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High-risk suicidal ideation after near-lethal attempt — RCPSC EM MCQ

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ModeratePsychiatric emergenciesHigh-risk suicidal ideation after near-lethal attemptRCPSC EM

CTAS 2: A 42-year-old is medically cleared after carbon monoxide exposure from a closed-garage attempt. Vitals are stable and carboxyhaemoglobin has normalised. They express regret about surviving, have access to firearms at a rural home, and refuse collateral contact. Mental status is coherent but hopeless. What is the most appropriate disposition?

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Correct answer: A — Involuntary psychiatric assessment under provincial mental health legislation

Persistent suicidal intent, lethal means and refusal of safety planning create imminent risk. Emergency physicians must use applicable provincial legislation for involuntary assessment when criteria are met.

Reference: Canadian mental health legislation principles; CAEP ED psychiatry resources