{"doi":"10.1016/j.jpeds.2022.07.036","title":"Adolescent Suicide Risk Screening: A Secondary Analysis of the SHIELD Randomized Clinical Trial","abstract":"OBJECTIVE: To evaluate the effectiveness of adolescent suicide risk screening to increase initiation of mental health services via a secondary analysis using data from the SHIELD (Screening in High Schools to Identify, Evaluate and Lower Depression) randomized clinical trial, which evaluated school-based screening for major depressive disorder (MDD). STUDY DESIGN: Students in 14 Pennsylvania high schools were randomized by grade to either the usual school practice of targeted referral for behavior raising a concern for suicide risk or universal screening using the Patient Health Questionnaire-9 (PHQ-9), with any response >0 to item 9 regarding suicide risk considered positive. Students identified in either arm were referred to the Student Assistance Program (SAP), which is mandated in all Pennsylvania schools. The SAP determined follow-up. Study groups were compared using mixed-effects logistic regression. RESULTS: The participants comprised 12 909 students, with 6473 (50.1%) randomized to universal screening. The study group was 46% female and 43% Hispanic or non-Hispanic Black. Adolescents in the universal screening arm had 7.1-fold greater odds (95% CI, 5.7-8.8) of being identified as at risk for suicide, 7.8-fold greater odds (95% CI, 4.6-13.1) of follow-up needs, and 4.0-fold greater odds (95% CI, 2.0-7.9) of initiating mental health treatment. CONCLUSIONS: Although the PHQ-9 is a MDD screening tool, its use in universal screening increased identification and treatment initiation for adolescents at risk for suicide. This confirms the value of universal screening and suggests that a suicide-specific risk assessment would have even greater impact on treatment initiation for identified youth. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03716869.","journal":"The Journal of Pediatrics","year":2022,"id":269735,"datarank":0.5308974825010169,"base_score":2.772588722239781,"endowment":2.772588722239781,"self_citation_contribution":0.41588830833596724,"citation_network_contribution":0.11500917416504965,"self_endowment_contribution":0.41588830833596724,"citer_contribution":0.11500917416504965,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":15,"citers_with_citation_signal":6,"citers_with_endowment":6,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.791,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03716869"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":584862,"name":"Erich K. Batra","orcid":"0000-0003-1168-2038","position":1,"is_corresponding":false},{"id":422084,"name":"Élise Schaefer","orcid":"0000-0003-1004-6814","position":2,"is_corresponding":false},{"id":656009,"name":"Leslie R. Walker-Harding","orcid":null,"position":3,"is_corresponding":false},{"id":655015,"name":"Krista L. Pattison","orcid":"0000-0003-0537-3570","position":4,"is_corresponding":false},{"id":655016,"name":"Alissa Molinari","orcid":"0000-0002-7912-7359","position":5,"is_corresponding":false},{"id":656010,"name":"Perri Rosen","orcid":null,"position":6,"is_corresponding":false},{"id":302113,"name":"Jennifer L. Kraschnewski","orcid":"0000-0003-0998-1346","position":7,"is_corresponding":false},{"id":426121,"name":"James G. Waxmonsky","orcid":"0000-0002-5563-3417","position":8,"is_corresponding":false},{"id":655014,"name":"Deepa L. Sekhar","orcid":"0000-0002-5784-7216","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-19T00:27:22.602796Z","pmid":"35944722","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}