A Guide for Taking Care of Your 

Family Member After Treatment 

in the Emergency Department

After an Attempt

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

www.samhsa.gov
If you are in crisis, please call:

National Suicide Prevention Lifeline

1-800-273-TALK (8255). 

www.suicidepreventionlifeline.org
A Guide for Taking Care of Your Family 

Member After Treatment in the Emergency 

Department
Acknowledgements

This brochure was originally developed by the National 

Alliance on Mental Illness (www.nami.org) in partnership 

with the Suicide Prevention Resource Center (www.

sprc.org) under Grant Number 1.U79 SM55029-01 

from the Substance Abuse and Mental Health Services 

Administration (SAMHSA), U. S. Department of Health 

and Human Services (HHS). 

Disclaimer

The views, opinions, and content of this publication are 

those of the authors and contributors and do not necessarily 

reflect the views, opinions, or policies of the Center for 

Mental Health Services (CMHS), SAMHSA, or HHS.

Public Domain Notice

All material appearing in this publication is in the public 

domain and may be reproduced or copied without 

permission from SAMHSA. Citation of the source is 

appreciated. This publication may not be reproduced 

or distributed for a fee without the specific, written 

authorization of the Office of Communications, SAMHSA, 

HHS.

Recommended Citation 

Substance Abuse and Mental Health Services 

Administration. After an Attempt: A Guide for Taking Care 

of Your Family Member After Treatment in the Emergency 

Department. (SMA 08-4357; CMHS-SVP06-0160), 

Rockville, MD: Center for Mental Health Services, 

Substance Abuse and Mental Health Services 

Administration, U.S. Department of Health and Human 

Services, 2006. Reprinted 2009. 

For Copies of This Publication

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Lifeline Website: http://www.suicidepreventionlifeline.org

7KLVSXEOLFDWLRQPD\EHGRZQORDGHGRURUGHUHGDW

http://www.samhsa.gov/shin. Or, please call SAMHSA’s 

Health Information Network at 1-877-SAMHSA-7 

(1-877-726-4727) (English and español).

Originating Office

Center for Mental Health Services

Substance Abuse and Mental Health Services 

Administration

1 Choke Cherry Road

Rockville, MD 20857

SMA 08-4357; CMHS-SVP06-0160

Printed 2006

Reprinted 2009
Suicidal thoughts and actions generate 

conflicting feelings in family members 

who love the person who wishes to take 

his or her own life. That is why this guide 

was developed for you. It will give you 

some important points on how to take 

care of yourself and your family member 

following a suicide attempt and it will 

provide resources to help you move 

forward.

What Happens in the Emergency 

Department

Goal

The goal of an emergency department 

visit is to get the best outcome for the 

person at a time of crisis—resolving 

the crisis, stabilizing the patient 

medically and emotionally, and making 

recommendations and referrals for 

followup care or treatment. There are 

several steps in the process, and they all 

take time.

When someone is admitted to an 

emergency department for a suicide 

1

Family Guide for

Your Family 

Member in 

the Emergency 

Department
attempt, a doctor will evaluate the 

person’s physical and mental health. 

Emergency department staff should look 

for underlying physical problems that may 

have contributed to the suicidal behavior, 

such as side effects from medications, 

untreated medical conditions, or the 

presence of street drugs that can cause 

emotional distress. While emergency 

department staff prefer to assess people 

who are sober, they should not dismiss 

things people say or do when intoxicated, 

especially comments about how they 

might harm themselves or others.

Assessment

After emergency department staff evaluate 

your family member’s physical health, 

a mental health assessment should be 

performed, and the physician doing the 

exam should put your relative’s suicidal 

behavior into context. The assessment will 

generally focus on three areas:

1. What psychiatric or medical conditions

are present? Are they being or have 

they been treated? Are the suicidal 

thoughts and behavior a result 

of a recent change, or are they a 

longstanding condition?

2. What did the person do to harm 

himself or herself? Have there been 

previous attempts? Why did the 

person act, and why now? What 

current stressors, including financial 

or relationship losses, may have 

contributed to this decision? Does 

the person regret surviving the suicide 

2
attempt? Is the person angry with 

someone? Is the person trying to 

reunite with someone who has died? 

What is the person’s perspective on 

death?

3. What support systems are there? Who 

is providing treatment? What treatment 

programs are a good match for the 

person? What does the individual and 

the family feel comfortable with?

