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

Ketabchi, Bijan; Chaudhary, Sofia; Cieslak, Kristine; Das, Kristol; Foster, Ashley A; Haasz, Maya; Hoffmann, Jennifer A; Hueschen, Leslie et al. · Ann Emerg Med · 2025

review · Level V

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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.

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