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Suicidal ideation with imminent risk — RCPSC EM MCQ

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ModeratePsychiatric emergenciesSuicidal ideation with imminent riskRCPSC EM

A 46-year-old presents after texting a suicide note and buying rope. He now asks to leave, denies current intent, and smells of alcohol. Collateral from family describes escalating threats and firearm access at home. What is the most appropriate disposition?

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

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Correct answer: D — Keep him in the ED under the applicable provincial mental health process for urgent psychiatric assessment

Keep him in the ED under the applicable provincial mental health process for urgent psychiatric assessment is correct: the clues indicate Suicidal ideation with imminent risk and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian ED suicide risk and provincial mental health legislation practice