{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:17:04Z","timestamp":1789031824962,"version":"build-2803163510"},"reference-count":78,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Suicide rates have increased in recent years to the third leading cause of death among youths. Children presenting to the emergency department (ED) for suicide thoughts and behaviors (STB) are at high risk for recurrent mental health (MH) concerns.<\/jats:p><\/jats:sec>Objective<\/jats:title>To quantify rates of STB among children presenting to EDs across the US and to identify risk factors for return ED visits for STB.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study examined electronic health records of children who presented to the ED from January 2010 to December 2020 using the State Emergency Department Database within the Healthcare Cost and Utilization Project. All ED visits were screened among children aged 8 to 12 years in 12 states with data linking patients across visits. International Classification of Disease<\/jats:italic> (ICD<\/jats:italic>) codes separated non-STB MH and STB-related visits. Data were analyzed from August 2024 to January 2025.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Analyses examined characteristics of visits for MH vs STB and patients returned for subsequent ED visit(s) for STB. Analyses compared visits for MH vs. STB and examined factors related to subsequent ED return visit(s) for STB. This included sociodemographic, clinical, and temporal factors derived from electronic health records.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 10\u202f131\u202f432 ED visits were screened, and 627\u202f517 visits (6%) among 374\u202f118 unique patients implicated ICD<\/jats:italic> codes for non-STB MH causes (534\u202f654 visits [5%]; mean [SD] age, 10.25 [1.41] years; 189\u202f701 female [35%]) or STB (92\u202f863 visits [1%]; mean [SD] age, 10.87 [1.27] years; 50\u202f679 female [55%]). MH and STB visits increased from 36\u202f623 ED visits (5%) in 2010 to 22\u202f443 ED visits (10%) in 2020. Compared with non-STB MH visits, patients with STB were more likely to have private insurance and reside in areas with higher income and less deprivation (via linkage to social deprivation index). There was an age-by-sex interaction (z<\/jats:italic>\u2009=\u200948.22; P<\/jats:italic>\u2009&amp;lt;\u2009.001); a greater percentage of STB patients were female at older ages vs younger ages. Suicide behaviors mostly implicated injury by ingestion (7121 [43%]) or sharp or blunt object (6518 [39%]). Additionally, 68\u202f897 patients had multiple ED visits (18%), 6537 with multiple STB visits (10%); 117\u202f377 of 187\u202f864 return ED visits were within 3 months (62%). STB was strongly associated with ED return for STB (aOR, 9.71 [99% CI, 9.66-9.76]; z<\/jats:italic>\u2009=\u2009127.93). Return STB visits within 1-year were more common for females and patients with more MH comorbidity, longer initial visits, and without private insurance.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Suicide risk is common but remains understudied among children. Early suicide risk was associated with recurrent STB, particularly in the months following ED discharge. Understanding risk and protective factors among children can enhance ED screening, intervention, and follow-up care.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.22591","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T15:00:34Z","timestamp":1753196434000},"page":"e2522591","source":"Crossref","is-referenced-by-count":11,"title":["Childhood Suicide Risk in the Emergency Department"],"prefix":"10.1001","volume":"8","author":[{"given":"David","family":"Pagliaccio","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Columbia University, New York, New York"},{"name":"Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn S.","family":"Kirshenbaum","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine M.","family":"Keyes","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy P.","family":"Auerbach","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Columbia University, New York, New York"},{"name":"Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"issue":"6","key":"zoi250661r1","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1001\/jamapediatrics.2019.0464","article-title":"Suicidal attempts and ideation among children and adolescents in US emergency departments, 