Apurva Bhatt

All Publications

• Breaking the Silence: An Epidemiological Report on Asian American and Pacific Islander Youth Mental Health and Suicide (1999-2021). Child and adolescent mental health Reyes, M. P., Song, I., Bhatt, A. 2024

  Abstract

  Limited studies have focused on recent trends in Asian American and Pacific Islander (AAPI) youth suicide. This study aimed to evaluate epidemiological trends in AAPI youth suicide and reports of depressive symptoms among Asian and Pacific Islander youth in the USA.This cross-sectional study analyzed mortality data from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) and reports of depressive symptoms from the Youth Risk Behaviour Surveillance System (YRBSS). Data from 1999 to 2021 were analyzed for suicide rates and methods used among AAPI youth aged 5-24 years. YRBSS data from 1991 to 2021 were analyzed for depressive symptoms reported by Asian American (AA) 9th-12th graders.From 1999 to 2021, 4747 AAPI youth died by suicide in the USA. Rates of suicide doubled from 3.6 to 7.1 per 100,000 during 1999-2021, with an increasing trend observed from 2014 onwards. The most common methods of suicide deaths in this population were suffocation, firearms and poisoning. Rates of suicide were higher among AA males than females, although more AA females reported depressive symptoms, including suicidal planning and attempts.This study shows a concerning increase in suicide rates among AAPI youth over 1999-2021. Suffocation, firearms and poisoning were the most common methods used. While more AAPI males died by suicide, AA females reported higher rates of depressive symptoms. These findings highlight the urgent need for targeted prevention strategies and clinical interventions for this vulnerable population. The study also emphasizes the importance of addressing mental health stigma to improve reporting and support for Asian American, Native Hawaiian and Pacific Islander (AANHPI) youth.

  View details for DOI 10.1111/camh.12708

  View details for PubMedID 38525866

• BEYOND THE BASICS: PRESCRIBING PRACTICES AND CLINICAL CHALLENGES IN EARLY PSYCHOSIS Bhatt, A., Elberg, Z., Malik, S., Zajac, J. L. ELSEVIER SCIENCE INC. 2023: S109

  View details for DOI 10.1016/j.jaac.2023.07.493

  View details for Web of Science ID 001098830400360

• UNRAVELING THE OVERLAP: NAVIGATING THE DIAGNOSTIC CHALLENGES BETWEEN ASD AND PSYCHOSIS SPECTRUM DISORDERS Bhatt, A., Gupta, A. ELSEVIER SCIENCE INC. 2023: S104

  View details for DOI 10.1016/j.jaac.2023.07.474

  View details for Web of Science ID 001098830400341

• TRAUMA, PSYCHOSIS, AND SYSTEMS-INVOLVED YOUTH: OPPORTUNITIES FOR EARLY INTERVENTION Bhatt, A., Folk, J. B. ELSEVIER SCIENCE INC. 2023: S351-S352

  View details for DOI 10.1016/j.jaac.2023.07.723

  View details for Web of Science ID 001098830401456

• Rising Rates of Adolescent Firearm Suicide and the Clinician's Role in Addressing Firearms. Journal of the American Academy of Child and Adolescent Psychiatry Bhatt, A., Gonzales, H., Pallin, R., Barnhorst, A. 2023; 62 (6): 614-617

