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Comment & Response |

Addressing Suicide Risk in Emergency Department Patients

David Hoyer, MD1
[+] Author Affiliations
1Department of Emergency Medicine, University of Texas Health Science Center, Houston
JAMA. 2014;312(3):297-298. doi:10.1001/jama.2014.7149.
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To the Editor In their Viewpoint, Dr Olfson and colleagues1 called for “enhanced training of emergency physicians in the management of suicidal patients and patients with deliberate self-harm” due to the “shortages of mental health specialists in emergency medical settings.”

Studies show that 1 in 5 emergency department patients may be depressed, yet the diagnosis is often missed for a variety of reasons including that patients do not complain of depression but of somatic depression symptoms.2 Similarly, overt suicidal behavior accounts for 0.6% of emergency department visits but the incidental suicidal ideation that is found in 3% to 11.6% of visits is often missed.3 There are 130 million patient visits to emergency departments each year, so there is much room for improvement.4


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July 16, 2014
Mark Olfson, MD, MPH; Steven C. Marcus, PhD; Jeffrey A. Bridge, PhD
1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York
2Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
3Research Institute at Nationwide Children's Hospital, Center for Innovation in Pediatric Practice, Columbus, Ohio
JAMA. 2014;312(3):298. doi:10.1001/jama.2014.7155.
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