Finally, a doctor may assess in more 

detail the actual suicide attempt that 

brought your relative into the emergency 

department. Information that the 

treatment team should look for includes 

the presence of a suicide note, the 

seriousness of the attempt, or a history of 

previous suicide attempts.

3

Inform the emergency department 

personnel if your relative has:

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medications, or other means of 

suicide.

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provider or physician.

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relationship.

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suicidal crisis following a certain type 

of intervention.
What the Emergency Department 

Needs To Know: How You Can 

Help

Confidentiality and Information Sharing

Family members are a source of history 

and are often key to the discharge plan.

Provide as much information as possible 

to the emergency department staff. Even 

if confidentiality laws prevent the medical 

staff from giving you information about 

your relative, you can always give them 

information. Find out who is doing the 

evaluation and talk with that person. You 

can offer information that may influence 

the decisions made for your relative.

If you ever again have to accompany your

relative to the emergency department 

after an attempt, remember to bring all 

medications, suspected causes of overdose, 

and any names and phone numbers of 

providers who may have information. 

Emergency department personnel should 

try to contact the medical professionals 

who know the situation best before 

making decisions. 

Other important information about your

relative’s history to share with the 

emergency department staff include:

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health professionals are taught to pay 

attention to this because there is an 

4
increased risk in families with a history of 

suicide.

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team—a recent change in medication, 

the therapist is on vacation, etc. This 

information is relevant for emergency 

department staff because if they do not 

feel hospitalization is best, they need 

to discharge your family member to a 

professional’s care.

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review this with the emergency 

department treatment team. If you have 

a guardianship, let them know that as 

well.

You may want to get permission from the 

staff and your relative to sit in on your 

relative’s evaluation in the emergency 

department to listen and add information 

as needed. Your role is to balance the 

emergency department staff’s training 

and the interview of the patient with 

your perspective. The best emergency 

department decisions are made with all 

the relevant information.

5

1 Advance directives are legal documents that allow someone to give 

directions for future medical care or designate another person to 

make medical decisions if one is unable to competently make such 

decisions. For more information, contact the National Disability Rights 

Network (NDRN) at 202-408-9514 or www.ndrn.org.
Next Steps After the Emergency 

Department

After your relative’s physical and mental 

health are thoroughly examined, the 

emergency department personnel will 

decide if your relative needs to be 

hospitalized—either voluntarily or by 

a commitment. If hospitalization is 

necessary, you can begin to work with the 

receiving hospital to offer information and 

support and to develop a plan for the next 

steps in your relative’s care. If involuntary 

hospitalization is necessary, the hospital 

staff should explain this legal procedure 

to your relative and you so that you both 

have a clear understanding of what will 

take place over the next 3–10 days, while 

a court decides on the next steps for 

treatment.

If your relative has a hearing impairment 

or does not speak English, he or she may 

have to wait for someone who knows 

American Sign Language or an interpreter. 

It is generally not a good idea to use a 

family member to interpret in a medical 

situation.

If the emergency department’s treatment

team, the patient, and you do not feel

hospitalization is necessary, then you 

should all be a part of developing a 

followup treatment plan. In developing a 

plan, consider the following questions:

6
7

Questions Family and Friends Should 

Ask About the Followup Treatment Plan

Ask your family 

member:

It is important to be 

honest and direct with 

your questions and 

concerns.

Ask the treatment 

team:

This includes the doctor, 

therapist, nurse, social 

worker, etc.

Do you feel safe to 

leave the hospital, 

and are you 

comfortable with 

the discharge plan?

Do you believe

professionally that 

my family member 

is ready to leave the 

hospital?

How is your 

relationship with 

your doctor, and 

when is your next 

appointment?

Why did you make

the decision(s) that 

you did about my 

family member’s 

care or treatment?

What has changed 

since your suicidal 

feelings or actions 

began?

Is there a followup 

appointment

scheduled? Can it be 

moved to an earlier 

date?

What else can I/

we do to help you 

after you leave 

the emergency 

department?

What is my role as 

a family member in 

the safety plan?

Will you agree to

talk with me/us if 

your suicidal feelings 

return? If not, is 

there someone else 

you can talk to?

What should we 

look for and when 

should we seek 

more help, such 

as returning to 

the emergency 

department or 

contacting other 

local resources and 

providers?