  Abstract

  Suicide is a leading cause of death of 10- to 19-year-olds in the United States.1 Firearms were used in 48% of suicides of 15- to 19-year-olds and in 38% of suicides of 10- to 14-year-olds in 2020.1 During the COVID-19 pandemic, gun sales surged, leading to increases in household firearm ownership,2 a known risk factor for suicide.3 There are many ways in which adolescents access firearms. Most commonly, adolescents encounter firearms owned by an adult in the home. One study showed that one-third of adolescents reported they could access a loaded household gun in less than 5 minutes, even in households where parents did not believe that their child could access a household firearm.4 Another study found that 39% of parents who reported that their children did not know the location of household guns, and 22% of parents who reported that their children had never handled a household gun, were contradicted by their children's reports.5Adolescents can legally own rifles or shotguns if gifted to them by a parent. Federal law (18 U.S.C. 922) prohibits possession of handguns by minors less than 18 years of age; however, there are no federal minimum age requirements for possession of long guns (shotguns, rifles).Social media contributes to adolescent gun culture. TikTok users have created and viewed popular videos about guns,6 including videos with instructions on building guns from hardware store materials or via 3D printing. Adolescents can purchase kits online to assemble fully functional handguns. No federal restrictions or background check requirements exist on who can purchase "ghost gun" kits.7Child and adolescent mental health providers often assess suicide risk with a screening tool such as the Columbia-Suicide Severity Rating Scale, with a clinical assessment, or with a combination of both. Either way, the assessment should include asking about access to lethal means, including firearms. Many adolescent suicide attempts are impulsive; completed suicides may be prevented if access to firearms is limited during periods of crisis.8 However, many clinicians do not talk about firearms with patients even when clinically relevant.9 This may be due to assumptions that adolescents do not have access to firearms, or to lack of comfort with this topic. One study surveying medical residents reported the most common barriers to providing firearm counseling were not knowing how to ask about firearm access and not knowing how to respond to patients' answers about firearm access.9Once identifying an adolescent at risk for suicide, clinicians can intervene by providing evidenced-based interventions tailored to each situation. In this article, we present steps adapted from the BulletPoints Project for clinicians to intervene with adolescents at risk for firearm suicide.

  View details for DOI 10.1016/j.jaac.2022.07.820

  View details for PubMedID 36007812

• DIAGNOSTIC, SYSTEMS-LEVEL, AND TREATMENT ADVANCES IN CLINICAL HIGH RISK FOR PSYCHOSIS Bhatt, A., Mayanil, T. ELSEVIER SCIENCE INC. 2022: S83-S84

  View details for DOI 10.1016/j.jaac.2022.07.349

  View details for Web of Science ID 000873567900289

• BEYOND THE BASICS: PRESCRIBING PRACTICES AND CLINICAL CHALLENGES IN EARLY Elberg, Z., Bhatt, A., Malik, S., Zajac, J. ELSEVIER SCIENCE INC. 2022: S73-S74

  View details for DOI 10.1016/j.jaac.2022.07.309

  View details for Web of Science ID 000873567900256

• Adolescent Suicide-Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death. Current trauma reports Hink, A. B., Killings, X., Bhatt, A., Ridings, L. E., Andrews, A. L. 2022; 8 (2): 41-53

  Abstract

  This provides up-to-date epidemiology of adolescent suicide and risk factors for suicide and highlights the overlap of risks for suicide and injury. It reviews signs and symptoms, and the up-to-date evidence on screening for depression, post-traumatic stress disorder (PTSD), suicide, substance abuse, and lethal means, and offers strategies of implementation in trauma centers.The incidence of adolescent suicide has continued to rise in the USA to 6.5 per 100,000, with notable racial disparities. The risk factors are complex, but many pre-existing risk factors and sequela after injury such as exposures to violence, suicidal behaviors, substance abuse, depression and post-traumatic stress disorder, and specific injuries including traumatic brain injury and spinal cord injury have further emerged as risks. Studies show rates of suicidality as high as 30% in the acute care setting. There are short screening instruments that can be used to universally screen for depression and suicidality in adolescent trauma patients. Step-up models of care for PTSD are promising to increase screening and services after injury. Lethal means counseling, secure firearm storage practices, and firearm safety policies can reduce the risk of suicide.Suicide is the second leading cause of death in US adolescents, and trauma patients have significant risk factors for mental illness and suicidality before and after injury. Trauma centers should strongly consider screening adolescents, establish strategies for mental health support and referrals, and provide lethal means counseling to help prevent suicide.

