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Severe Pain Can Trigger Suicide in Hospital ERs
Date:12/15/2010

bout the associated emotional issues of their disease," Wise said, adding that caregivers may not think to ask about it because that's not their initial focus.

"Emergency room and hospital staffs tend to see medical illness -- the high fever, chest pains that suggest serious medical problems," he said. "They may be less likely to think about how a cancer patient in unremitting pain feels when they are told the increase of pain is caused by the spread of the disease."

Elana Premack Sandler, a prevention specialist with the U.S. Suicide Prevention Resource Center, said that the commission's alert highlights the fact that not every person who dies by suicide has a psychiatric history. It gets health-care providers in hospital settings "to think outside the box about their roles -- to be equipped to know the warning signs of suicide and respond appropriately," she said.

Those warnings include irritability, agitation, complaints of unrelenting pain, refusing visitors or medications and requesting early discharge, the commission noted. Dementia, chronic pain or illness, end-stage cancer, acute signs of depression and drug or alcohol intoxication may also heighten suicide risk.

"These are signs that anyone -- like friends, family or co-workers -- can be aware of," Sandler said. And anyone who notices such signs, she said, should reach out to hospital staff or other mental-health professionals who could help.

Teaching hospital and ER staff members about suicide risk factors and warning signs of an imminent attempt is the first step, the alert said. Other strategies include:

  • Doing suicide screenings in the ER.
  • Screening all patients for depression when they're admitted to a hospital.
  • Checking anyone deemed to be at risk for items they could use to harm themselves.
  • Encouraging staff to call a mental health professional to evaluate patients believed to be at risk.

Suicide is the 10th lead
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