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Emergency department suicide prevention

A hospital’s emergency department often deals with people who are struggling with suicidal urges or in the immediate aftermath of an attempt.

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It is estimated that 8 percent of all adult patients who end up in the emergency department, regardless of their primary complaint, have had recent suicidal thoughts or behaviors.

These risk factors often go undisclosed because they are not asked. It is important that no matter how doctors and nurses personally view mental health and suicide they establish a dialogue with patients believed to be suicidal. Like anyone dealing with someone struggling with suicidal thoughts, personnel should not be afraid to ask direct questions about suicide and self harm. However, they should also make sure that they are doing it in a non-judgmental and positive way.

Recommendations for emergency department suicide prevention

  • Screen all patients presenting with psychiatric disorders for suicidal ideation.
  • Formally assess the risk of a suicide attempt among patients with suicidal ideation — this can be a secondary screening.
  • Conduct a risk assessment for objects that pose a risk for self-harm and identify those objects that should be routinely removed from the immediate vicinity of patients with suicidal ideation who are cared for in the main area of the emergency department.
  • Have a protocol for removing all movable items that could be used for self-harm from within reach of a patient with suicidal ideation.
  • Have protocols for monitoring patients with suicidal ideation, including the use of the bathroom, and how to ensure that visitors to not bring objects that the patient could use for self-harm.
  • Have a protocol to have qualified staff accompany a patient with serious suicidal ideation from one area of the hospital to another.
  • Train staff and test them for competency on how they would address a situation with a patient with serious suicidal ideation.

In addition, officials said that anyone who is deemed a serious suicide risk should be placed under continuous monitoring by a staff member who is qualified to intervene if the need arises. It should also be steadfast policy that anyone being evaluated for suicidal thoughts or behaviors is not allowed to leave the ED until such an evaluation is completed and that person is given an assessment that shows they are no longer at immediate risk.

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