How do you approach patients who present repeatedly to the ED with suicidal ideation but no clear acute change in risk?

If a young patient presents repeatedly to the ED with SI, even if there is no change in acute risk, it is an indication that whatever is being put in place is not working well enough to support the patient, and/or a communication of the young patient's distress.

This warrants a careful assessment of...

Each ED encounter for patients with suicidal ideation should include an assessment that evaluates the essential pieces of information to complete a suicide risk assessment. This includes obtaining updated information on events that occurred since the patient’s previous encounter to limit assumptions...

This scenario is very common in our practice. Our primary goal is to protect patients' lives. We must remember the "wolf story." Documentation, documentation, and documentation of both active and passive suicidal risk is essential. Then admit the patient or send to IOP according to your judgement.

I...