2007-2015.","volume":"173","author":"Burstein","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"3","key":"zoi250661r3","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1176\/appi.ps.202100608","article-title":"Racial differences in emergency department visit characteristics and management of preadolescents at risk of suicide.","volume":"74","author":"Vidal","year":"2023","journal-title":"Psychiatr Serv"},{"issue":"5","key":"zoi250661r4","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/j.jaac.2021.08.021","article-title":"Black youth suicide: investigation of current trends and precipitating circumstances.","volume":"61","author":"Sheftall","year":"2022","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"7","key":"zoi250661r5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.15683","article-title":"Characteristics and precipitating circumstances of suicide among children aged 5 to 11 years in the United States, 2013-2017.","volume":"4","author":"Ruch","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"7","key":"zoi250661r6","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1001\/jamapsychiatry.2022.1256","article-title":"Prevalence and correlates of suicide and nonsuicidal self-injury in children: a systematic review and meta-analysis.","volume":"79","author":"Liu","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"7","key":"zoi250661r7","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.24664","article-title":"Suicide in US preteens aged 8 to 12 years, 2001 to 2022.","volume":"7","author":"Ruch","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi250661r8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.55986","article-title":"Prediction of suicide attempts and suicide-related events among adolescents seen in emergency departments.","volume":"6","author":"Brent","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"1","key":"zoi250661r9","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1037\/0022-006X.76.1.92","article-title":"Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization.","volume":"76","author":"Prinstein","year":"2008","journal-title":"J Consult Clin Psychol"},{"issue":"2","key":"zoi250661r10","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1207\/S15374424JCCP3202_14","article-title":"Predictors of continued suicidal behavior in adolescents following a suicide attempt.","volume":"32","author":"Spirito","year":"2003","journal-title":"J Clin Child Adolesc Psychol"},{"issue":"3","key":"zoi250661r11","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1037\/h0079362","article-title":"Adolescent suicide attempts: outcomes at follow-up.","volume":"62","author":"Spirito","year":"1992","journal-title":"Am J Orthopsychiatry"},{"issue":"3","key":"zoi250661r13","first-page":"143","article-title":"The healthcare cost and utilization project: an overview.","volume":"5","author":"Steiner","year":"2002","journal-title":"Eff Clin Pract"},{"issue":"5","key":"zoi250661r14","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.annemergmed.2014.09.014","article-title":"Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.","volume":"64","author":"Mutter","year":"2014","journal-title":"Ann Emerg Med"},{"key":"zoi250661r15","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.jpeds.2018.10.017","article-title":"Child and adolescent suicidal ideation and suicide attempts: evidence from the healthcare cost and utilization project.","volume":"206","author":"Carbone","year":"2019","journal-title":"J Pediatr"},{"issue":"4","key":"zoi250661r16","doi-asserted-by":"publisher","first-page":"e1213","DOI":"10.1097\/PEC.0000000000002553","article-title":"Sources of medications used by children and adolescents for intentional ingestion: a retrospective chart review.","volume":"38","author":"Larson","year":"2022","journal-title":"Pediatr Emerg Care"},{"issue":"12","key":"zoi250661r17","doi-asserted-by":"publisher","first-page":"885","DOI":"10.7326\/M19-1324","article-title":"Suicide case-fatality rates in the United States, 2007 to 2014: a nationwide population-based study.","volume":"171","author":"Conner","year":"2019","journal-title":"Ann Intern Med"},{"issue":"11","key":"zoi250661r18","doi-asserted-by":"publisher","first-page":"743","DOI":"10.12788\/jhm.3070","article-title":"Readmissions after pediatric hospitalization for suicide ideation and suicide attempt.","volume":"13","author":"Doupnik","year":"2018","journal-title":"J Hosp Med"},{"issue":"10","key":"zoi250661r21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885","article-title":"The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement.","volume":"12","author":"Benchimol","year":"2015","journal-title":"PLoS