Using the suicide risk screen to identify suicidal adolescents among potential high school dropouts.

OBJECTIVE To examine the validity of the Suicide Risk Screen (SRS) for identifying suicide-risk youths among potential high school dropouts. METHOD Five hundred eighty-one potential dropouts, aged 14 to 20 years, participated in a 3-stage case identification protocol. A potential dropout pool was created in 7 schools; students, randomly selected, completed a questionnaire containing the SRS and participated in an assessment interview. Validity measures included Reynolds' Suicide Ideation Questionnaire (SIQ-JR) and 2 clinician rating scales, the Direct Suicide Risk (DSR) and Clinical Risk Assessment (CRA). RESULTS Suicide-risk severity was significantly associated with categorization defined by the SRS criteria. SRS sensitivity ranged from 87% to 100%, specificity from 54% to 60%. Of 7 SRS elements, depression, suicidal ideation, and suicide threats predicted all validity measures. Suicide attempts predicted the DSR and CRA, but not Reynolds' SIQ-JR. Drug involvement, though relatively weaker, consistently predicted all validity measures. No additional psychosocial indicators improved the prediction of SIQ-JR or the DSR. Family support, likelihood of dropout, and risky behaviors, however, were additional predictors of the CRA ratings. CONCLUSIONS The SRS is an effective and pragmatic method for identifying suicide-risk youths among potential dropouts in school settings.

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