  View details for DOI 10.1007/s40719-022-00223-7

  View details for PubMedID 35399601

  View details for PubMedCentralID PMC8976221

• EXPLORING TRENDS IN PEDIATRIC PHENCYCLIDINE USE IN THE USA: A RETROSPECTIVE ANALYSIS USING BIG DATA Patel, R., Bhatt, A., Depala, K., Sahil, S., Abbass, Z. ELSEVIER SCIENCE INC. 2021: S231-S232

  View details for DOI 10.1016/j.jaac.2021.09.323

  View details for Web of Science ID 000707082801152

• GUN LAWS AND YOUTH SUICIDE BY FIREARMS SYMPOSIUM: WHAT THE CLINICIAN NEEDS TO KNOW Bhatt, A., Barnhorst, A. ELSEVIER SCIENCE INC. 2021: S262

  View details for DOI 10.1016/j.jaac.2021.07.564

  View details for Web of Science ID 000707082801242

• ONE EXAMPLE STATE: THE IMPACT OF MISSOURI'S FIREARM LAW CHANGES ON RATES OF YOUTH SUICIDE BY FIREARMS Bhatt, A. ELSEVIER SCIENCE INC. 2021: S263

  View details for DOI 10.1016/j.jaac.2021.07.567

  View details for Web of Science ID 000707082801245

• Association of Changes in Missouri Firearm Laws With Adolescent and Young Adult Suicides by Firearms. JAMA network open Bhatt, A., Wang, X., Cheng, A. L., Morris, K. L., Beyer, L., Chestnut, A., Steigerwalt, K., Metzner, J. 2020; 3 (11): e2024303

  Abstract

  Suicide by firearm is a major cause of mortality in young Missouri residents. Changes in statewide firearm policy may have contributed to changes in suicide rates.To evaluate if changes in Missouri permit-to-purchase (PTP) and concealed carry firearm laws were associated with changes in rates of suicide by firearms in young Missouri residents.This cross-sectional study examined rates of suicide by firearm in Missouri among adolescents (ages 14-18 years) and young adults (ages 19-24 years) from January 1999 to December 2018, following changes to state PTP and concealed carry law, in comparison with a donor state pool with existing firearm laws (13 states in PTP pool; 42 states in concealed carry pool) that did not make changes during this period. This study used a quasiexperimental, synthetic control design at the state level that defined Missouri as the treated state and treatment as changes in firearm laws.Legislative changes to Missouri's PTP and concealed carry firearm laws.Age-adjusted annual rates of firearm-related suicide mortality per 100 000 people for adolescents (aged 14-18 years) and young adults (aged 19-24 years).Repeal of the PTP law was associated with a 21.8% increase in firearm suicide rates in young adults aged 19 to 24 years in Missouri. Lowering the minimum age of concealed carry to 19 years in Missouri was associated with a 32.0% increase in firearm suicide rates and a 29.7% increase in nonfirearm suicide rates in adolescents aged 14 to 18 years, and a 7.2% increase in firearm suicide rates in young adults aged 19 to 24 years.Increases in rates of suicide by firearms in adolescents and young adults were seen following repeal of Missouri's PTP law and lowering of the minimum age for concealed carry in 2014. Changes in Missouri's firearm policies may be an important contributor to rates of suicide by firearm in young Missouri residents.

  View details for DOI 10.1001/jamanetworkopen.2020.24303

  View details for PubMedID 33146733

  View details for PubMedCentralID PMC7643031

• SUICIDE AND HOMICIDE BY FIREARMS IN YOUNG MISSOURI RESIDENTS, AND CHANGES IN MISSOURI FIREARM POLICY FROM 1999-2018 Bhatt, A., Abbass, Z., Beyer, L., Morris, K. L. ELSEVIER SCIENCE INC. 2020: S183-S184

  View details for DOI 10.1016/j.jaac.2020.08.177

  View details for Web of Science ID 000579844101038