Conference Agenda

Introduction: In Denmark, individuals presenting with suicidal behavior without other engagement in mental health services are treated in regional specialized suicide prevention clinics, a model unique to the country. Although suicide among Danish adolescents is rare, particularly 15-19-year-old girls present with the highest suicide attempt rates. This study aims to characterize the clinical, psychological, and social profiles of adolescents referred to a specialized suicide prevention unit and to explore factors associated with heightened risk of future suicide attempts. Methods: The study utilizes data from an ongoing cohort initiated in February 2020, comprising adolescents referred for suicidal behavior within the Child and Adolescent Mental Health Services in the Capital Region of Denmark. Data include self-reported questionnaires (READ, K-10, C-SSRS) and demographic and clinical information extracted from electronic medical records. Planned analyses involve descriptive comparisons between adolescents presenting with suicidal thoughts versus suicide attempts, stratified by gender. Additionally, predictive modelling will examine whether psychological distress and resilience indicators predict subsequent suicide attempts. Results: Data collection will be completed early 2026. Preliminary findings will be available for presentation at the ESSSB21 conference. This study is the first to characterize adolescents treated in Denmark at a specialized suicide‑prevention unit and aims to identify predictors of increased suicidal behavior. Conclusion: This study will provide novel insights into clinical, psychological and social profiles of adolescents receiving specialized suicide prevention treatment in Denmark. Findings are expected to inform targeted interventions and guide clinical decision-making in high-risk youth, contributing to evidence-based strategies for reducing suicidal behavior as recommended in a Danish National Action Plan 2025.

Background:
Rising rates of suicidal ideation and behavior among adolescents have intensified pressure on child and adolescent mental health services, underscoring the need for more accessible and scalable models of care. This study evaluates the feasibility, acceptability, and safety of a stratified stepped-care (SSC) model in which trained bachelor-level psychology graduates deliver early suicide-focused intervention to suicidal youth in real-world outpatient settings.

Methods:
Adolescents aged 7–18 presenting with suicidal thoughts or behaviors to tertiary outpatient services were screened and stratified by risk following structured assessment. Eligible participants were offered Interpersonal Counseling for Suicide Crisis Intervention (IPC-A-SCI), an eight-session intervention focusing on risk assessment, safety planning, coping skills, and emotion regulation, delivered by psychology graduates under close clinical supervision. Feasibility indicators included recruitment, consent, retention, attendance, and protocol adherence; safety events were monitored throughout. Acceptability and perceived impact were assessed via satisfaction questionnaires (CSQ-4), routine outcome ratings (ORS), and qualitative interviews with adolescents, parents, and providers.​

Results:
Of 161 eligible adolescents, 78% consented to participate; 66% completed at least six sessions, while only 4–5% required specialist or hospital referral for safety reasons. Youth and parents reported high satisfaction (mean scores approximately 5.6–5.8/7) and perceived reductions in suicidal risk and distress, alongside improvements in mood, family relationships, and social functioning. Qualitative feedback highlighted enhanced accessibility, emotional support, and timeliness as key strengths of the psychology graduate–delivered model, and no iatrogenic or serious adverse events were reported.

Conclusions:
Findings support the feasibility, acceptability, and safety of an SSC model for suicidal adolescents delivered by bachelor-level psychology graduates, suggesting a promising strategy to expand early suicide prevention capacity and alleviate workforce shortages. This model offers a pragmatic way to enhance access to care for suicidal youth while aligning with contemporary efforts to rethink and redesign suicide prevention systems.​

Introduction

Suicide-related emergency department (ED) encounters among youth have risen in recent years, yet rural-urban differences in nonfatal suicidal thoughts and behaviors (STBs) remain insufficiently understood. Geographic variation in demographic and clinical features of STB encounters may reveal disparities in access to mental health care, crisis response, and severity at presentation, particularly during periods of population-level stress such as the COVID-19 pandemic.

Methods

We conducted a cross-sectional analysis of statewide ED encounters from 2018-2021 using the Kentucky and Arkansas HCUP State Emergency Department Databases for youth ages 6-21. Logistic regression models estimated adjusted odds of STB-related ED encounters overall, ED revisits, and admission or death before and during the COVID-19 period. Models adjusted for demographic and community characteristics and accounted for patient-level clustering to address repeated encounters.

Results

Among 33,104 STB-related encounters, 41% occurred in rural counties. Rural youth were more likely to be White and low-income, while mechanisms of self-harm were similar across settings. STB encounters increased significantly during the COVID-19 period, with the steepest rises among females, particularly in rural areas. Although rural youth were less likely to present to the ED for STBs overall, rural STB encounters had higher odds of admission or death, while same-year revisit likelihood did not differ by rurality.

