Suicide Prevention in the ED

Chronic illness is estimated to be involved in up to 25% of all suicides (Mosicki, 1995). In addition to mood disorder, chronic illness is a significant risk factor for both suicidal ideation and suicide attempts. Patients with depression and comorbid chronic medical conditions are are at especially high risk of suicidal ideation.

Suicide Prevention Resource Center's Best Practices Registry

Best Practices for the Treatment of Patients with Mental and Substance Use Illnesses in the Emergency Department -- Illinois Hospital Association: Behavioral Health Steering Committee Best Practices Task Force (June 2007)

Emergency Room Intervention for Adolescent FemalesQPR for NursesClinical practice guideline: suicide risk assessment - National Guideline Clearinghouse.  Target Population: Patients who present to the emergency setting who have suicidal ideation or after attempted suicide and/or those patients at high risk for future attempts of suicide
  • See Part Three: The Emergency Department and Impediments to Suicide Prevention for research and recommendations on topics such as screenings, trainings for clinicians, and suicide risk-reduction therapies
Suicide Attempts and Suicide Deaths Subsequent to Discharge from an Emergency Department or an Inpatient Psychiatry Unit. Continuity of Care for Suicide Prevention and Research. 2011  Report was commissioned by the Suicide Prevention Resource Center (SPRC) in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA).

Resources, Webinars, and Publications & Research for Emergency Departments  [The Suicide Prevention Resource Center]
Below are examples of resources listed

Kognito At-Risk in the ED - "a one-hour, online, interactive training simulation that teaches Emergency Department (ED) staff how to (1) recognize patients who exhibit warning signs of suicide and substance abuse risk, (2) screen patients for suicide and substance abuse risk, and (3) respond to patients who screen positive for suicide and substance abuse risk.

Suicide care in systems framework

      This report represents the findings and recommendations of the Clinical Care and Intervention Task Force to the National Action Alliance for Suicide Prevention.


Emergency Department Suicide Prevention Trainings

        [Tennessee Suicide Prevention Network] posters, brochures, and clinical guide]


Suicide Risk Assessment and Management Protocols: Emergency Department

          [2004 report, New South Wales, Australia]

Substance Abuse and Suicide Prevention: Evidence & Implications -- A White Paper
Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration

"In late 2008, the Wisconsin Hospital Association established the WHA Behavioral Health Task Force (the “Task Force”). The Task Force was formed in response to hospitals’ growing concerns regarding the treatment of patients with severe and acute behavioral health issues brought to hospital emergency rooms. A too frequent lack of a coordination between county mental health services, law enforcement, physicians, and hospitals, combined with inconsistent interpretations of Wisconsin’s sometimes confusing mental health laws and scarce behavioral health resources has meant that in many cases patients’ and communities’ needs were not being satisfactorily met."  [From the Executive Summary of the Wisconsin Hospital Association's Behavioral Task Force White Paper.]

The Task Force formalized 12 Recommendations to improve the care of people with a diagnosis of a mental illness in Emergency Departments. These recommendations

  • "address the shortage of resources,
  • make mental health laws more understandable and workable for hospitals,
  • take advantage of and encourage more of what is currently working well, and
  • encourage accountability and improvement in the system." 

Read the full document at: http://www.wha.org/Data/Sites/1/behaviorhealth/bhtf-whitepaper.pdf

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