Suicide Risk Assessment in the Emergency Department Setting

Suicide is a prominent problem that has far-reaching effects. In 2013, 41,149 suicides were reported in the United States, a rate of 13.0 per 100,000. Suicide was the tenth leading cause of death for Americans with someone in the country committing suicide every 12.8 minutes. The World Health Organization estimates that by the year 2020 roughly 1.53 million people will commit suicide annually, and 10-20 times more will attempt suicide. This translates to one death due to suicide every 20 seconds and one suicide attempt every 1-2 seconds (World Health Organization, 1999, 2006). Given these trends, it is becoming even more important to develop and utilize screening and assessment measures to assist in identifying individuals who are at risk for suicide in order to implement appropriate treatment. Emergency departments (ED) are responsible for providing medical and surgical care to patients in need of immediate treatment upon arriving at hospitals. As such, EDs are a primary point of access for individuals immediately following a suicide attempt. Previous studies have investigated the prevalence of suicidal ideation in patients presenting to the ED for non-psychiatric reasons and found that increased suicide-related risk for nearly all of the patients was undetected during routine care. Given these findings, it is highly important that ED providers understand how to perform a proper suicide risk assessment to evaluate for intensity and severity of risk and develop an appropriate care plan.