(PS9-7) Integrating Cultural Considerations into Suicide Risk Assessment: Insights from Emergency Department Clinicians

Objectives:  Suicide risk assessment in the emergency department (ED) is a critical process that can determine life-saving interventions. Nearly half of individuals who die by suicide have visited a healthcare provider within the month prior to their death (Nock et al., 2022), yet gaps in risk identification remain. Cultural background plays a significant role in shaping both patient risk factors and clinician decision-making, but little is known about how these considerations influence suicide risk assessments and treatment recommendations in ED settings. This study examined how ED clinicians incorporate cultural factors into their assessments and clinical decisions.

Methods:  Semi-structured interviews were conducted with 20 ED clinicians to explore how cultural background influences suicide risk assessment and treatment planning. The interviews focused on clinicians’ experiences, perceived barriers, and strategies for incorporating cultural considerations into decision-making.

Results:  Thematic analysis revealed that clinicians identified key cultural factors affecting suicide risk assessment and treatment recommendations, including (1) patients’ beliefs about mental health, (2) experiences of discrimination or stigmatization, (3) cultural mistrust of medical systems, and (4) gender. Some clinicians reported challenges in explicitly incorporating cultural considerations due to the absence of standardized guidelines and linguistic or literacy barriers. To address these gaps, clinicians emphasized the need for (1) bias recognition training, (2) improved accessibility of mental health resources for diverse communities, and (3) enhanced incorporation of culturally relevant risk and protective factors into clinical workflows.

Conclusions:  These findings highlight the need for implementing training programs that emphasize cultural competence and awareness of implicit biases in suicide risk assessment and care planning. By addressing these gaps, ED clinicians may be better equipped to provide equitable and culturally responsive care for individuals at risk of suicide. Future research should explore the development of structured approaches to support clinicians in integrating cultural considerations into risk assessment practices.