Suicide and attempted suicide: a challenge in emergency-urgency. Critical review and experience in the emergency departments of Parma’s province.

Suicide is a public health problem with important social consequences. Its prevalence is highly variable across different ages and cultures. In western countries suicide accounts for several deaths, representing one among the ten leading causes, one among the three in the age group between 15 and 44 years. There are nearly one million suicidal deaths per year worldwide, i.e., more than 2700 per day. In Italy, ~4000 suicidal deaths (three fourth in males) are recorded each year, but – rather understandingly – the data are underestimated due to uncertainty in causal events, reticence of victim’s relatives and friends, occult poisoning. Moreover, at least ten attempted suicides are reported for each one accomplished. The Emergency Department (ED) represents the facility where more than 80% attempted suicides are referred and it is therefore the privileged location for their evaluation and prevention. ED represents for many people the first and often the only chance for asking and gathering help. Several persons had contact with ED or with their General Practitioner (GP) during the few days/weeks before suicide attempting. As such, since the risk of reiteration is much higher in the few weeks after a first attempt, a rapid and structured care of the patient is advisable, starting from ED or GP. The aim of this article is the description and the synthesis of the current indications for the care of suicidal patient