Journal article
Suicide risk among emergency care patients: Exploring incidental risk detection during routine care
General hospital psychiatry, Vol.101, pp.82-92
07/2026
DOI: 10.1016/j.genhosppsych.2026.05.011
PMCID: PMC13245539
PMID: 42214265
Abstract
Background
Universal screening improves detection of suicide risk in emergency department (ED) patients presenting with a medical chief complaint, referred to as incidental risk. We sought to better understand characteristics of individuals who present with incidental suicide risk and evaluate their suicide-related outcomes after the ED visit.
Methods
The Emergency Department Safety Assessment and Follow-up Evaluation 2 (ED-SAFE 2) trial involved eight geographically diverse EDs. We randomly sampled data from two samples (cross-sectional, longitudinal) to compare patients with incidental risk to those with either negligible (i.e., screened negative for suicide risk) or congruent risk (i.e., behavioral health patients with suicide risk), as well as evaluate suicide-related outcomes in the 24 weeks after the ED visit. Chi-square tests, Student's t-tests, Fisher's exact tests, and one-way ANOVAs were used.
Results
The relative percentage of incidental versus congruent risk was largely similar across sex, race, and ethnicity groups. Those with congruent or incidental risk were younger than those with negligible risk. Compared to congruent risk, incidental risk was driven more frequently by a past suicide attempt without recent ideation and was less likely to result in a behavioral health evaluation or intervention during the visit. Both congruent and incidental risk groups had substantial post-visit suicidal behavior, though rates were higher with congruent risk.
Conclusions
ED patients with suicide risk incidental to their chief complaint often have significant risk factors for suicide and exhibit elevated post-visit suicidal behavior but are less likely than those with congruent risk to receive a behavioral health evaluation or intervention during the visit.
Details
- Title: Subtitle
- Suicide risk among emergency care patients: Exploring incidental risk detection during routine care
- Creators
- Edwin D. Boudreaux - University of Massachusetts Chan Medical SchoolAlan J. Ardelean - University of Massachusetts Chan Medical SchoolRachel E. Davis-Martin - University of Massachusetts Chan Medical SchoolLourah Kelly - University of Massachusetts Chan Medical SchoolMarian Betz - University of Colorado Anschutz Medical CampusSarah A. Arias - Brown UniversityKatherine Boyle - Beth Israel Deaconess Medical CenterCarlos A. Camargo - Massachusetts General HospitalJeffrey M. Caterino - The Ohio State University Wexner Medical CenterCarly Eastin - University of Arkansas for Medical SciencesSharon Johnson - Worcester Polytechnic InstituteFrank LoVecchio - Banner - University Medical Center PhoenixAnne Manton - Cape Cod HospitalKristin Mattocks - University of Massachusetts Chan Medical SchoolBarbara Stanley - Columbia University Irving Medical CenterLisa A. Uebelacker - Brown University
- Resource Type
- Journal article
- Publication Details
- General hospital psychiatry, Vol.101, pp.82-92
- DOI
- 10.1016/j.genhosppsych.2026.05.011
- PMID
- 42214265
- PMCID
- PMC13245539
- NLM abbreviation
- Gen Hosp Psychiatry
- ISSN
- 0163-8343
- eISSN
- 1873-7714
- Publisher
- Elsevier; NEW YORK
- Grant note
- National Institute of Mental Health: R01MH106726, P50MH129701
No financial disclosures were reported by the authors of this paper. The work was supported by the National Institute of Mental Health R01MH106726 and P50MH129701. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health, the National Institutes of Health, or the authors'employers.
- Language
- English
- Electronic publication date
- 05/2026
- Date published
- 07/2026
- Academic Unit
- Emergency Medicine
- Record Identifier
- 9985164604802771
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