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Emergency Departments Could Play Significant Role in Reducing Suicide Attempts

NIH-funded research shows an intervention that includes follow-up phone calls reduces the risk of future suicide attempts for people at risk

Science Update

Suicide is the tenth leading cause of death in the United States. A significant proportion of individuals who die by suicide have made a prior suicide attempt, and often access emergency care (ED) services. Research funded by the National Institute of Mental Health (NIMH) now shows hospital emergency departments can play a vital role in lowering the number of suicide attempts among adults by as much as 30 percent.

In results published April 29, 2017 in JAMA Psychiatry, the largest ED-based suicide intervention trial ever conducted in the United States examined how screening in emergency departments, followed by safety planning guidance and periodic phone check-ins led to a 30 percent decrease in suicide attempts over the 52 weeks of follow-up, compared to standard emergency department care. The five-year Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study involved nearly 1,400 suicidal patients in eight hospital emergency rooms across seven states. 

“We expect that EDs are capable of helping individuals at risk for suicide attempts. Earlier ED-SAFE study findings showed that brief universal screening could improve detection of more individuals at risk,”, said Jane Pearson, Ph.D., chair of the Suicide Research Consortium at the NIMH. “These recent findings show that if ED care also includes further assessment, safety planning, and telephone-based support after discharge, there is a significant reduction in later suicide attempts among adults.”  

“We were happy that we were able to find these results,” said lead author Ivan Miller, Ph.D., Professor of Psychiatry and Human Behavior at Brown University, Providence, Rhode Island. “We would like to have had an even stronger effect, but the fact that we were able to impact attempts with this population and with a relatively limited intervention is encouraging.”

The collaborative effort included researchers at Brown University and Butler Hospital in as well as: Massachusetts General Hospital, Harvard Medical School; University of Colorado Depression Center; Cape Cod (MA) Hospital; University of Massachusetts Medical School; and the Division of Services and Intervention Research at NIMH.