Med"},{"issue":"2 Pt 1","key":"zoi250661r24","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1111\/j.1475-6773.2012.01449.x","article-title":"Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery.","volume":"48","author":"Butler","year":"2013","journal-title":"Health Serv Res"},{"issue":"26","key":"zoi250661r25","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1056\/NEJMp1802313","article-title":"Making neighborhood-disadvantage metrics accessible\u2014the neighborhood atlas.","volume":"378","author":"Kind","year":"2018","journal-title":"N Engl J Med"},{"issue":"4","key":"zoi250661r27","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.acap.2021.12.015","article-title":"The association of the Childhood Opportunity Index on pediatric readmissions and emergency department revisits.","volume":"22","author":"Bettenhausen","year":"2022","journal-title":"Acad Pediatr"},{"issue":"4","key":"zoi250661r28","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1016\/j.cpr.2014.03.005","article-title":"Correlates of suicide attempts among self-injurers: a meta-analysis.","volume":"34","author":"Victor","year":"2014","journal-title":"Clin Psychol Rev"},{"issue":"1","key":"zoi250661r29","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1037\/0022-006X.76.1.84","article-title":"Sleep disturbance preceding completed suicide in adolescents.","volume":"76","author":"Goldstein","year":"2008","journal-title":"J Consult Clin Psychol"},{"issue":"3-4","key":"zoi250661r30","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1080\/09540261.2022.2053070","article-title":"Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis.","volume":"34","author":"Marchi","year":"2022","journal-title":"Int Rev Psychiatry"},{"issue":"4","key":"zoi250661r31","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1089\/lgbt.2021.0106","article-title":"Minority stress and suicidal ideation and suicide attempts among LGBT adolescents and young adults: a meta-analysis.","volume":"9","author":"de Lange","year":"2022","journal-title":"LGBT Health"},{"key":"zoi250661r32","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.annepidem.2021.04.015","article-title":"Childhood adversity, suicidality, and nonsuicidal self-injury among children and adolescents admitted to emergency departments.","volume":"60","author":"Carbone","year":"2021","journal-title":"Ann Epidemiol"},{"key":"zoi250661r33","doi-asserted-by":"publisher","DOI":"10.1177\/24705470241268483","article-title":"Substance use disorder and suicidal ideation in rural Maryland.","author":"Ahuja","journal-title":"Chronic Stress (Thousand Oaks)"},{"issue":"43","key":"zoi250661r35","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.21105\/joss.01686","article-title":"Welcome to the tidyverse.","volume":"4","author":"Wickham","year":"2019","journal-title":"J Open Source Softw"},{"issue":"5","key":"zoi250661r37","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1093\/humupd\/dmac013","article-title":"Prenatal and postnatal exposures to endocrine disrupting chemicals and timing of pubertal onset in girls and boys: a systematic review and meta-analysis.","volume":"28","author":"Uldbjerg","year":"2022","journal-title":"Hum Reprod Update"},{"issue":"1","key":"zoi250661r38","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1038\/s41398-024-02914-y","article-title":"Why do adolescents attempt suicide? insights from leading ideation-to-action suicide theories: a systematic review.","volume":"14","author":"Kirshenbaum","year":"2024","journal-title":"Transl Psychiatry"},{"issue":"1","key":"zoi250661r39","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1038\/s41380-021-01171-5","article-title":"Psychobiological risk factors for suicidal thoughts and behaviors in adolescence: a consideration of the role of puberty.","volume":"27","author":"Ho","year":"2022","journal-title":"Mol Psychiatry"},{"key":"zoi250661r40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2024.10.016","article-title":"Early pubertal timing, suicidality, and self-injurious behaviors in preadolescents: evidence for concurrent and emergent risk prediction.","author":"Luking","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"5","key":"zoi250661r41","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1016\/j.cpr.2007.02.001","article-title":"Sex differences in child-onset, life-course-persistent conduct disorder: a review of biological influences.","volume":"27","author":"Eme","year":"2007","journal-title":"Clin