Medical errors in the management of suicidal patients is a death sentence. Suicide rates are climbing in the U.S., so primary care providers (PCPs) are facing more encounters with suicidal patients. In this blogpost, I will discuss treatment guidelines set forth in the Primary Care Companion to the Journal of Clinical Psychiatry for suicidal patients.
The patient-PCP relationship is important in preventing future suicides. The Journal reports that “between 20% and 76% of patients who commit suicide have seen their primary care physician in the prior month.“ Likewise, PCPs may assume care of a suicidal patient after the patient is stabilized following a suicide attempt.
When a patient has attempted suicide, the first step is to treat the patient and also ensure the patient’s safety so no further attempts can be made while convalescing. In an acute care setting, the patient should be watched and kept in a room that is designed to minimize the risk of another suicide attempt (e.g., no sharp objects, no open windows, etc.). In an office-based setting, the suicidal patient should not be allowed to leave alone.
After the acute phase, the PCP must assess the patient for future suicide risk. The guidelines recommend that the physician undertake a thorough history and mental and physical assessment, and “