Citation

Hill NTM, Shand F, Torok M, Halliday L, Reavley NJ. BMC Psychiatry 2019; 19(1): e6.

Affiliation

Centre for Mental Health, The Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Victoria, 3010, Australia.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12888-018-1995-1

PMID

30616582

Abstract

BACKGROUND: For those who have experienced suicidal behaviour, discharge from the hospital emergency department and other acute settings represents a period of heightened vulnerability for future suicide risk. Current guidelines for suicide response in acute settings often fail to fully address the barriers faced by emergency department personnel who have contact with a person who presents for suicidal behaviour, and have been developed largely without the input of consumers or service users. The aim of the study was to use the Delphi expert consensus method to develop guidelines for staff responding to suicidal presentations in acute settings.

METHODS: Systematic searches of academic and grey literature and interviews with key informants were conducted in order to develop a 525-item questionnaire, which comprised actions staff can take when responding to suicide-related presentations in acute settings. This was administered over three rounds to two panels consisting of Australian experts (39 health professionals, 50 consumers with lived experience). Items that reached consensus by at least 80% across both panels were included in the guidelines.

RESULTS: A total of 420 items were rated as essential or important by at least 80% of both panels. The items included strategies that covered initial contact, assessment, referral, discharge and follow-up, staff training, and linkage with community aftercare services. Participation rate across all three rounds was 67.4% (78% consumers, 53.8% professionals).

CONCLUSION: The guidelines include strategies for responding to suicidal behaviour in acute settings. These guidelines can be used to inform policy development and address barriers to best practice for those working in the area. Future research should investigate ways to optimise implementation of these guidelines in order to improve equal access to quality care for who present to acute settings for suicidal behaviour.

Language: en

Keywords

Acute settings; Delphi method; Emergency department; Expert consensus; Self-harm; Suicide prevention