The mental health crisis among our pediatric patients has been exacerbated by the COVID-19 pandemic. Now more than ever, children, adolescents, and their families need access to mental health care and resources.
Since the start of the pandemic, pediatricians at Weill Cornell Medicine and NewYork-Presbyterian Hospital have witnessed increased rates of suicidality in their patients, in an addition to increased depression, eating problems, and anxiety. As a result, more youth are being admitted to the emergency room for inpatient mental health care.
The need for pediatricians to assist in identifying children at risk for suicide and addressing their mental health has become more evident to physicians like Cori M. Green, M.D., M.Sc., Director of Behavioral Health Education and Integration in Pediatrics and associate professor of clinical pediatrics at Weill Cornell Medicine. "It's time for pediatric clinicians to partner with mental health specialists and assume some responsibility for addressing mental health to meet the needs of children," says Dr. Green, who has been working for over a decade to bring mental health issues and the lack of access to care to the forefront of pediatric issues. In 2020, she teamed up with Janet C. Chen, M.D., a Child and Adolescent Psychiatrist and previous Chief of Outpatient Child and Adolescent Psychiatry Ambulatory Services at NewYork-Presbyterian Hospital, to write a grant to join a collaborative on implementing the Zero Suicide framework. As part of the grant, Alexandra Huttle, M.D., a Chief Resident at NewYork-Presbyterian/Weill Cornell Medical Center, created and pilot tested an evidence-based curriculum for pediatric trainees on suicide prevention and management as her resident research project.
The suicide prevention and management training is designed to educate future pediatricians on how to identify children at risk of suicide and increase their confidence in addressing their patients' mental and emotional health needs. "As we continue to implement this curriculum, we hope to empower pediatric trainees to prevent and manage youth at risk for suicide," says Dr. Huttle.
Drs. Green and Huttle share details of their study, its purpose, and findings thus far:
"We are increasingly seeing youth who are at risk for suicide. Prior to the pandemic. suicide became the second leading cause of death starting at age 10. Once the pandemic hit rates increased even further and in younger children. Caring for a young child with suicidal thoughts or behaviors can be paralyzing without the training, experience, and resources needed to respond appropriately. We conducted a pilot study to assess an evidence-based curriculum for pediatric trainees focused on suicide prevention and management. The formal suicide training included a didactic session followed by a virtual standardized patient simulation, allowing for direct application of the instructed principles. Baseline data demonstrated that pediatric trainees perceived identification of youth at risk for suicide to be of high importance but did not feel confident in their skills. After pilot testing the curriculum with residents, they reported improved overall preparedness in caring for youth at risk for suicide. Furthermore, pediatric trainees endorsed improved self-efficacy in identifying suicidal thoughts, stratifying suicide risk, and developing a safety plan."