How are patients at-risk for depression and suicide identified?

Updated: Sep 02, 2020
  • Author: Louise B Andrew, MD, JD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Although primary at-risk populations include young adults and elderly persons, [30] depression and suicidality can occur in any age group, including children.

Depression should be strongly suspected as an underlying factor in drug abuse or overdose (including alcohol) with self-inflicted injury or even in an intentionally inflicted injury by another in which the assailant is known to the victim. In any such patient, screening for diagnostic symptoms of major depression and suicidality is mandatory, in addition to protective custody. 

When a patient has contemplated or attempted suicide, the burden is on the health-care provider to directly explore the situation with the patient in as much detail as possible to determine the current presence of suicidal ideation as well as accessible means and plans for completion of suicide. Discussing these is the most important step emergency department clinicians can take in an attempt to prevent suicide in a patient at risk.

If suicidality is present, hospitalization with the patient's consent or via emergency commitment should be undertaken unless clear-cut means to assure the patient's safety can be assured while outpatient treatment is begun. A child who is suicidal or has made an attempt at suicide should be admitted to a protected environment until all medical and social services can be employed to ensure the child's safety and continued monitoring.


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