American Indian Adolescents in Emergency Departments

A study of White Mountain Apache adolescents who had attempted suicide found that 82 percent had visited an emergency department (ED) within a year before the attempt. Only a minority of these young people had visited the ED because of suicidal thoughts or self-harm (7 percent) or psychiatric problems (26 percent). The authors suggest that American Indian youth who visit EDs should be screened for suicide risk by trained personnel using an instrument validated as effective with this population and age group.

The authors pointed out that EDs are often the primary place in which American Indians living on reservations receive health care and thus represent a strategic opportunity for suicide prevention. The 72 study participants had a lifetime average 18 ED visits prior to their attempts. There was no difference in the rate of ED visits by sex, although four of the five young people visiting the ED because of suicidal thoughts or self-harm were female. Twenty-six percent of the sample had visited an ED for psychiatric problems in the year before the attempt (i.e. psychiatric problems were recorded in ED records as one of the first three presenting concerns). The most common presenting concern was trauma (41 percent).

Ballard, E. D., Tingey, L., Lee, A., Suttle, R., Barlow, A., & Cwik, M. Emergency department utilization among American Indian adolescents who made a suicide attempt: A screening opportunity. Journal of Adolescent Health, 54(3), 357-359.