A6 – Primary Care to Emergency Department Navigation for Patients with Suicidal Ideation: Barriers and Facilitators

Summary

45% of people who have died by suicide attended a primary care appointment in the month preceding (SAMHSHA-HRSA, 2019). As such, primary Care is the front line for assessment of patients presenting with SI. When a patient demonstrates that they are a threat to their own safety, the standard of care is to send the patient to the ED for evaluation. For systems following this standard protocol, ED providers are often called upon to be the “first responders”to mental health concerns in emergency care settings (Suicide Prevention Resource Center [SPRC], 2016). Unfortunately, what was particularly concerning is there has been a relationship between visits to the ED (for suicide ideation) and subsequent suicide deaths (within two months post ED visit) (Knesper, 2011). In order to provide effective and seamless care for this nuanced issue, the gap between primary care and ED systems must be bridged and providers trained accordingly. We plan to share clinical examples of 6 patients who presented to primary care with SI and were escorted to the ED for further evaluation and treatment. These examples highlight the complex systemic barriers both providers and patients face. We plan to share how these barriers have been addressed in two primary care clinic through interdisciplinary collaboration and systemic understanding.