Psychol Rev"},{"issue":"1","key":"zoi250661r42","doi-asserted-by":"publisher","DOI":"10.1111\/desc.12721","article-title":"Sex differences in ADHD trajectories across childhood and adolescence.","volume":"22","author":"Murray","year":"2019","journal-title":"Dev Sci"},{"issue":"4","key":"zoi250661r43","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-2192","article-title":"Trends in psychiatric emergency department visits among youth and young adults in the US.","volume":"143","author":"Kalb","year":"2019","journal-title":"Pediatrics"},{"issue":"10","key":"zoi250661r44","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.36049","article-title":"Temporal trends in suicide methods among adolescents in the US.","volume":"5","author":"Joseph","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"102997","key":"zoi250661r46","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2023.102997","article-title":"Measuring disadvantage: a systematic comparison of United States small-area disadvantage indices.","volume":"80","author":"Lou","year":"2023","journal-title":"Health Place"},{"issue":"4","key":"zoi250661r47","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-056098","article-title":"Neighborhood child opportunity and emergency department utilization.","volume":"150","author":"Kaiser","year":"2022","journal-title":"Pediatrics"},{"issue":"2","key":"zoi250661r48","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-032755","article-title":"The Child Opportunity Index 2.0 and hospitalizations for ambulatory care sensitive conditions.","volume":"148","author":"Krager","year":"2021","journal-title":"Pediatrics"},{"issue":"2","key":"zoi250661r49","doi-asserted-by":"publisher","DOI":"10.20900\/jpbs.20200006","article-title":"Racial disparities in pediatric psychiatric emergencies: a health systems approach.","volume":"5","author":"Das","year":"2020","journal-title":"J Psychiatr Brain Sci"},{"issue":"12","key":"zoi250661r50","doi-asserted-by":"publisher","first-page":"1336","DOI":"10.1111\/acem.13812","article-title":"Psychiatric-related revisits to the emergency department following rapid expansion of community mental health services.","volume":"26","author":"Singh","year":"2019","journal-title":"Acad Emerg Med"},{"issue":"6","key":"zoi250661r51","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-2426","article-title":"Hospitalization for suicide ideation or attempt: 2008-2015.","volume":"141","author":"Plemmons","year":"2018","journal-title":"Pediatrics"},{"issue":"7","key":"zoi250661r52","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.24183","article-title":"Trends and seasonality of emergency department visits and hospitalizations for suicidality among children and adolescents in the US from 2016 to 2021.","volume":"6","author":"Kim","year":"2023","journal-title":"JAMA Netw Open"},{"key":"zoi250661r53","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.jad.2016.02.036","article-title":"Do suicide attempts occur more frequently in the spring too? a systematic review and rhythmic analysis.","volume":"196","author":"Coimbra","year":"2016","journal-title":"J Affect Disord"},{"issue":"2","key":"zoi250661r54","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/j.1600-0447.2011.01750.x","article-title":"Suicide and seasonality.","volume":"125","author":"Christodoulou","year":"2012","journal-title":"Acta Psychiatr Scand"},{"issue":"10","key":"zoi250661r55","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.10830","article-title":"Seasonal trends in hospitalization of attempted suicide and self-inflicted injury in United States adults.","volume":"12","author":"Oladunjoye","year":"2020","journal-title":"Cureus"},{"issue":"19","key":"zoi250661r56","doi-asserted-by":"publisher","first-page":"656","DOI":"10.15585\/mmwr.mm7119e1","article-title":"Vital signs: Changes in firearm homicide and suicide rates\u2014United States, 2019-2020.","volume":"71","author":"Kegler","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"zoi250661r57","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.jad.2021.12.054","article-title":"The lethality of suicide methods: a systematic review and meta-analysis.","volume":"300","author":"Cai","year":"2022","journal-title":"J Affect Disord"},{"issue":"3","key":"zoi250661r58","doi-asserted-by":"publisher","first-page":"S23","DOI":"10.1097\/TA.0000000000000320","article-title":"Restricting youth suicide: behavioral health patients in an urban pediatric emergency