Assessment and disposition planning for adolescent suicide attempters treated in the emergency department

Emergency departments (EDs) are often the adolescent suicide attempter’s first point of contact with the medical system. After reviewing the characteristics of adolescent suicide attempters treated in EDs, a procedure for the evaluation of a variety of suicide-specific factors when planning the disposition of adolescents who attempt suicide is discussed. Current suicidal ideation, intent, history of suicidal behavior, reasons for the attempt, common stressful events that might trigger another suicidal act in a vulnerable adolescent, as well as reasons for future hope are assessed. Because it is difficult to predict adolescents at risk for repeat attempts, emphasis is placed on hospitalizing high risk patients and enhancing the probability that those appropriate for discharge receive psychiatric aftercare in the community.