Remember: It is critical for the patient to schedule 

a followup appointment as soon as possible after 

discharge from the emergency department.
What You Need To Know

Make safety a priority for your relative 

recovering from a suicide attempt. 

Research has shown that a person who 

has attempted to end his or her life has a 

much higher risk of later dying by suicide. 

Safety is ultimately an individual’s 

responsibility, but often a person who feels 

suicidal has a difficult time making good 

choices. As a family member, you can help 

your loved one make a better choice while 

reducing the risk.

Reduce the Risk at Home—To help reduce 

the risk of self-harm or suicide at home, 

here are some things to consider:

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means of death for suicidal people—

they should be taken out of the home 

and secured.

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lethal—if it is necessary to keep 

pain relievers such as aspirin, Advil, 

and Tylenol in the home, only keep 

small quantities or consider keeping 

medications in a locked container. 

Remove unused or expired medicine 

from the home.

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inhibitions and cause people to act 

more freely on their feelings. As 

with pain relievers, keep only small 

quantities of alcohol in the home, or 

none at all.

Create a Safety Plan—Following a suicide 

attempt, a safety plan should be created 

8
to help prevent another attempt. The 

plan should be a joint effort between your 

relative and his or her doctor, therapist, or 

the emergency department staff, and you. 

As a family member, you should know 

your relative’s safety plan and understand 

your role in it, including: 

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“triggers,” such as an anniversary 

of a loss, alcohol, or stress from 

relationships.

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member with mental health 

professionals, family, friends, and 

community resources.

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strengths to promote his or her safety.

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in your relationship with your family 

member.

Remember that safety cannot be 

guaranteed by anyone—the goal is to 

reduce the risks and build supports for 

everyone in the family. However, it is 

important for you to believe that the 

safety plan can help keep your relative 

safe. If you do not feel that it can, let the 

emergency department staff know before 

you leave.

Maintain Hope and Self-Care—Families

commonly provide a safety net and a 

vision of hope for their suicidal relative, 

and that can be emotionally exhausting. 

Never try to handle this situation 

alone—get support from friends, relatives, 

9
and organizations such as the National 

Alliance on Mental Illness (NAMI), and 

get professional input whenever possible. 

Use the resources on the back pages of 

this brochure, the Internet, family, and 

friends to help you create a support 

network. You do not have to travel this 

road alone.

Moving Forward

Emergency department care is by nature

short-term and crisis oriented, but some 

longer-term interventions have been shown 

to help reduce suicidal behavior and 

thoughts. You and your relative can talk 

to the doctor about various treatments for 

mental illnesses that may help to reduce 

the risk of suicide for people diagnosed 

with illnesses such as schizophrenia, 

bipolar disorder, or depression. Often, 

these illnesses require multiple types 

of interventions, and your relative may 

benefit from a second opinion from a 

specialist. 

If your relative abuses alcohol or other 

drugs, it is also important to seek help 

for this problem along with the suicidal 

behavior. Seek out a substance abuse 

specialist. Contact your local substance 

abuse treatment provider by calling 

1-800-662-4357 or visiting 

www.findtreatment.samhsa.gov, or contact 

groups like Alcoholics Anonymous (AA) 

or Narcotics Anonymous (NA) to help 

your loved one; Al-Anon may be a good 

10
resource for you as a family member.2 If 

it is available in your area, an integrated 

treatment program like Assertive 

Community Treatment (ACT) may 

provide better outcomes than traditional 

care for some severely ill individuals.3

Ultimately, please reach out for help in

supporting your family member and 

yourself through this crisis. See the list 

below of hotlines, information, and 

support organizations to help you and 

your family member move forward with 

your lives. 

Remember that the emergency 

department is open 24 hours a day, 365 

days a year to treat your family member, if 

the problem continues and if your family 

member’s medical team is unavailable to 

provide the needed care.

11

2 Contact Alcoholics Anonymous at 212-870-3400 or www.aa.org; 

contact Narcotics Anonymous at 818-773-9999 or www.na.org;

contact Al-Anon (or Alateen for youth) at 757-563-1600 or

www.al-anon.alateen.org.

3 To learn more about ACT, contact NAMI at 1-800-950-NAMI (6264) 

or www.nami.org/act.
To learn more about suicide and 

to get help, consider the following 

resources.

