Suicidal patients in the emergency room: a guide for evaluation and disposition.

The inexperienced emergency room clinician can find it difficult and frustrating to make decisions about patients who have threatened or attempted suicide. A review of the literature suggests two approaches to the evaluation of suicide-attempters: awareness of demographic and social characteristics that identify patients at high risk of another attempt, and simple numerical rating scales focusing on suicide predictors that help the clinician determine level of risk. The authors discuss how to choose the most appropriate disposition for the suicidal patient and emphasize the need for adequate documentation of the decision in the medical record.