Challenges of Suicide Risk Assessment in Emergency Rooms

Abstract

Introduction

Suicidal behaviour is one of the most common reasons for presentation to the emergency rooms. Perhaps the most frequently examined topic in the field of suicidology, is the degree to which death by suicide can be predicted. Moreover, some suicide risk factors may not be included consistently in the suicidal risk assessments in the emergency room.

Objectives

Understand the suicide risk predictors that are most important in decision making in the emergency room, risk factors that often get missed in the emergency room assessments

Aim

We aim to use the results of this study to implement educational intervention that gears towards improving suicidal risk assessment and documentation in emergency room.

Method

An online survey was sent to all psychiatry and emergency physicians at Queen's university to assess their opinion on predictors of suicide while assessing patients. The importance of predictors was compared between 2 groups. In addition charts of all patients assessed for suicide risk were reviewed. Suicide predictors assessed, the clinical decision made and the suicide predictors missed at the time of assessment, were recorded.

Results

Our study shows that although there is a significant links between bullying and childhood trauma, and suicidal behaviour, these predictors were not commonly assessed. The result of our study also shows that many predictors deemed important by physicians are missed on actual assessment.

Conclusion

Our study shows that many important suicidal risk factors are missed in emergency room assessments. It is important that physicians identify these risk factors while assessing suicidality.