In a crisis, contact:

1-800-273-TALK (8255)

TTY: 1-800-799-4TTY (4889)

National Suicide Prevention Lifeline

A 24-hour, toll-free crisis hotline that links 

callers to a nearby crisis center. 

www.suicidepreventionlifeline.org

For more information about suicide and

mental illness:

American Association of Suicidology

A resource and education organization 

dedicated to the understanding and 

prevention of suicide.

www.suicidology.org or call 202-237-2280

American College of Emergency 

Physicians (ACEP)

A national medical society committed to 

advancing emergency care through continuing 

education, research, and public education. 

www.acep.org or call 1-800-798-1822

American Foundation for Suicide 

Prevention

Dedicated to advancing the public’s 

knowledge of suicide and its prevention.

www.afsp.org or call 1-888-333-AFSP

American Psychiatric Association

A national professional organization of 

psychiatrists.

www.psych.org or call 703-907-7300

12
American Psychological Association

A national professional organization of 

psychologists.

www.apa.org or call 1-800-374-2721

Befrienders International/Samaritans

An online resource that gives support through 

e-mail and offers a directory of local crisis 

helplines.

www.befrienders.org 

Covenant House Nineline Hotline 

1-800-999-9999

A 24-hour, toll-free crisis hotline offering 

confidential and immediate crisis intervention 

and referrals to community resources.

www.covenanthouse.org/programs_nl.html 

Hispanic Community Resource Helpline

1-800-473-3003

(La Linea Nacional de Ayuda)

Offers support for Latinos who need 

information about educational, health, and 

human service providers.

Link’s National Resource Center for 

Suicide Prevention and Aftercare 

(LINK–NRC)

Provides suicide-related community education in 

prevention, intervention, aftercare, and support.

www.thelink.org or call 404-256-9797

Mental Health America

Addresses all aspects of mental health and 

mental illness.

www.nmha.org or call 1-800-969-NMHA (6642)

13
National Alliance on Mental Illness 

(NAMI)

Offers information, support, and advocacy for

persons affected by mental illnesses.

www.nami.org or call 1-800-950-NAMI (6264)

National Disability Rights Network

Serves individuals with a wide range of 

disabilities by guarding against abuse, 

advocating for basic rights, and ensuring 

system accountability. The Web site provides a 

directory of member agencies by State.

www.ndrn.org or call 202-408-9514 or 

202-408-9521 (TTY)

National Institute of Mental Health 

The leading Federal agency for research on 

mental and behavioral disorders.

www.nimh.nih.gov or call 1-866-615-6464

National Organization for People of 

Color Against Suicide 

Addresses and raises awareness about suicide 

in minority communities.

www.nopcas.com or call 1-866-899-5317

National Strategy for Suicide Prevention

A comprehensive national plan to confront 

suicide in the United States.

www.mentalhealth.samhsa.gov/suicideprevention

SAMHSA Health Information Network

The SAMHSA Health Information Network 

connects the behavioral health workforce and 

the general public to the most current and 

comprehensive information on the prevention 

and treatment of mental and substance use 

disorders. To speak with a trained Information 

Specialist (English/Spanish):

For treatment referrals, call 1-800-662-HELP 

(1-800-662-4357) 24 hours a day, 7 days a week.

14
For all other inquiries, call 1-877-SAMHSA-7 

(1-877-726-4727) M – F, 8 a.m. – 8 p.m. ET 

www.samhsa.gov

Suicide Awareness Voices of Education 

(SAVE)

Dedicated to preventing suicide through 

education, public awareness, and stigma 

reduction.

www.save.org or call 952-946-7998

Suicide Prevention Action Network 

(SPAN) USA 

A national organization dedicated to action 

and advocacy for suicide prevention.

www.spanusa.org or call 202-449-3600

Suicide Prevention Resource Center

Supports suicide prevention with the best of 

science, skills, and practice. 

www.sprc.org or call 1-877-GET-SPRC (438-

7772)

The Trevor Helpline

1-866-4U-TREVOR

A national 24-hour, toll-free suicide prevention

hotline aimed at gay and questioning youth.

www.thetrevorproject.org

These resources may contain materials that 

express views, policies, and opinions that do not 

necessarily reflect those of the Substance Abuse and 

Mental Health Services Administration and the 

U.S. Department of Health and Human Services.

15
For More Information:

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SMA 08-4357; CMHS-SVP06-0160

www.nami.org