Why ERs and Suicidal People Don’t Mix
Emergency rooms (ERs) across America are the daily front lines in trying to ward off death or serious disability for hundreds of thousands of Americans every year. They are constantly stressful arenas that pit skilled and dedicated doctors, nurses and health care workers against a myriad of problems from diseases and accidents, to strokes and death. It is not a place you would ever choose to be.
For better or worse in our health care system today, it is also the place of last resort that hundreds of thousands of people who are often in severe emotional pain turn to — people who try to commit suicide. In fact, many therapists will tell their actively suicidal patients, “If you feel like you’re going to harm yourself, call 911.” 911 wil get you a quick ambulance ride to the closest emergency room (if your county or state doesn’t provide access to a 24-hour psychiatric hospital, as most do not).
Generally speaking, most staff in ERs think and act like this doctor reveals — they don’t really care about most people who try to commit suicide and come to the ER because they view most of them as “not serious,” and therefore there’s little they, as medical professionals, can do for them. You see, ER staff are not really equipped or well-trained in mental health issues. Their focus is on life and death physical conditions, not mental ones. And so they dismiss most failed suicidal people as not really deserving their time, energy, or attention:
Many a time an irritated [ER] nurse has approached me and grimly suggested that we publish an educational flier titled “Suicide: getting it right the first time.”
If this makes it sound like we don’t take suicide attempts awfully seriously, then you’re right. Mostly it’s due to the preponderance of minor suicidal gestures over real attempts. Don’t think we’re not professional about it — we know how to rule out the serious threats and make sure that a safe disposition is accomplished. But we are not overly impressed with the low-level stuff we usually see.
From an ER doctor’s own mouth, they don’t take suicide attempts seriously. They are not “impressed” with the less serious attempts, as though a person’s attempt at suicide was some sort of contest done to try and win the ER staff’s respect.
This blog entry made me sad and enraged. Sad to see this kind of attitude from a real live medical doctor, because it seems to just reinforce the stigma of mental disorders in general — they aren’t real or serious and aren’t deserving of the medical staff’s time or attention. After all this effort of educating people about the “realness” of mental disorders, and we still have medical docs who think they are something less than the broken arm they just saw.
Really? This kind of attitude in 2008?? What will it take for the medical profession to wake up and smell the reality of serious mental disorders such as depression — a devastating condition that leads to 34,000+ people a year to successfully commit suicide. It’s the 11th leading cause of death in the U.S., and the 3rd amongst young adults and teens.
So I guess it’s not “serious” enough for the ER to pay anything but fake empathy and lip service to.
Maybe it’s an implication of the lack of appropriate psychiatric emergency services available in most local cities and towns. Maybe I’m expecting too much of a medical profession designed from the ground up to treat physical illness and diseases of the body, but not mental disorders and concerns of the mind.
But whatever the case, I find it increasingly difficult in recommending, in good conscience, that people seek out an ER in their time of need. A person seems to be just as likely to become demoralized and further depressed from the experience, than to actually receive compassionate care and treatment for their underlying mental disorder.
Grohol, J. (2018). Why ERs and Suicidal People Don’t Mix. Psych Central. Retrieved on April 1, 2020, from https://psychcentral.com/blog/why-ers-and-suicidal-people-dont-mix/