Healthcare News & Insights

What hospitals should do to prevent patient suicide

Suicide is a significant problem in the U.S. And the Joint Commission wants hospitals to do a better job at identifying patients who are at risk of harming themselves and referring them to the appropriate treatment resources. 

dr-visitAccording to federal statistics, suicide is now the 10th leading cause of death in the country. The Joint Commission recently released updated guidance about how hospitals should screen patients for suicidal thoughts.

Hospitals’ role

It’s important for hospitals and healthcare providers to look for signs of mental health conditions such as depression in patients.

Research indicates that people who commit suicide typically receive healthcare services in the year before they die – and they’re often unrelated to mental health or suicide. So healthcare providers of all types have the opportunity to potentially identify suicidal patients.

Patients suffering from other conditions, such as drug addiction or chronic illness, might come to the hospital to treat their immediate problem, but may be having thoughts of suicide that are exacerbated by their physical condition. That’s why it’s a good idea to assess the mental health of all your patients.

Suicide risk factors

According to the Joint Commission, there are several significant risk factors for suicide that may show up in a patient’s medical history, including:

  • mental or emotional disorders (depression, bipolar disorder, etc.)
  • alcohol or drug abuse
  • recent discharge from an inpatient psychiatric care facility (within one year)
  • previous suicide attempts
  • history of self-harm
  • family history of suicide
  • history or pattern of aggressive or antisocial behavior
  • history of trauma or loss (such as past child abuse), and
  • social isolation.

Providers should review patients’ history for these risk factors, or ask about them if collecting medical information from a new patient.

Next steps

After looking for risk factors, providers should screen patients for suicide ideation using a brief, standardized questionnaire. This can be filled out by patients in the waiting room or upon admission.

Hospitals can choose from several short screening tools, including the ED-SAFE Patient Safety Screener, developed by the Emergency Medicine Network specifically for use in the emergency department, and the Suicide Behaviors Questionnaire-Revised (SBQ-R).

Once providers have reviewed the assessment’s results and the risk factors present, if they feel a patient may be considering suicide, it’s important to take proactive steps based upon the level of risk.

Patients at lower risk of suicide should be referred to the appropriate outpatient behavioral health resources for follow-up care. Appointments should be made within a week.

Those who are more likely to attempt suicide should be admitted to the hospital, or referred to a specialized behavioral health facility where they’ll receive one-on-one observation. These patients should be monitored at all times, keeping them away from objects and materials that could be used for self injury.

All patients who express some form of suicide ideation should be made aware of community resources such as peer support groups. They can also be given the number for the National Suicide Prevention Lifeline (1-800-273-8255) if they simply want to talk about their feelings with an impartial third party.

Document everything

Each step in the decision-making process for suicidal patients should be documented in the medical record, so any providers who request the information while conducting follow-up care can have a full and accurate picture of the patient’s mental state at the time of his or her referral.

Documentation should also include the patient’s reaction to proposed interventions, as well as any plans for following up with the patient after discharge.

Taking the initiative to add a mental health screening to your standard hospital admissions process could literally make the difference between life and death for vulnerable patients.

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