CASSY: A Universal Screening Tool for Suicide Risk


In this podcast, Hannah Wulczyn, MPA, Project Director at Adaptive Testing Technologies, Chicago, Illinois, discusses the Computerized Adaptive Screen for Suicidal Youth, or CASSY, the first universal screener for suicide risk in pediatric emergency departments or other places that large scale suicide screening risk occurs.



Hannah Wulczyn:  Hi. My name is Hannah Wulczyn, and I'm a project director at Adaptive Testing Technologies. I am here today to talk a little bit about the Computerized Adaptive Screen for Suicidal Youth, which is the first universal screen for suicide risk in pediatric emergency departments or other places that large‑scale suicide screening risk occurs.

The CASSY is a computerized adaptive test, and it is a scientific breakthrough in the world of pediatric suicide risk screening. It's a great way to measure and monitor screening within the pediatric emergency departments. We'd like to talk a little bit more about how this tool came about and what makes it unique.

The CASSY utilizes computerized adaptive testing and multidimensional item response theory to provide a suicide risk stratification from negligible to very high risk. The combination of these 2 things allows for the accuracy and precision never before seen in a fraction of the time that it takes to complete a structured clinical diagnostic interview.

The CASSY adaptively pulls an average of 11 questions from a 72‑question item bank and is completed in 84 seconds. This means professionals have a fast, accurate, and precise way to determine the risk of suicide, allowing more time to make important decisions around safety and care for our youth.

The CASSY was validated in pediatric emergency departments, and within this population, it can be used. The tools that are behind the technology itself and the statistical engine that powers the CASSY is also available for use with other mental health disorders through Adaptive Testing Technologies, the organization that I work for.

The CAT‑MH and the K‑CAT suites of assessment tools provide a dimensional severity score for a wide array of mental and behavioral health conditions, including depression, anxiety, mania, hypomania, ADHD, psychosis, PTSD, social determinants of health, and then, in juvenile populations, conduct disorder and oppositional defiant disorder.

These tools can be implemented in a wide variety of settings and are very flexible and designed to work with different populations of people.

Our hope with the CASSY is that it will be used anywhere that large‑scale screening for suicide risk occurs.

For clinicians who are interested in a more accurate and precise measurement of suicidal ideation in a smaller population or in a private practice, the K‑CAT suicide scale is a dimensional severity measure of suicidality and is well suited to be used in longitudinal assessment when evaluating the efficacy of treatment and also in understanding how a patient is doing and looking at how that changes over time.

The K‑CAT‑SS is also a great way to understand if there is emerging suicidality that an individual is experiencing.

When we think about the goals for these tools and the way that we want to use these tools in the environment out in the world, for us, the most important thing is that CASSY gets the information to providers that they need to make informed decisions alongside of their patients about what resources, services, and support are needed to help a young person through a difficult time in their life.

In short, we hope that CASSY is used to save lives within the populations that it is used in, and we hope that the world is a little bit of a better place because appropriate action is taken to save some lives.

Hannah Wulczyn, MPA, has a Master’s in Public Administration from the University of Baltimore and a BA in Criminology and Criminal Justice from the University of Maryland, College Park. As Project Director at Adaptive Testing Technologies (ATT), Hannah works with organizations to implement and integrate the CAT-MH™, K-CAT®, and CASSY suites of assessment tools. Prior to joining Adaptive Testing Technologies, she worked to advocate for children and youth in Child Welfare and Juvenile Justice systems across the country while working for the Annie E. Casey Foundation and Kids Insight. Hannah’s primary focus was improving outcomes for children and youth through evidence-informed decision-making and a deepened understanding of trauma informed care for vulnerable populations.