When patients are found to be at imminent risk for suicide, they need compassionate care and to be kept safe. Patients should be praised for talking about thoughts they usually keep to themselves. They should be listened to openly and patiently, without judgement. No one can be “convinced” out of suicidal thoughts, attending to the patient in a caring and compassionate way may help them feel less alone with their thoughts and struggles.
Example phrases include:
- "Thank you for telling me how you’re feeling. It was very brave to share those thoughts."
- "I am here to help you; you don’t have to go through this alone."
Note: If the patient disclosed their suicide risk to you confidentially, explain that you’ll need to talk with their parents/caregivers. (See Further Considerations for Caring for all Patients at Risk for Suicide for more information on navigating confidentiality concerns.)
Implement immediate safety precautions
Explain to the patient that their safety is your number one priority and that you are going to keep them safe while you figure out how to get them the help they need. Explain safety precautions, and ensure the patient understands that these measures are being taken to protect them, not to punish them.
Utilize trauma-informed care principles when talking with youth and families about suicide. Be careful not to rush the conversation and choose words carefully to avoid making the family feel blame or guilty about their child’s suicidal ideation or behaviors.
Example phrases include:
- "I care about you, and I am going to take some steps to help keep you safe while you’re feeling this way."
- "I’m going to have your dad stay in the room with you, while I step out to make arrangements to get you some more support today."
Remove all potentially dangerous objects from the room, including belts, shoelaces, pills, knives, firearms, ropes, etc.
Do not leave the patient alone in the room, and ensure someone escorts them to the restroom, if needed.
Connect patient and family to urgent mental health care
Find out if the patient has a mental health clinician they are in treatment with. If they do, ask permission to reach out because they may already have a safety plan in place, which could help avoid an unnecessary visit to the ED.
If there is not an onsite mental health professional embedded in your practice, transfer the patient with an escort to the ED, community mobile crisis team, or acute mental health evaluation center for emergency evaluation.
Conduct a follow-up phone call check in with the patient and their family after stabilization in an ED. The provider can phone the patient within the next 72 hours to inquire about mental health treatment linkage.
American Academy of Pediatrics