Suicide is a major and growing public health problem in the United States. The 10th leading cause of death, suicide claimed 44 193 American lives in 2015, and the rate of suicide increased 27% between 1999 and 2015 from 10.5 to 13.3 per 100 000.1 The lifetime prevalence of nonfatal suicide attempts, the strongest predictor of suicide, is 5%; 14% of adults will experience significant suicidal ideation in their lifetime.2 More than 460 000 emergency department (ED) visits occur annually following self-harm,3 and a single ED visit for self-harm increases future suicide risk nearly 6-fold.4 It is especially disconcerting that up to 40% of individuals who die by suicide visit an ED in the year before death, including 15% due to self-harm.5 In February 2016, the Joint Commission issued a Sentinel Event Alert recommending that hospitals screen all medical patients for suicide risk, including those that present to EDs.6 Since the alert, many hospitals have implemented suicide risk screening without the benefit of evidence-based tools and clinical pathways, potentially increasing the risk of underdetection (ie, false-negatives) or overburdening limited mental health resources with false-positives....
Language: en
", language="en", issn="2168-622X", doi="10.1001/jamapsychiatry.2017.0677", url="http://dx.doi.org/10.1001/jamapsychiatry.2017.0677" }