Conclusions

Youth suicide-related ED encounters increased during the pandemic, with rural female adolescents experiencing disproportionate rises and rural youth presenting with greater severity. Findings highlight critical rural-urban differences in presentation and underscore the ED’s role as a key intervention point for adolescent suicide prevention.

Suicide is the second leading cause of death among youth and young adults aged 15 to 24 in Canada. Emergency departments (EDs) are increasingly the initial point of contact for youth experiencing distress and suicidality. Between 2008 and 2017, mental health–related ED visits among Canadian youth increased by 61%. Although ED visits represent a critical opportunity to identify distress and intervene, a substantial body of research has documented an elevated risk of suicide following hospital discharge. Moreover, key evidence-informed practices are not implemented consistently in ED settings, including standardized suicide risk assessments, consistent safety planning, meaningful family involvement, and effective follow-up with community mental health services.

The aim of this qualitative study was to examine how service providers describe suicide risk assessment practices for youth in emergency departments across two Canadian provinces. Eligible participants included service providers working in EDs in Québec and Ontario. Data were analyzed using thematic analysis.

The sample consisted of 56 service providers (28 in Québec and 28 in Ontario), including social workers (66%), nurses (16%), physicians (13%), and psychologists (5%). Six key themes were identified: (1) inadequate training for service providers, (2) challenges related to coordination and continuity of care, (3) discrepancies in practices across hospitals, (4) compassion fatigue and limited clinical support for service providers, (5) insufficient involvement of families, and (6) EDs being ill-equipped to adequately respond to youth with more complex needs and more elevated suicide risk.

Overall, the findings highlight the need to strengthen community mental health services so that EDs are not the primary point of entry for youth in distress, while also reinforcing ED capacity to respond more effectively to youth and families. Improved training, organizational support, and system-level coordination are also needed to better support service providers engaged in suicide risk assessment and care.

Introduction: After a suicide attempt, adolescents should ideally receive psychosocial assessment and aftercare. We investigated the proportion of girls and boys receiving mental health treatment and social interventions within the first weeks and one year after a suicide attempt.
Methods: This study included a national cohort of children born in Denmark in 1996–2003 who had a hospital-recorded suicide attempt before age 18 years (N=3650). We also had information on self-reported suicide attempts without hospital presentation on those participating in the 18-year follow-up of the Danish National Birth Cohort (N=1489). Examined treatment included: i) psychiatric in- or outpatient contact, ii) psychotropic medication, iii) primary care mental health-related contact, and iv) social interventions. Further, factors associated with not receiving treatment were examined in regression analyses.
Results: Two weeks after a hospital-recorded suicide attempt, 55% of girls and 58% of boys had received in- or outpatient treatment at a psychiatric hospital. After one year, 13% of girls and 16% of boys had not received any type of treatment. Younger age at first suicide attempt, no previous psychiatric contact and lower parental education were associated with not receiving treatment. The proportion receiving treatment was lower among adolescents with self-reported suicide attempts compared to adolescents with hospital-recorded attempts.
Conclusion: Efforts should focus on ensuring that adolescents receive psychosocial care after a suicide attempt, particularly younger adolescents and those without previous experiences in the psychiatric system, as well as those who do not present to a hospital with their suicide attempts.

Introduction: International studies place Estonia among countries with high adolescent suicide rates globally (Glenn et al., 2020; OECD 2024). At the same time, Estonias social and healthcare systems are limited, a shortage of specialists, and a strong reliance on intersectoral collaboration. Data indicate that youth aged 13–15 experience suicidal ideation (30% of girls,14% of boys), and that in the 10-19 age group, suicide (6.5 per 100,000) remains one of the leading causes of death (Oja et al., 2023; Usberg et al., 2025). It is critical to understand how child welfare specialists (CWS) function as case managers for suicidal minors and what structural constraints define their practice.

Methods: Data collected through semi-structured, in-depth interviews with child welfare specialists (N = 15) in Tallinn who encounter minors at risk of suicide in their daily practice. Data collection and analysis are ongoing, completed by August 2026. This abstract is based on findings from the first interviews.

Results indicate that in a small-state setting, CWS act as central "system connectors." Their role is constrained by shortage in child psychiatry and mental health services, professional burnout, and inconsistent information exchange with schools, EDs, and hospitals. Collaboration often relies on personal trust and individual networks rather than institutionalized mechanisms. The absence of unified tools and practical guidelines for suicide risk assessment and crisis communication increases professional uncertainty.

Conclusions: Early findings suggest that the effective support of suicidal youth cannot rely solely on the efforts of individual professionals. There is a need for standardized assessment frameworks, strengthened intersectoral collaboration, and a sustainable case management model adapted to the specificities of a small-state infrastructure. This study provides empirical input for integrating child welfare and mental health systems within a resource-constrained context, and, following the completion of all interviews, formulates practice-oriented recommendations for addressing the identified needs.