Despite the high stakes-both in terms of possible suicide and in terms of use of resources-few research data are available to inform clinical decision making in the assessment of acutely suicidal patients.

However, use of these approaches may not allay clinicians' anxiety about their patients' potential for suicide ( 5, 6). Crisis intervention, addiction rehabilitation, social services, and legal support are less costly options that may focus intervention on factors that contribute to suicide risk. Admission in these situations offers shelter, solace, and an escape from legal or social difficulties, but it is costly and seldom provides long-term solutions for the underlying problems. Acute suicidality tops most checklists of admission criteria and is the justification for many admissions ( 4), although the effect of brief hospitalizations on long-term suicide risk is unknown. In some settings, patients with social difficulties such as homelessness or legal problems present themselves as suicidal in order to be admitted to the hospital ( 3). Long-term risk factors for suicide, such as past attempts, serious mental illness, alcohol dependence, advanced age, male gender, Caucasian race, and poor health, also must be considered but are less amenable to acute interventions ( 1, 2). The emergency evaluation of potentially suicidal patients must take into account immediate risk factors for suicide, such as a recent attempt, hopelessness, intoxication, psychosis, or unwillingness or inability to reassure the clinician that no imminent self-harm will occur.

Suicide risk management is one of the most important tasks mental health professionals perform.

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