Emergency management of the adolescent suicide attempter: a review of the literature. (Mental health).

S.E. Stewart, I.G. Manion & S. Davidson, Journal of Adolescent Health, v.30, n.5, 2002, pp. 312-25.

This review by American authors of risk factors, assessment, disposition, treatment options and noncompliance of adolescent suicide attempters presenting to hospital emergency departments (EDs) was based on searches of the Medline database and the reference sections of published papers. One difficulty faced by EDs in the management of suicidal youth is risk assessment because although suicide attempts are common and the risk of later death among attempters is substantial completed suicide is itself rare. In addition, ED staff often have negative attitudes towards suicidal patients, there is little uniformity of care, and there is a deficit of studies about and guidelines for managing these patients. In response to their findings, the authors developed an assessment instrument with guidelines for appropriate psychiatric referral of adolescent suicide attempters by ED staff. They also put forward for future application and evaluation a model for ED management that incorporates four key aspects of suicide management: treatment team, enhancing compliance, admission specifics, and management approach.