Coping with suicidal urges among youth seen in a psychiatric emergency department. (30th July 2016)

• Record Type: Journal Article
• Authors: Czyz, Ewa K.; Horwitz, Adam G.; Arango, Alejandra; Cole-Lewis, Yasmin; Berona, Johnny; King, Cheryl A.
• Is Part Of: Psychiatry research. Volume 241(2016)
• Page Start: 175
• Page End: 181
• Publication Date: 2016-07-30
• Subjects: Suicide attempt -- Youth -- Coping -- Self-efficacy -- Safety planning -- Emergency department; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2016.04.118
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: This study of youth seeking psychiatric emergency department (ED) services examined (1) youth self-efficacy to use suicide-specific coping strategies, (2) whether these self-efficacy beliefs varied by demographic and clinical characteristics, (3) and associations of these beliefs with suicide attempts and ED visits 3–5 months later. Participants were 286 psychiatric ED patients (59% Female), ages 13–25. Ratings of self-efficacy to engage in 10 suicide-specific coping behaviors were assessed at index visit. A total of 226 participants (79%) were assessed 3–5 months later. Youth endorsed low-to-moderate self-efficacy for different suicide-specific coping behaviors, with lowest ratings endorsed for limiting access to lethal means and accessing professional resources. More severe baseline psychopathology was associated with lower self-efficacy. Males endorsed higher self-efficacy for coping behaviors not requiring external support. Lower coping self-efficacy for some of the key strategies, and lower confidence that these strategies will be helpful, differentiated those with and without follow-up suicide attempts and ED visits. The generally low-to-moderate confidence in youths' ability to engage in coping behaviors to manage suicidal crises, and its association with follow-up suicidal crises, is concerning because many of these strategies are commonly included as part of discharge recommendations or safety planning. Implications of findings are discussed. Highlights: Youth seen in psychiatric emergency department at risk for suicide-related events. Suicide-specific coping strategies are often part of discharge or safety planning. Youth reported low confidence in their ability to use these coping strategies. Lower confidence was associated with follow-up suicide attempts and return visits. Attention needed to youths' confidence in ability to use recommended strategies.