ED Suicides: More Vigilance, Less Boarding


ACEP News, January 2011 — More than a decade after issuing its first report on suicides in hospitals, the Joint Commission has followed up with a new one, reminding clinicians that suicides and suicide attempts can occur anywhere – not just in psychiatric units.

But emergency physicians say that suicides in nonpsychiatric units are part of a broader and more difficult problem to solve: a lack of appropriate care for psychiatric patients that forces other units – particularly emergency departments – to hold these patients in environments not designed for their safety.

Since 1995, the commission wrote, there have been 827 reports of patient suicides, 14% of which occurred in nonpsychiatric settings, more than half of these in emergency departments. The 827 cases represented only those voluntarily reported, the commission noted, and therefore is likely an undercount.

The suicides occurred in bathrooms, bedrooms, closets, showers, or just after patients left the hospital against medical advice. Patients hung, shot, lacerated, or asphyxiated themselves, jumped from high places, or ingested drugs. A number of suicides were carried out using materials immediately available in the hospital – bell cords, bandages, sheets, plastic bags, or elastic tubing.

Read the entire ACEP News article online.

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