Tennakoon, GByrne, EMVaithianathan, RMiddeldorp, CM2023-10-152023-10-152023-08-14Suicide and Life-Threatening Behavior, ISSN: 0363-0234 (Print); 1943-278X (Online), Wiley, 53(5), 853-869. doi: 10.1111/sltb.129880363-02341943-278Xhttp://hdl.handle.net/10292/16783Introduction: Identifying young people who are at risk of self-harm or suicidal ideation (SHoSI) is a priority for mental health clinicians. We explore the utility of routinely collected data in developing a tool to aid early identification of those at risk. Method: We used electronic health records of 4610 young people aged 5–19 years who were treated by Child and Youth Mental Health Services (CYMHS) in greater Brisbane, Australia. Two Lasso models were trained to predict the risk of future SHoSI in young people currently rated SHoSI; and those who were not. Results: For currently non-SHoSI children, an Area Under the Receiver Operating Characteristics (AUC) of 0.78 was achieved. Those with the highest risk were 4.97 (CI 4.35–5.66) times more likely to be categorized as SHoSI in the future. For current SHoSI children, the AUC was 0.62. Conclusion: A prediction model with fair overall predictive power for currently non-SHoSI children was generated. Predicting persistence for SHoSI was more difficult. The electronic health records alone were not sufficient to discriminate at acceptable levels and may require adding unstructured data such as clinical notes. To optimally predict SHoSI models need to be tested and validated separately for those young people with varying degrees of risk.http://creativecommons.org/licenses/by-nc-nd/4.0/child and youth mental health serviceelectronic health record datapredictive risk modelingself-harm or suicidal ideation4203 Health Services and Systems42 Health SciencesPreventionMental HealthBehavioral and Social SciencePediatric4 Detection, screening and diagnosis4.1 Discovery and preclinical testing of markers and technologiesMental health3 Good Health and Well Being1701 PsychologyPsychiatry4203 Health services and systems5203 Clinical and health psychology5205 Social and personality psychologyJournal ArticleOpenAccess10.1111/sltb.12988