Routine use of the Beck Scale for Suicide Ideation in a psychiatric emergency department

Abstract

Background U.S. suicide rates are estimated to be 11 per 100,000 people, and improved screening in emergency departments may reduce suicide rates. Method This study examined the relationship between clinician rating of suicide ideation and Beck Scale for Suicide Ideation (BSI) scores when clinicians had access to the BSI results and whether BSI scores and/or clinician ratings of suicidality are associated with patient disposition from the psychiatric emergency department. Results Of 735 patients, 665 (90%) had documentation of suicide ideation in the chart; 246 (37%) were rated as suicidal; 487 (66%) patients completed the BSI forms; 300 patients (62%) scored positive on the BSI. Logistic regression analysis for BSI scores and clinician ratings of suicidality showed similar results, except clinicians were more likely to rate males as suicidal, while BSI scores did not vary according to sex. Hospitalization occurred more often for patients with mood disorder who had positive BSI scores, while hospitalization occurred more often for patients with a diagnosis of bipolar disorder or schizophrenia who were rated by clinicians as suicidal. Conclusions There were important demographic and diagnostic differences revealed by logistic regression analysis of BSI scores and clinician-rated suicidality, and these differences may be associated with disposition for patients presenting with suicide ideation.