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High-risk suicidal ideation — MCCQE Part 1 MCQ

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HardSuicidal IdeationHigh-risk suicidal ideationMCCQE Part 1

A 38-year-old woman with major depression tells her family physician she has bought medication with the intention of overdosing tonight. She refuses to go to hospital and says her children would be better without her. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Arrange emergency psychiatric assessment and ensure safe transport despite refusal

Specific suicidal intent, means, and imminent plan indicate high acute risk; emergency assessment and safety measures are required, using mental health legislation if criteria are met. Follow-up in two weeks is unsafe. A large sedative supply increases lethality. Confidentiality and autonomy do not prevent urgent action when there is serious risk of harm.

Reference: CAMH suicide risk resources; provincial Mental Health Acts