ACEP Level B: consultation with psychiatry for high-risk patients
Joint Commission National Patient Safety Goal for Suicide Prevention (2018)
Universal screening, risk stratification, safety planning, and follow-up requirements
USPSTF: Screening for Suicide Risk in Primary Care (2014)
Insufficient evidence for universal adult screening outside high-risk populations
USPSTF: Screening for Depression in Adults including Item 9 PHQ-9 (JAMA 2023)
Landmark clinical studies
Stanley B et al. Safety Planning Intervention vs. Usual Care in ED (JAMA Psychiatry 2018)
SPI associated with half the rate of suicidal behavior at 6 months
Boudreaux ED et al. ED-SAFE 2 Cluster RCT (JAMA Psychiatry 2023)
ED process improvement including universal screening and SPI reduces reattempts
D'Anci KE et al. Treatments for Prevention and Management of Suicide: Systematic Review (Annals of Internal Medicine 2019)
Lithium and clozapine with strongest antisuicidal evidence
Mann JJ et al. Improving Suicide Prevention Through Evidence-Based Strategies (American Journal of Psychiatry 2021)
Means restriction and crisis intervention as evidence-based population strategies
Turecki G, Brent DA. Suicide and Suicidal Behaviour (Lancet 2016)
Comprehensive review of epidemiology, risk factors, and pathophysiology
Fazel S, Runeson B. Suicide (New England Journal of Medicine 2020)
Epidemiology, risk stratification, and clinical management framework
Knipe D et al. Suicide and Self-Harm (Lancet 2022)
Updated evidence on interventions, epidemiology, and prevention
Kozhevnikova S et al. Psychotropic Medications and Suicide-Related Outcomes (EClinicalMedicine 2026)
Meta-analysis of observational data on medication effects on suicidality
Disease coding references
ICD-10 coding for suicidal presentations
R45.851: suicidal ideation
T14.91: suicide attempt, unspecified
T14.91XA: suicide attempt, initial encounter
Z91.5: personal history of self-harm
F32.x–F33.x: major depressive disorder
F31.x: bipolar disorder
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