department.","volume":"77","author":"Rogers","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"issue":"3","key":"zoi250661r59","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1007\/s10900-022-01077-5","article-title":"Motivating behavior change in parents for suicide prevention in the Midwest, USA.","volume":"47","author":"Sullivant","year":"2022","journal-title":"J Community Health"},{"issue":"1","key":"zoi250661r60","doi-asserted-by":"publisher","DOI":"10.1093\/jamiaopen\/ooab011","article-title":"Natural language processing and machine learning of electronic health records for prediction of first-time suicide attempts.","volume":"4","author":"Tsui","year":"2021","journal-title":"JAMIA Open"},{"issue":"1","key":"zoi250661r61","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1038\/s41398-020-01100-0","article-title":"Machine learning for suicide risk prediction in children and adolescents with electronic health records.","volume":"10","author":"Su","year":"2020","journal-title":"Transl Psychiatry"},{"issue":"1","key":"zoi250661r62","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.annemergmed.2004.06.023","article-title":"Does lack of a usual source of care or health insurance increase the likelihood of an emergency department visit? results of a national population-based study.","volume":"45","author":"Weber","year":"2005","journal-title":"Ann Emerg Med"},{"key":"zoi250661r63","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/842847","article-title":"The impact of insurance and a usual source of care on emergency department use in the United States.","volume":"2014","author":"Liaw","year":"2014","journal-title":"Int J Family Med"},{"issue":"4","key":"zoi250661r64","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1007\/s11606-013-2734-4","article-title":"National study of health insurance type and reasons for emergency department use.","volume":"29","author":"Capp","year":"2014","journal-title":"J Gen Intern Med"},{"issue":"2","key":"zoi250661r65","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1097\/01.mlr.0000108747.51198.41","article-title":"Characteristics of occasional and frequent emergency department users: do insurance coverage and access to care matter?","volume":"42","author":"Zuckerman","year":"2004","journal-title":"Med Care"},{"issue":"7","key":"zoi250661r66","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1111\/j.1469-7610.2005.01543.x","article-title":"Annotation: pathways to care for children with mental health problems.","volume":"47","author":"Sayal","year":"2006","journal-title":"J Child Psychol Psychiatry"},{"issue":"3","key":"zoi250661r67","first-page":"182","article-title":"Engaging families into child mental health treatment: updates and special considerations.","volume":"19","author":"Gopalan","year":"2010","journal-title":"J Can Acad Child Adolesc Psychiatry"},{"issue":"6","key":"zoi250661r68","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1007\/s00787-016-0930-6","article-title":"What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? a systematic review of qualitative and quantitative studies.","volume":"26","author":"Reardon","year":"2017","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"zoi250661r69","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.childyouth.2017.04.017","article-title":"A scoping literature review of service-level barriers for access and engagement with mental health services for children and young people.","volume":"77","author":"Anderson","year":"2017","journal-title":"Child Youth Serv Rev"},{"issue":"1","key":"zoi250661r70","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.44373","article-title":"Prediction of suicide attempts using clinician assessment, patient self-report, and electronic health records.","volume":"5","author":"Nock","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"S1","key":"zoi250661r71","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1002\/pds.2335","article-title":"A systematic review of validated methods for identifying suicide or suicidal ideation using administrative or claims data.","volume":"21","author":"Walkup","year":"2012","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"5","key":"zoi250661r72","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.1093\/ije\/dyz038","article-title":"A systematic review of validated suicide outcome classification in observational studies.","volume":"48","author":"Swain","year":"2019","journal-title":"Int J Epidemiol"},{"issue":"5","key":"zoi250661r73","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1027\/0227-5910\/a000071","article-title":"Counting