ED-SAFE—Can Suicide Risk Screening and Brief Intervention Initiated in the Emergency Department Save Lives?

Suicide is a major and growing public health problem in the United States. The 10th leading cause of death, suicide claimed 44 193 American lives in 2015, and the rate of suicide increased 27% between 1999 and 2015 from 10.5 to 13.3 per 100 000.¹ The lifetime prevalence of nonfatal suicide attempts, the strongest predictor of suicide, is 5%; 14% of adults will experience significant suicidal ideation in their lifetime.² More than 460 000 emergency department (ED) visits occur annually following self-harm,³ and a single ED visit for self-harm increases future suicide risk nearly 6-fold.⁴ It is especially disconcerting that up to 40% of individuals who die by suicide visit an ED in the year before death, including 15% due to self-harm.⁵