Quality of care in emergency psychiatry is correlated with rapid diagnose, application of validated clinical guidelines for emergencies and focus on therapeutic alliance. We propose a specific diagnosis and intervention program for the management of patients with suicidal thoughts and behaviour. The specificity of this program involves the evaluation of the level of suicidal risk, the lethality of the suicidal thoughts and the timeframe planned before the occurrence of the suicidal behavioural. Risk level depends on age, gender, substance use, etc. Evaluation of these items and intervention programs concerning these issues will be discussed in a real life emergency department environment.