Youth Suicide Prevention in the Emergency Department: Lethal Means Counseling 101

Authors

• Bijan Ketabchi, Division of Emergency Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA. Electronic address: ketabchib@chop.edu.
• Sofia Chaudhary, Division of Emergency Medicine, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA.
• Kristine Cieslak, Division of Emergency Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, IL.
• Kristol Das, Department of Pediatric Emergency Medicine, Sinai Hospital, Baltimore, MD.
• Ashley A. Foster, Department of Emergency Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA.
• Maya Haasz, Section of Pediatric Emergency Medicine, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.
• Jennifer A. Hoffmann, Division of Emergency Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, IL.
• Leslie Hueschen, Division of Emergency Medicine, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO.
• Elizabeth Lehto, Division of Pediatrics, Norton Children's, University of Louisville School of Medicine, Louisville, KY.
• Sagar Devendra Mehta, Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, GA; Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, GA.
• Shilpa J. Patel, Division of Emergency Medicine, Children's National Hospital, the George Washington University School of Medicine and Health Sciences, Washington, DC.
• Wendy J. Pomerantz, Division of Emergency Medicine, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH.
• Christian D. Pulcini, Department of Emergency Medicine, University of Vermont Larner College of Medicine, Burlington, VT.
• Curt Stankovic, Division of Emergency Medicine, Children's Hospital of Michigan, Central Michigan University School of Medicine, Detroit, MI.
• Amanda Stewart, Division of Emergency Medicine, Children's National Hospital, the George Washington University School of Medicine and Health Sciences, Washington, DC.
• Sindhu Sudanagunta, Dell Children's Medical Center, University of Texas Austin Dell Medical School, Austin, TX.
• Irma T. Ugalde, Department of Pediatrics, Comer Children's Hospital, University of Chicago, Chicago, IL.
• Eric Fleegler, Division of Pediatric Emergency Medicine, Massachusetts General Hospital, Boston, MA; MGH Gun Violence Prevention Center, Massachusetts General Hospital, Boston, MA; Pediatrics and Emergency Medicine, Harvard Medical School, Boston, MA.
• Susan Duffy, Department of Emergency Medicine, Alpert Medical School, Brown University, Hasbro Children's Hospital, Providence, RI.

Document Type

Journal Article

Publication Date

4-17-2025

Journal

Annals of emergency medicine

DOI

10.1016/j.annemergmed.2025.02.021

Keywords

Lethal means counseling; Mental health; Pediatrics; Suicide prevention; Youth suicide

Abstract

Suicide remains one of the leading causes of death among youth, as the incidence of suicidal ideation and attempts continue to rise. Mental health-related concerns now account for nearly 1 in 7 presentations to the emergency department (ED) among youth-approximately 7.5 million visits annually. For many children in the United States, the ED serves as their first or only point of medical contact, placing emergency clinicians on the front lines of suicide prevention. Lethal means counseling is an evidence-based suicide prevention strategy that emphasizes securement or removal of potentially dangerous items in the home. Implementation of lethal means counseling in the ED has been shown to be both feasible and efficacious. In this piece, we discuss the need for suicide prevention in the ED, the evidence behind lethal means counseling and effective strategies for implementation in your department.

APA Citation

Ketabchi, Bijan; Chaudhary, Sofia; Cieslak, Kristine; Das, Kristol; Foster, Ashley A.; Haasz, Maya; Hoffmann, Jennifer A.; Hueschen, Leslie; Lehto, Elizabeth; Mehta, Sagar Devendra; Patel, Shilpa J.; Pomerantz, Wendy J.; Pulcini, Christian D.; Stankovic, Curt; Stewart, Amanda; Sudanagunta, Sindhu; Ugalde, Irma T.; Fleegler, Eric; and Duffy, Susan, "Youth Suicide Prevention in the Emergency Department: Lethal Means Counseling 101" (2025). GW Authored Works. Paper 7032.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7032

Department

Emergency Medicine