Year: 2024
Type: dissertation
Study design: Systematic Review
Abstract: Aim: To assess the suicide risk among emergency department (ED) patients. Objectives: 1. To evaluate the tools used to identify suicidal ideation or behavior among ED patients 2. To assess the sociodemographic characteristics of ED patients with suicidal ideation or behavior 3. To identify most common symptoms associated with suicidal ideation and behavior among ED patients 4. To identify improvements to lower the suicide risk among ED patients Methodology: Most relevant literature of the last 10 years was searched and reviewed via the databases PubMed and Elsevier related to the suicide screening in the emergency department. When applying Boolean operators and inclusion and exclusion criteria 23 articles were selected as eligible to be included into this literature review. Results: In the Emergency Department (ED), accurate suicide risk assessment is challenging due to the sensitivity of the topic and limited confidence among staff. Training Programs and educational resources can address this barrier, enhancing staff competence. Implementing universal screeners and assessment guides, along with structured training, can improve staff approach in the absence of mental health professionals. While commonly used suicide risk scales like SPS and MSPS show limited predictive efficacy, the Patient Safety Screener (PSS-3) offers a concise primary screening tool. The ED-SAFE study, using the PSS-3, demonstrated increased detection rates and a 5% decrease in suicide attempts through a comprehensive intervention strategy. Universal screening, a comfortable environment for patients, and brief interventions with follow-ups are recommended. Special attention is needed for high-risk populations, such as lesbian, gay, and bisexual populations, and transgender individuals, females, unmarried individuals, and those with lower socioeconomic status or previous mental health disorders. The integration of technology, specifically computerized screening, holds promising advances in accuracy and health care professionals’ satisfaction in suicide risk assessment in the ED. Conclusion: • 1.The most validated screening tool for adults presenting to the ED is the Patient Safety Screener-3 (PSS-3). • 2. The most common populations of patients presenting to the ED with SI or SA are lesbian, gay, bisexual, and transgender individuals, females, and people between the age groups 15-24. • 3. High risk is associated with patients which suffer from previous mental health diseases, substance abuse, low socioeconomical status and are unmarried. • 4. ED staff should receive special training and education related to suicide during their speciality training. Future research should focus on computerized methods to administer suicide screening questionnaires in the ED. Recommendations: Universal screening should be implemented in all EDs, with the best validated screening tool being the PSS-3. Every patient screening positive should receive comprehensive assessment with short in-ED interventions to evaluate patient disposition and discharge safety. Discharged patients should be followed-up for a minimum period of 12 months.
Author: Heiland, Jonas Nicolai
Institution: Lithuanian University of Health Sciences
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7132076243