Barriers to Screening Adverse Childhood Experience and Suicide Risk in Adults: An Integrative Review

Abstract

Adverse childhood experiences (ACE) can have significant emotional and behavioral consequences long after the events occurred. This integrative review answered the clinical question: What are the barriers to routinely screening adults for ACEs to identify those at higher risk of suicide?” Search criteria were applied using several databases to find a body of relevant sources, that were critically appraised. Data were analyzed by ordering, categorizing, and summarizing. Levels of evidence ranged from I through V. Primary care providers reported several barriers to screening for ACEs, to include lack of time, competing primary practice recommendations, lack of confidence in ACE screening skills, lack of education, provider’s discomfort with asking patients about ACE, lack of knowledge of male and of female ACE prevalence, and providers’ negative attitude towards screening ACEs.