and believe the benefits would be more than moderate. On suicide risk, the USPSTF concluded there is insufficient evidence to weigh the benefits and harms of screening asymptomatic children and adolescents. However, in regards to the suicide risk, the report excluded or overlooked a number of key research studies that find universal suicide screening in pediatric medical settings validated with high sensitivity (97%) and specificity (91%), and demonstrate feasibility, accessibility by youth, parents, and clinicians, and importantly, demonstrate no evidence of harm.