A panel convened by the Joint Commission has issued a set of guidelines to help providers prevent suicides in healthcare settings.
The guidelines—which were assembled by a panel that includes providers, Joint Commission representatives, experts in behavioral health and representatives from the Centers for Medicare & Medicaid Services—apply to emergency departments, general inpatient units and psychiatric hospitals.
"There needs to be consensus on these issues so that health care organizations will know what changes they need to make to keep patients safe and so surveyors can reliably assess organizations’ compliance with standards," the commission said.
The Joint Commission noted that suicide is the 10th leading cause of death in the U.S., and that while relatively few suicides occur in healthcare facilities, experts suggest that more may occur shortly after discharge, though there is limited data available to study this.
Inpatient units and emergency departments likely cannot meet the same rigorous ligature-resistance standards that the commission recommends for psychiatric facilities, as patients typically need monitoring equipment and machinery that could be a risk. However, the Joint Commission recommends that inpatient units and ERs conduct a risk assessment for items that could be used in suicide attempts, and avoid making them available to patients with suicide ideation.
The commission offered strategies to keep suicidal patients safe in the emergency room:
- Place the patient in a safe room or keep them in the main ER with constant one-on-one monitoring.
- Train staff to deal to recognize and respond to patients who may be suicidal.
- Routinely screen patients for signs of suicide risk.
- Out in place a clear policy for handling patients who are demonstrable suicide risk.
- Closely monitor patients and visitors who may be at risk for suicide.
The Joint Commission's panel will continue to meet and discuss suicide prevention strategies, according to the announcement. It met most recently on Oct. 11 to discuss prevention solutions in other healthcare settings, including residential treatment, outpatient care and partial hospitalization.
The commission expects to release additional guidelines for those settings.