BACKGROUND: The Joint Commission recently revised its National Patient Safety Goal requirements to include standardizing suicide screening. Sutter Health launched system-wide standardized use of the Columbia Suicide Severity Rating Scale (C-SSRS) in acute care facilities in July 2019.

OBJECTIVES: Describe and compare characteristics of adult patients screening positive for suicidal thoughts or behaviors (STB) including those with major depressive disorder (MDD).

METHODS: Electronic health record-based observational cohort study describing and comparing sociodemographic and clinical characteristics of adult patients screening positive for STB (7/1/2019-10/4/2020), including those with MDD. MDD+STB were compared to those with STB without MDD (STB-MDD) and on risk categories (no risk v any risk). Wilcoxon rank-sum tests for continuous variables and χ2 tests for categorical variables were used. Results reported are statistically significant at 0.05.

RESULTS: 410,302/478,143 (85.8%) of adults were screened by C-SSRS, 8,416 (2.05%) had STB, 914 (10.9%) had MDD+STB, 7,502 (89.1%) had STB without MDD. Of those with STB, 3,278 (38.9%) were low risk, 1,314 (15.6%) moderate risk, and 3,824 (45.4%) high risk. Any risk vs no risk: males (46.6% v 42.3%), White (55.5% v 47.9%), mean age 41.6 v 50.3 years, homeless in last 12 months (12.0% v 2.5%), index encounter Psych unit (10.3% v 0.2%), mental health diagnoses (22.2% v 4.9%), MDD (10.9% v 1%). MDD+STB patients vs MDD-STB: mean age 38.8 v 41.9 years, female (58.6% v 52.8%), Asian (9.7% v 6.6%), income $75,000+ (45.5% v 34.0%), index encounters in Psych units (46.5% v 5.9%), substance abuse (12.1% v 3.9%), anxiety (16% v 2.2%) and documented prior suicidal ideation (3.7% v 0.5%).

CONCLUSIONS: Screening for STB identified 2.05% with any STB and 10.9% with MDD+STB. Characteristics differed based on risk and MDD status. Highlighting demographic and clinical differences between these patient groups can guide efforts to provide mental health consultation and referrals.