This article describes an exploratory qualitative study that examined the impact of suicide on a group of 19 African American families who lost a family member to suicide. The majority of suicide survivors were women who lost children to suicide. The participants were interviewed for an average of 2.5 hours using a semi-structured interview that was developed by the author. The majority of survivors felt that they had to go through the grieving process alone. Those survivors who did receive support most often received it from family members and friends. Most of the respondents felt that the support, if any, that was offered from the church was unhelpful. Negative attitudes about suicide from the broader community and from family members made it more difficult for these families to grieve.

Joint Commission National Patient Safety Goal 15 calls for organizations "to identify patients at risk for suicide." Overt suicidal behavior accounts for 0.6% of emergency department (ED) visits, but incidental suicidal ideation is found in 3%-11.6%. This is the first multicenter study of suicide screening in EDs. Of 2,243 patients in six diverse emergency settings, 1,068 (47.7%) were screened with a brief instrument. Depression was endorsed by 369 (34.5%); passive suicidal ideation by 79 (7.3%); and active suicidal ideation by 24 (2.3%). One hundred thirty-seven (12.8%) reported prior attempts, including 35 (3.3%) with current suicidal ideation. Almost half of those with current ideation had a prior attempt (43.8%) versus those without current ideation, 10.3%, χ2 (1) = 75.59, p < .001. Twenty cases (25%) were admitted to medical services, but only 10 (12.5%) received mental health assessment; none were admitted directly to a psychiatry service. The prevalence of suicidal ideation here is similar to previous studies but the frequency of prior attempts has not been reported. The 35 cases with current ideation and prior attempt are at risk. As they did not present psychiatrically, they would likely have gone undetected. Despite reporting these cases to clinical staff, few received risk assessment.

A linguistic analysis of a series of letters written by a young man who died by suicide to 1 friend over a period of 2 years prior to his death revealed several trends, including a decrease in negative emotion words and an increase in death words. The implication of these trends was discussed.

A brief, self-administered, Web-based training program shows promise for improving residents' knowledge about suicidal behaviors in youth.

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