EDs Struggle to Cope with Suicidal Patients
Abstract
ImageMany patients who kill themselves in emergency departments do not have psychiatric histories or past suicide attempts, leaving emergency physicians scrambling to find ways to detect at-risk patients. After the Joint Commission issued a sentinel event alert about suicide this past fall, EDs sat up and took notice, but the problem remained that they often lack the resources to cope with the problem. The commission said 827 suicides occurred in hospitals since 1995, with eight percent of those in EDs. Another 14.25 percent occurred in non-psychiatric inpatient units, and 2.45 percent occurred in other non-psychiatric settings such as critical access hospitals, long-term care facilities, and physical rehabilitation hospitals. While emergency physicians may not know the exact statistics and the Joint Commission thinks they are underreported, the association between suicide and emergency departments is nothing to new to those who staff the nation's EDs. They recognize that the site of the emergency department itself is a risk factor: The staff cannot spot every person with a psychiatric problem, and the greater risk occurs after discharge. As hard as emergency department staffs try to recognize suicide risk in their patients and prevent attempts, they are hamstrung. “The problem is a lack of resources,” said David J. Mendelson, MD, the vice president for medical affairs at EmCare and the lead author of a 2008 survey for the American College of Emergency Physicians on the…
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