suicides and making suicide count as a public health problem.","volume":"31","author":"Rockett","year":"2010","journal-title":"Crisis"},{"issue":"12","key":"zoi250661r74","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1093\/jamia\/ocac144","article-title":"Accuracy of ICD-10-CM encounter diagnoses from health records for identifying self-harm events.","volume":"29","author":"Simon","year":"2022","journal-title":"J Am Med Inform Assoc"},{"issue":"3","key":"zoi250661r75","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1559","article-title":"Emergency department and inpatient coding for self-harm and suicide attempts: validation using clinician assessment data.","volume":"26","author":"Randall","year":"2017","journal-title":"Int J Methods Psychiatr Res"},{"key":"zoi250661r76","doi-asserted-by":"publisher","DOI":"10.2196\/46364","article-title":"Determining distinct suicide attempts from recurrent electronic health record codes: classification study.","volume":"8","author":"Bentley","year":"2024","journal-title":"JMIR Form Res"},{"issue":"7","key":"zoi250661r77","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1097\/PEC.0000000000002753","article-title":"Evaluating provider documentation of suicide risk factors among youth screening positive for suicide risk in a pediatric emergency department.","volume":"38","author":"Cafferty","year":"2022","journal-title":"Pediatr Emerg Care"},{"issue":"2","key":"zoi250661r78","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s11121-016-0717-5","article-title":"Identification of at-risk youth by suicide screening in a pediatric emergency department.","volume":"18","author":"Ballard","year":"2017","journal-title":"Prev Sci"},{"key":"zoi250661r2","unstructured":"Curtin? SC, Warner? M, Hedegaard? H. Suicide rates for females and males by race and ethnicity: United States, 1999 and 2014. Accessed June 13, 2025. https:\/\/www.cdc.gov\/nchs\/data\/hestat\/suicide\/rates_1999_2014.htm"},{"key":"zoi250661r12","unstructured":"Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality, Rockville. HCUP State Emergency Department Databases (SEDD). Accessed June 13, 2025. http:\/\/www.hcup-us.ahrq.gov\/seddoverview.jsp"},{"key":"zoi250661r19","unstructured":"Redivis. Redivis. Accessed June 20, 2025. https:\/\/redivis.com\/"},{"key":"zoi250661r20","unstructured":"User guide: HCUP supplemental variables for revisit analyses. Healthcare Cost and Utilization Project. Accessed June 20, 2025. https:\/\/hcup-us.ahrq.gov\/toolssoftware\/revisit\/revisit.jsp"},{"key":"zoi250661r22","unstructured":"Healthcare Cost and Utilization Project. Suicidal ideation, suicide attempt, or self-inflicted harm: pediatric emergency department visits, 2010\u20132014 and 2016. Agency for Healthcare Research and Quality. Accessed June 13, 2025. http:\/\/www.hcup-us.ahrq.gov\/reports\/ataglance\/findingsataglance.jsp"},{"key":"zoi250661r23","unstructured":"Social deprivation index (SDI). policy studies in family medicine and primary care. Robert Graham Center. Accessed October 30, 2024. https:\/\/www.graham-center.org\/maps-data-tools\/social-deprivation-index.html"},{"key":"zoi250661r26","unstructured":"Child opportunity index 2.0 zip. diversitydatakids.org. Accessed October 30, 2024. https:\/\/data.diversitydatakids.org\/dataset\/coi20_zipcodes-child-opportunity-index-2-0-zip-code-data?_external=True"},{"key":"zoi250661r34","unstructured":"R Core Team, R. R: a language and environment for statistical computing. Accessed July 1, 2025. http:\/\/www.R-project.org\/"},{"key":"zoi250661r36","unstructured":"Pagliaccio? D. Scipub: summarize data for scientific publication (R package version 1.2.2). Github. Accessed June 13, 2025. https:\/\/dpagliaccio.github.io\/scipub\/"},{"key":"zoi250661r45","unstructured":"Franchi L, Rossi FM, Chorniy A, et al. Comparing area-level socio-economic status indices: predictive power across health outcomes and geographic levels. Accessed July 1, 2025. https:\/\/papers.ssrn.com\/sol3\/papers.cfm?abstract_id=4547382"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2836691\/pagliaccio_2025_oi_250661_1752262277.988.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T15:00:36Z","timestamp":1753196436000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2836691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,22]]},"references-count":78,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.22591","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,22]]}}}