title: Barriers and facilitators of suicide risk assessment in emergency departments: a qualitative study of provider perspectives.
abstract: OBJECTIVE
  To understand emergency department (ED) providers' perspectives regarding the barriers and facilitators of suicide risk assessment and to use these perspectives to inform recommendations for best practices in ED suicide risk assessment.
  
  
  METHODS
  Ninety-two ED providers from two hospital systems in a Midwestern state responded to open-ended questions via an online survey that assessed their perspectives on the barriers and facilitators to assess suicide risk as well as their preferred assessment methods. Responses were analyzed using an inductive thematic analysis approach.
  
  
  RESULTS
  Qualitative analysis yielded six themes that impact suicide risk assessment. Time, privacy, collaboration and consultation with other professionals and integration of a standard screening protocol in routine care exemplified environmental and systemic themes. Patient engagement/participation in assessment and providers' approach to communicating with patients and other providers also impacted the effectiveness of suicide risk assessment efforts.
  
  
  CONCLUSIONS
  The findings inform feasible suicide risk assessment practices in EDs. Appropriately utilizing a collaborative, multidisciplinary approach to assess suicide-related concerns appears to be a promising approach to ameliorate the burden placed on ED providers and facilitate optimal patient care. Recommendations for clinical care, education, quality improvement and research are offered.
authors.affiliation: Rocky Mountain Mental Illness Research Education and Clinical Center, Denver VA Medical Center, Denver, CO, USA; Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Petrik
authors.affiliation: Rocky Mountain Mental Illness Research Education and Clinical Center, Denver VA Medical Center, Denver, CO, USA; Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Gutierrez
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Jon S
authors.initials: JS
authors.lastname: Berlin
authors.affiliation: Department of Psychology, Marquette University, Milwaukee, WI, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Saunders
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D015146:Midwestern United States; D036301:Qualitative Research; D018570:Risk Assessment / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D000092864:Suicide Prevention
keywords: Emergency department; Health care providers; Qualitative methods; Suicide; Suicide risk assessment