Suicidal and self-harm behaviors in emergency psychiatry: bridging risk assessment and clinical decision-making

Background Suicidal behavior and non-suicidal self-injury (NSSI) represent major clinical challenges in psychiatric emergency settings. Despite extensive research on risk factors, the prediction and management of suicidal behavior remain complex, often requiring rapid decision-making under conditions of uncertainty. Objective To provide a practical, clinically grounded framework for the assessment and management of suicidal and self-harm behaviors in emergency settings, integrating current evidence with real-world clinical practice. Methods This narrative review synthesizes key findings from the literature alongside clinical experience in psychiatric emergency care. Core domains include conceptual definitions, functions of self-harm, suicide risk assessment, and acute management strategies. Results Self-harm behaviors frequently serve multiple intrapersonal and interpersonal functions, including emotional regula