TY - JOUR
AU - L. M. O'Reilly
AU - D. Meadors
AU - B. R. Marriott
AU - L. Hulvershorn
AU - M. C. Aalsma
A1 - 
AB - BACKGROUND: Nearly 9 out of 10 youth who die by suicide visit health care settings in the year prior to their death. Given the opportunity of primary care to screen for youth suicide risk, past research has focused on understanding provider attitudes toward screening and barriers to screening implementation. However, research has not robustly examined how providers utilize information gathered from screening tools. Therefore, the aim of this qualitative study was to outline existing suicide protocols and characterize attitudes and practices toward youth suicide risk screening and subsequent triage. METHODS: Youth-serving primary care providers and clinic staff working at clinics in one Midwest health network participating in a randomized control trial implementing integrated behavioral health care were contacted via email by a research assistant. Nineteen individuals participated in 30-minute, semi-structured interviews regarding attitudes and practices toward youth suicide risk screening in primary care. Interviews were transcribed and analyzed using consensus deductive and inductive coding. RESULTS: Existing clinic workflow largely pertained to screening administration. Participants discussed the intention to universally screen pediatric patients using the Patient Health Questionnaire (PHQ)-2 for sick visits, which served as gate questions for the PHQ-9. For well child visits, clinics implemented universal PHQ-9 screeners. Participants were largely not aware of standardized processes, including brief suicide risk assessment, use of consultation services, or risk triage decision-making. Interviews described themes of attitudes toward youth suicide screening, primary care protocols, risk triage decision-making, and barriers and facilitators to youth suicide risk screening. Overall, providers and clinic staff expressed overwhelming confidence in administering screens, which was considered within their scope of practice. Confidence, however, wavered when providers discussed their ability and/or comfort determining follow-up steps, providing brief interventions, and connecting youth to behavioral health services. CONCLUSIONS: Results emphasize that without adequate behavioral health assessment and intervention post-screening, primary care providers face significant burden managing suicide risk, which was often felt outside their scope of practice. Developing and adapting intervention models within primary care (e.g., integrated care models) are crucial next steps.
AD - Department of Psychiatry, Indiana University School of Medicine, 410 W 10th Street, Indianapolis, 46202, USA. loreilly@iu.edu.; Department of Pediatrics, Indiana University School of Medicine, 410 W 10th Street, Indianapolis, 46202, USA.; Department of Psychiatry, Indiana University School of Medicine, 410 W 10th Street, Indianapolis, 46202, USA.; Department of Psychiatry, Indiana University School of Medicine, 355 W 16th Street, Indianapolis, 46202, USA.
AN - 41469565
BT - BMC Prim Care
C5 - Healthcare Disparities
CP - 1
DA - Dec 30
DO - 10.1186/s12875-025-03102-7
DP - NLM
ET - 20251230
IS - 1
JF - BMC Prim Care
LA - eng
N2 - BACKGROUND: Nearly 9 out of 10 youth who die by suicide visit health care settings in the year prior to their death. Given the opportunity of primary care to screen for youth suicide risk, past research has focused on understanding provider attitudes toward screening and barriers to screening implementation. However, research has not robustly examined how providers utilize information gathered from screening tools. Therefore, the aim of this qualitative study was to outline existing suicide protocols and characterize attitudes and practices toward youth suicide risk screening and subsequent triage. METHODS: Youth-serving primary care providers and clinic staff working at clinics in one Midwest health network participating in a randomized control trial implementing integrated behavioral health care were contacted via email by a research assistant. Nineteen individuals participated in 30-minute, semi-structured interviews regarding attitudes and practices toward youth suicide risk screening in primary care. Interviews were transcribed and analyzed using consensus deductive and inductive coding. RESULTS: Existing clinic workflow largely pertained to screening administration. Participants discussed the intention to universally screen pediatric patients using the Patient Health Questionnaire (PHQ)-2 for sick visits, which served as gate questions for the PHQ-9. For well child visits, clinics implemented universal PHQ-9 screeners. Participants were largely not aware of standardized processes, including brief suicide risk assessment, use of consultation services, or risk triage decision-making. Interviews described themes of attitudes toward youth suicide screening, primary care protocols, risk triage decision-making, and barriers and facilitators to youth suicide risk screening. Overall, providers and clinic staff expressed overwhelming confidence in administering screens, which was considered within their scope of practice. Confidence, however, wavered when providers discussed their ability and/or comfort determining follow-up steps, providing brief interventions, and connecting youth to behavioral health services. CONCLUSIONS: Results emphasize that without adequate behavioral health assessment and intervention post-screening, primary care providers face significant burden managing suicide risk, which was often felt outside their scope of practice. Developing and adapting intervention models within primary care (e.g., integrated care models) are crucial next steps.
PY - 2025
SN - 2731-4553
SP - 415
ST - Beliefs about and approaches to youth suicide risk screening and triage in primary care: a qualitative analysis
T1 - Beliefs about and approaches to youth suicide risk screening and triage in primary care: a qualitative analysis
T2 - BMC Prim Care
TI - Beliefs about and approaches to youth suicide risk screening and triage in primary care: a qualitative analysis
U1 - Healthcare Disparities
U3 - 10.1186/s12875-025-03102-7
VL - 26
VO - 2731-4553
Y1 - 2025
ER -