TY - JOUR PY - 2013// TI - Knowledge, attitudes, and practices of emergency department providers in the care of suicidal patients JO - Depression and anxiety A1 - Betz, Marian E. A1 - Sullivan, Ashley F. A1 - Manton, Anne P. A1 - Espinola, Janice A. A1 - Miller, Ivan W. A1 - Camargo, Carlos A. A1 - Boudreaux, Edwin D. SP - 1005 EP - 1012 VL - 30 IS - 10 N2 - BACKGROUND: We sought to examine the knowledge, attitudes, and practices of emergency department (ED) providers concerning suicidal patient care and to identify characteristics associated with screening for suicidal ideation (SI). METHODS: Six hundred thirty-one providers at eight EDs completed a voluntary, anonymous survey (79% response rate). RESULTS: The median participant age was 35 (interquartile range: 30-44) years and 57% of the participants were females. Half (48%) were nurses and half were attending (22%) or resident (30%) physicians. More expressed confidence in SI screening skills (81-91%) than in skills to assess risk severity (64-70%), counsel patients (46-56%), or create safety plans (23-40%), with some differences between providers. Few thought mental health provider staffing was almost always sufficient (6-20%) or that suicidal patient treatment was almost always a top ED priority (15-21%). More nurses (37%, 95% confidence interval [CI] 31-42%) than physicians (7%, 95% CI 4-10%) reported screening most or all patients for SI; this difference persisted after multivariable adjustment. In multivariable analysis, other factors associated with screening most or all patients for SI were self-confidence in skills, (odds ratio [OR] 1.60, 95% CI 1.17-2.18), feeling that suicidal patient care was a top ED priority (OR 1.73, 95% CI 1.11-2.69) and 5+ postgraduate years of clinical experience (OR 2.06, 95% CI 1.03-4.13). CONCLUSIONS: ED providers reported confidence in suicide screening skills but gaps in further assessment, counseling, or referral skills. Efforts to promote better identification of suicidal patients should be accompanied by a commensurate effort to improve risk assessment and management skills, along with improved access to mental health specialists.
Language: en
LA - en SN - 1091-4269 UR - http://dx.doi.org/10.1002/da.22071 ID - ref1 ER -