Suicidal ideation in emergency department (ED) patients is common. More than four percent of all ED visits are related to psychiatric conditions, and three to eight percent of ED patients have suicidal ideation when screened. Approximately 420,000 individuals are treated in emergency departments each year for intentional harm. However, many patients’ suicide risk may be overlooked if their chief complaint is unrelated.
Patients with severe anxiety and depression often translate their mental health issues into physical symptoms, such as headaches, back pain, chest pain, or nausea. A patient may present with a history of severe left-sided chest pain rather than communicating that they were romantically rejected and now want to take their own life. Emergency physicians should be alert to this frequent and well-known incidence of psychiatric issues presenting as somatic complaints.
Is Universal Screening for Suicide Risk Reasonable?
Unfortunately, there are no effective ways to quickly, accurately, and consistently screen for suicide risk other than to listen to what the patient is saying. It is not feasible to delve into the psychosocial history of each patient presenting with a somatic complaint in an ED setting. Instead, soliciting patient history should be conducted in a sufficiently open-ended manner that provides patients an opportunity to verbalize experiencing severe mental distress and suicidal ideation.
It is not realistic for ED physicians to universally screen patients for suicidal ideation, and there are no effective ways to predict whether patients who provide positive responses will go on to attempt or commit suicide.
What Are Liability Implications for ED Physicians?
If an element of significant history presents a patient at major suicide risk, physicians must inquire about suicidal ideation thoughts and plans and document patients’ responses. Adding a short, straightforward note in the medical record documenting that the physician inquired about suicidal ideation and plans and that the inquiries were denied or admitted and an appropriate plan, such as obtaining a psychiatric consultation, will go a long way to defend the physician if the patient attempts or commits suicide soon after discharge.
The Washington, D.C. Medical Malpractice Lawyers at the Law Offices of Dr. Michael M. Wilson, M.D., J.D. & Associates Assist Families of Lost Loved Ones
If you lost a loved one due to a negligent emergency department, contact the experienced Washington, D.C. medical malpractice lawyers at the Law Offices of Dr. Michael M. Wilson, M.D., J.D. & Associates to discuss your legal options. Call us today at 202-223-4488 or contact us online to schedule a free consultation. Located in Washington, D.C., we serve clients in the surrounding areas, including Northern Virginia and Maryland.
Dr. Michael M. Wilson is an attorney and a physician who earned his undergraduate degree from the Massachusetts Institute of Technology and his legal and medical degrees from Georgetown University. He has focused in the area of medical malpractice for more than three decades and secured more than $100 million in settlements and verdicts on behalf of clients throughout the country. He is admitted to practice in the District of Columbia and New York as well as the U.S. Court of Appeals for the District of Columbia and the U.S. Supreme Court. He is listed in America’s Top 100 High Stakes Litigators.
