Call for improved suicide risk screening in ASCs aims to strengthen safety protocols

Editor's Note

According to medical experts, healthcare professionals in ambulatory surgery centers (ASCs) must be more vigilant in recognizing and managing suicidal ideation among patients, Pain Medicine News January 27 reports. With the increasing shift of surgical procedures from hospitals to ASCs, clinicians are more likely to encounter patients struggling with mental health crises.

Suicide remains a major public health concern, ranking as the 11th leading cause of death in the US in 2022. That year, there were 1.6 million suicide attempts, with an average of 135.5 deaths per day, according to the Centers for Disease Control and Prevention. Notably, a 2019 study found over 54% of individuals who died by suicide had seen a healthcare provider within a month—and nearly 30% had a visit within a week—of their deaths.

In the article, Kara M. Barnett, MD, director of anesthesia services at Memorial Sloan Kettering Monmouth, emphasized the need for clear protocols in ASCs for suicide risk assessment. She recounted an incident involving a 71-year-old cancer patient with chronic pain who admitted to suicidal thoughts while receiving care at a freestanding ASC. Due to the lack of an official suicide risk assessment tool, the patient was transferred to the emergency department, where he was ultimately deemed low risk—causing an unnecessary delay in his procedure.

Since then, Dr Barnett’s institution has implemented the abbreviated Columbia-Suicide Severity Rating Scale (C-SSRS), a “widely available” tool for quickly assessing suicidal ideation and risk level, the article noted. She urges anesthesiologists and ASC providers to be aware of suicide prevalence, available screening tools, and key risk assessment questions. The C-SSRS, for instance, can help ASCs efficiently screen patients and ensure high-risk individuals receive immediate intervention, while low-risk patients avoid unnecessary delays in their care.