emDOCs - July 11, 2022 - By Noah Rohrer and Maxine Dudek
Reviewed by: Courtney Cassella; Alex Koyfman; Brit Long
Take-home Points
- Suicidal ideation is common, dangerous, and requires appropriate clinical assessment.
- Presence of suicidal thinking with any high-risk factor including a history of prior suicide attempt, recent psychosocial stressor, older age, Caucasian race, psychiatric illness, or substance abuse likely qualifies an individual as at least moderate risk and should prompt consideration of involuntary hold and psychiatry consultation.
- For a structured and comprehensive approach toward suicide risk assessment, we recommend using the Columbia Suicide Severity Rating Scale.
- Document in your note the protective factors and risk factors that justify your determination of risk and decision to either involuntarily hold for psychiatric consultation or discharge home.