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Gen Hosp Psychiatry. 2018 Jul 22. pii: S0163-8343(18)30093-8. doi: 10.1016/j.genhosppsych.2018.07.004. [Epub ahead of print]

Examining the impact of emergency care settings on suicidal patients: A call to action.

Author information

1
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, United States of America.
2
Department of Emergency Medicine, Columbia University Medical Center, United States of America.
3
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, United States of America. Electronic address: cbc2120@tc.columbia.edu.

Abstract

OBJECTIVE:

The emergency department (ED) offers a critical and unique opportunity to assess and intervene on suicide risk. Despite its potential benefits, the ED setting presents several potential sources of stress. The present paper calls attention to how suicidal patients may be especially vulnerable to stressful ED experiences.

METHOD:

This research synthesis cites the growing literature on ED-related stressors, as they have been shown to affect both psychiatric and nonpsychiatric patient populations.

RESULTS:

We identified specific interpersonal, physical, and temporal features of the ED that have been shown to affect multiple patient populations, including suicidal individuals. Beyond this, there appears to be broad underutilization of therapeutic care in ED settings.

CONCLUSIONS:

It is important to consider how the ED setting may be both helpful and harmful toward suicidal patients. We conclude with recommended domains of study and methodological considerations when pursuing these future directions. The proposed research agenda would help address this known high risk period around hospitalization and discharge, and ultimately optimize suicide prevention efforts.

KEYWORDS:

Emergency department; Imminent risk factors; Stressors; Suicide

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