091 - Associated Factors for Youth Suicide Risk in a Diverse Psychiatric ED Sample Utilizing the CSSRS

Publication Number: 91.3942

Michelle Zhang, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States; Jane Onoye, University of Hawaii, Honolulu, HI, United States

Background: Youth suicide is acutely presented and assessed in the emergency department (ED). In the US, suicide is the second leading cause of death for children ages 10-14, and third among ages 15-24. In 2019, 10.5% of Hawaii public high school students attempted suicide (vs 8.9% nationally), and 3.2% needed medical treatment for their attempt (vs 2.5% nationally).

Objective: Mental health conditions and substance use are known risk factors for youth suicide; however, Asian-American and Native Hawaiian and Pacific Islander (NHPI) populations are often understudied. To address this gap, our study examined risk factors associated with youth suicide in a large multi-ethnic diverse ED dataset in Hawaii.

Design/Methods: A secondary analysis on a pediatric subset of a psychiatric ED (PED) dataset in Hawaii (2019-2023) was conducted (n=20,591). Age groups were categorized into 4-17 years (24%) and 18-24 (76%). The Columbia-Suicide Severity Rating Scale (CSSRS) screens were classified as low, moderate, or high risk. SPSS® v26 was used to conduct chi-square and regression analyses for demographic and related risk factors for CSSRS level of risk.

Results: Overall, 12.8% of the pediatric PED screened high on the CSSRS. Significant differences for high suicide risk were seen by demographic factors: age group (ages 4-17, 26.5%; ages 18-24, 8.4%); sex (females, 15.6%; males, 9.7%); ethnicity (Japanese [17.7%], Chinese [16.9%], Filipino [14.2%], Vietnamese [13.6%], Black or African American [13.4%], Other Asian [13.4%], White/Caucasian [12.6%], Native Hawaiian [12.4%], Korean [11.5%], Hispanic/Latino [10.7%], Samoan [7.7%], and Other Pacific Islander [9.2%]).

Differences for high suicide risk were significant for depression (positive history: 35.6%; none: 6.2%) and anxiety (positive history: 20.4%; none: 9.5%). For substance use disorders (SUDs), differences were significant for cannabis (positive history: 18.8%; none: 12.0%) and nicotine (positive history: 5.3%; none: 16.3%).

Significant predictors from the logistic regression for likelihood of high suicide risk were found for: history of depression 5.9x, history of anxiety 1.3x; younger age (4-17 year olds, ref: 18-24 years) 2.8x, females 1.2x (ref: male); SUDs alcohol 1.4x, cannabis 1.5x, cocaine 1.4x, other stimulants 1.7x, nicotine 0.6x; ethnicity Japanese 1.3x, Chinese 1.3x, Filipino 1.2x (ref: White).

Conclusion(s): In summary, young age, female sex, Japanese, Chinese, and Filipino ethnicities, as well as depression, anxiety and SUD history were significant predictors for high suicide risk. This highlights the need for targeted interventions to support at-risk youth.