Introduction
Emergency departments (EDs) are often the first point of contact for individuals in acute suicidal crisis. While immediate care may stabilize the crisis, the days following discharge remain one of the most dangerous periods, with suicide attempts frequently occurring within hours or days (Chung et al., 2017). Despite long-standing recognition of this risk, health systems across the world continue to lack standardized protocols to ensure safe transitions (Boudreaux et al., 2015).
Methods
We conducted a structured review of literature published between 2010 and 2025 using PubMed, Google Scholar, and World Health Organization (WHO) reports. Studies were included if they reported outcomes following ED discharge, evaluated suicide risk assessment tools, or investigated follow-up interventions. MeSH terms included “suicidal ideation,” “emergency department,” “post-discharge,” “follow-up,” and “suicide prevention.”
Results
Patients discharged from the ED after presenting with suicidal ideation have the highest risk of repeat self-harm within the first month, especially in the first 72 hours (Chung et al., 2022; Carroll et al., 2014). Although tools such as the Columbia Suicide Severity Rating Scale (C-SSRS) and the SAD PERSONS scale are available, their predictive accuracy is limited and application in routine practice remains inconsistent (Saunders et al., 2014). Interventions that combine safety planning with proactive follow-up, such as structured phone calls or rapid linkage to outpatient care, have shown significant reductions in repeat suicide attempts (Stanley et al., 2018; Luxton et al., 2013). Nonetheless, barriers persist, with nearly 70% of patients failing to attend follow-up care after ED discharge (Chung et al., 2022).
Conclusion
Suicide prevention in the immediate post-discharge period remains a neglected global patient safety challenge. Implementing standardized discharge protocols that include suicide risk screening, effective communication, and timely follow-up could prevent avoidable deaths and should be prioritized worldwide.
