A new UCLA study found that suicidal emergency patients face numerous barriers to outpatient treatment after leaving the emergency department. Titled "Survey of California Emergency Departments About Practices for Management of Suicidal Patients and Resources Available for Their Care," the study depicts a health care system inadequate to the needs of one of emergency medicine's most vulnerable patient populations: the suicidal. It will be published in the Aug. 18 online edition of the Annals of Emergency Medicine.

The majority of life-threatening and medically severe suicide attempts are treated in emergency departments, and patients who survive these attempts are at risk for repeat attempts with more lethal methods, as reflected in previous studies.

The new study showed that 71 percent of California emergency physicians responding to a UCLA survey reported that they need improved access to mental health personnel for evaluation of suicidal patients, and 61 percent reported needing improved access to mental health personnel for patient disposition.

"We are undermanned and understaffed, and the need for health care is increasing faster than resources are," said Dr. Larry J. Baraff, professor of emergency medicine at the David Geffen School of Medicine at UCLA. "In the emergency department itself, no single type of mental health professional - including psychiatrist, social worker, county or private psychiatric evaluation team, psychiatric nurse, or psychologist - was available for evaluation of suicidal patients in more than 50 percent of those who responded. Our survey indicates that lack of adequate community mental health resources contributes to the documented difficulties in linking emergency patients with mental health problems, including suicide, to outpatient mental health treatment."

"This article illustrates what is well known to emergency physicians: Our health care system is broken," said Dr. Frederick C. Blum, president of the American College of Emergency Physicians. "Emergency physicians provide care to many of our nation's most at-risk patients. Unfortunately, once they leave the emergency department, they have to fend for themselves."

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