[Issues in emergency care for people who attempted suicide]

To examine issues in care for patients who come to the emergency department after a suicide attempt.

Cross-sectional multicentre questionnaire survey.

In 2015, 7 emergency departments across the Netherlands participated in a questionnaire survey of the 113 Suicide Prevention (113 Zelfmoordpreventie) service as a part of the 2014-2017 National Suicide Prevention Agenda. Emergency physicians and nurses and managers answered 25 multiple-choice questions about: (a) current treatment of and contact with patients who attempted suicide, (b) available knowledge and skills of emergency physicians and nurses and (c) after-care for patients who attempted suicide.

In total, 33 emergency physicians, 40 emergency nurses and 5 managers completed the questionnaire. When a patient comes to the emergency department after a suicide attempt, emergency physicians and nurses often consult with the crisis service, psychiatrist or a colleague and they request extra diagnostics. The most important issue indicated by emergency staff is that they do not have enough time, knowledge and skills to estimate the suicide risk and to conduct a conversation with the patient about her or his suicidal thoughts. One-fifth of the respondents indicated that they do not always treat patients who committed a previous suicide attempt with respect. The respondents also thought that the emergency department environment is too restless or unsafe and thought that they have to wait for the crisis service for a long time. The majority of the emergency physicians and nurses worried about the condition of the patient after her or his discharge, especially when they estimate a high probability of another suicide attempt.

Insufficient knowledge and skills of emergency department staff, a sometimes negative attitude towards people who attempted suicide and a heavy workload are hindering care at the emergency department for people who attempted suicide. Targeted training, a quiet area and deployment of specialised care could improve this care.