Emergency Rooms Can – and Should – Screen for Suicide Risks
Identifying people at risk of suicide is an essential step to providing these patients with the care they require. A new study shows care providers in the emergency room have an important role to play in identifying people at risk; this is yet another study stating the obvious. Healthcare professions in an ER setting must do their part to ensure patients are identified so they can receive appropriate care. If not, an attempted suicide may occur within minutes to hours of an unthoughtful disposition.
ER Nurses Can Help Identify Patients at Risk of Death by Suicide
NewsWise reported on the recent study showing the important role emergency room caregivers can play in preventing a suicide. The research was conducted by UMass Medical School. Researchers discovered when emergency room nurses conducted a universal suicide risk screening, almost double the number of at-risk patients were identified. At-risk patients included those who were positively identified as thinking about suicide or patients with attempted suicide.
The study spanned a five year period. During this time, there were 236,791 visits to emergency rooms included in the study. Suicide risks screenings performed on patients increased from 26 percent to 84 percent of patients undergoing screening over the study period. This increased the rate of detection of suicide risk from 2.9 percent to 5.7 percent.
The suicide screening performed in the emergency room was simple. Nurses in the ER departments were trained to administer a brief questionnaire to patients focused on three risk factors for suicide: depressive symptoms, lifetime attempts to die by suicide, and active suicidal ideation.
Patients were identified as having a positive screen if they had either confirmed they have active suicidal ideation or if they had attempted to die by suicide within six months of the time of the visit to the emergency department. With this screening process, a subset of patients was identified whose risk of suicide was serious enough the patients needed inpatient psychiatric treatment. Other patients were identified who needed additional evaluation and intervention resources such as a self-help safety card and information about a suicide prevention lifeline.
The lead author of the study indicated: “Our study is the first to demonstrate that near-universal suicide risk screening can be done in a busy ED during routine care. The public health impact could be tremendous, because identification of risk is the first and necessary step for preventing suicide.” The lead author is correct and we applaud the entire team performing the research. We hope that the study is transformed into action in the emergency departments and the study is not just a group soliloquy among academics.
No further efforts to help identify risk of suicide in emergency departments are needed at this time. This need has been answered by the Suicide Prevention Resource Center last year, 2015. Skip Simpson highly recommends the outstanding work produced by the SPRC: “Caring for Adult Patients with Suicide Risk: A Consensus Guide for Emergency Departments.” This important work (the ED Guide) is designed to assist emergency department (ED) providers with decisions about the care and discharge of patients with suicide risk.
