Abstract
OBJECTIVES: While suicide is the second leading cause of death among 10- to 14-year-old children, information regarding the factors associated with suicide-related behaviors is scarce-especially for children under the age of 12. We aimed to examine characteristics associated with suicidal ideation, as compared with other behavioral health concerns, in elementary school-aged children seeking emergency medical care. METHODS: We conducted a retrospective analysis of all 5- to 11-year-old children seen in a pediatric emergency department for a behavioral health concern during a 1-year period. Data on patient demographics, medical history, and behavioral health history were abstracted from the electronic medical record. Multivariate logistic regression was used to determine the associations between demographic and behavioral health characteristics and suicidal ideation. RESULTS: Of the 393 children in the study sample, 56.7% were seen for suicidal ideation, and 43.3% were seen for other behavioral health concerns. Both groups had similar demographic characteristics and were mostly male, White, non-Hispanic, and covered by public health insurance. Patients seen for suicidal ideation were more likely to have depression (adjusted odds ratio (aOR)=2.88, 95% CI: 1.54-5.40), a family history of psychiatric disorders (aOR=2.03, 95% CI: 1.27-3.25), experienced bullying (aOR=2.82, 95% CI: 1.48-5.39), been a victim of abuse (aOR=2.01, 95% CI: 1.10-3.64), and be of older age (aOR=1.33, 95% CI: 1.17-1.52) than patients seen for other behavioral health concerns. CONCLUSIONS: Most elementary school-aged children presenting to the emergency department for behavioral health concerns were seen for suicidal ideation. Similar to studies among adolescents, depression, psychiatric family history, bullying, abuse, and age were associated with suicidal ideation among younger children. An important future direction will be to replicate these findings in other geographic locations where children seek emergency medical care for behavioral health conditions and to find ways to address the growing mental health needs of children before they resort to emergency care.