Development of a Repeat Suicide Risk Management Protocol for Emergency Department Patients With Suicide Attempts: An...

Area of Science:

• Public Health
• Clinical Psychology
• Emergency Medicine

Background:

• Emergency departments are critical for identifying and managing suicide risk in patients with prior attempts.
• A lack of evidence-based protocols for repeat suicide risk management exists in Chinese emergency departments.
• This gap necessitates the development of structured approaches to improve patient safety and outcomes.

Purpose of the Study:

• To develop a preliminary, evidence-informed protocol for managing repeat suicide risk.
• To address the specific needs of emergency department patients with a history of suicide attempts.
• To provide a framework for healthcare providers in Chinese emergency settings.

Main Methods:

• An exploratory sequential mixed-methods design was employed across two phases.
• Phase 1: Evidence synthesis and semi-structured interviews to draft the initial protocol.
• Phase 2: Two-round Delphi expert consultation with 19 specialists to refine and finalize the protocol.

Main Results:

• Phase 1 identified key themes: attitudes toward suicide prevention, social norms, and perceived behavioral control.
• Phase 2 achieved expert consensus on a protocol comprising 4 primary, 12 secondary, and 38 tertiary indicators.
• High expert authority (Cr=0.927, Ca=0.958) and consensus (Kendall's W=0.292-0.385, p<0.001) were demonstrated.

Conclusions:

• An actionable and focused risk management protocol for repeat suicide attempters in emergency departments was successfully developed.
• The protocol provides a valuable reference for clinical practice and future research in suicide prevention.
• This initiative addresses a critical need for structured suicide risk management in Chinese emergency care settings.