Youth Suicide Prevention in the Emergency Department: Lethal Means Counseling 101 - 18/09/25
Doi : 10.1016/j.annemergmed.2025.02.021
Bijan Ketabchi, MD, MPH a, ⁎ 
, Sofia Chaudhary, MD b, Kristine Cieslak, MD c, Kristol Das, MD, MPH d, Ashley A. Foster, MD e, Maya Haasz, MD f, Jennifer A. Hoffmann, MD, MS c, Leslie Hueschen, MD g, Elizabeth Lehto, DO, MS h, Sagar Devendra Mehta, MD i, j, Shilpa J. Patel, MD, MPH k, Wendy J. Pomerantz, MD, MS l, Christian D. Pulcini, MD, MEd m, Curt Stankovic, MD, MBA n, Amanda Stewart, MD, MPH k, Sindhu Sudanagunta, MD o, Irma T. Ugalde, MD p, Eric Fleegler, MD, MPH q, r, s, Susan Duffy, MD, MPH t
, Sofia Chaudhary, MD b, Kristine Cieslak, MD c, Kristol Das, MD, MPH d, Ashley A. Foster, MD e, Maya Haasz, MD f, Jennifer A. Hoffmann, MD, MS c, Leslie Hueschen, MD g, Elizabeth Lehto, DO, MS h, Sagar Devendra Mehta, MD i, j, Shilpa J. Patel, MD, MPH k, Wendy J. Pomerantz, MD, MS l, Christian D. Pulcini, MD, MEd m, Curt Stankovic, MD, MBA n, Amanda Stewart, MD, MPH k, Sindhu Sudanagunta, MD o, Irma T. Ugalde, MD p, Eric Fleegler, MD, MPH q, r, s, Susan Duffy, MD, MPH t a Division of Emergency Medicine, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
b Division of Emergency Medicine, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA
c Division of Emergency Medicine, Ann & Robert H Lurie Children’s Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, IL
d Department of Pediatric Emergency Medicine, Sinai Hospital, Baltimore, MD
e Department of Emergency Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA
f Section of Pediatric Emergency Medicine, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
g Division of Emergency Medicine, Children’s Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO
h Division of Pediatrics, Norton Children's, University of Louisville School of Medicine, Louisville, KY
i Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, GA
j Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, GA
k Division of Emergency Medicine, Children's National Hospital, the George Washington University School of Medicine and Health Sciences, Washington, DC
l Division of Emergency Medicine, Cincinnati Children’s Hospital, University of Cincinnati, Cincinnati, OH
m Department of Emergency Medicine, University of Vermont Larner College of Medicine, Burlington, VT
n Division of Emergency Medicine, Children's Hospital of Michigan, Central Michigan University School of Medicine, Detroit, MI
o Dell Children’s Medical Center, University of Texas Austin Dell Medical School, Austin, TX
p Department of Pediatrics, Comer Children's Hospital, University of Chicago, Chicago, IL
q Division of Pediatric Emergency Medicine, Massachusetts General Hospital, Boston, MA
r MGH Gun Violence Prevention Center, Massachusetts General Hospital, Boston, MA
s Pediatrics and Emergency Medicine, Harvard Medical School, Boston, MA
t Department of Emergency Medicine, Alpert Medical School, Brown University, Hasbro Children’s Hospital, Providence, RI
∗Corresponding Author.
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.
Le texte complet de cet article est disponible en PDF.Keywords : Suicide prevention, Pediatrics, Lethal means counseling, Mental health, Youth suicide
Plan
| Supervising editor: Steven M. Green, MD. Specific detailed information about possible conflicts of interest for individual editors is available at editors. |
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| Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals' policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. This collaborative review did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. |
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| Presentation information: A didactic workshop, based on the information within this piece, was presented by Bijan Ketabchi, Sofia Chaudhary, Eric Fleegler, Susan Duffy, and Lauren Hudak at the Society of Academic Emergency Medicine Conference on May 16, 2024 in Phoenix, AZ. |
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| Continuing Medical Education exam for this article is available at ACEPeCME/. |
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| A podcast for this article is available at www.annemergmed.com. |
© 2025
American College of Emergency Physicians. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 86 - N° 4
P. 415-426 - octobre 2025 Retour au numéro
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