The assessment and management of people at risk of suicide: Best practice evidence-based guideline for emergency departments and mental health service acute assessment settings.

The purpose of these guidelines is to guide those working in emergency departments and in acute psychiatric services in the appropriate assessment and early management of suicidal people. They complement the related primary mental health guidelines for use in general practice,8 schools,9 and also the Guidelines for Clinical Risk Assessment and Management in Mental Health Services (1998).10 They replace the earlier guideline for mental health services prepared by the Ministry of Health in 1993.11 These guidelines focus on intervening with people who have made a suicide attempt with the intent (or partial intent) of ending their lives and those who are at risk of taking their own life. Some people harm themselves deliberately without suicidal intent, such as by repeated cutting or other forms of deliberate self-harm. While some of the management principles described in these guidelines may be helpful for assisting these people, additional measures are necessary, which are beyond the scope of these guidelines. The Royal Australian and New Zealand College of Psychiatrists is currently developing guidelines for the treatment of adult deliberate self-harm which are due for release in 2003. These guidelines are evidence-based. Where clear recommendations for action are made, there are statements about the strength of supporting evidence that these are built upon. In the absence of research evidence, recommendations are made on the basis of the expert opinion of a working party of nominated individuals, substantiated by a wide peer review process.