Suicide behavior constitutes a public health problem worldwide. It deserves epidemiological investigation regarding “best clinical practices”, and it is fundamental since the patient's first observation at psychiatric emergencies services. These are the ideal practices to start suicide prevention, and prevent further suicidal behavior. The improvement of healthcare quality includes the adoption of clinical guidelines, which support medical care since the emergencies services. The lack of specific instruments to evaluate suicidal risk urges the scientific community to create them.

The authors aim to discuss the advantages and limitations of the application of these kinds of instruments, and the creation of models based in scientific evidence available.

From multiple available studies, the Modified Sad-Persons Scale (MSPS) seems to be one of the most scientifically used in literature, as well as in epidemiological studies of suicide attempts and their repetition, either by nonfatal or fatal attempts. However, even this scale has been questioned by experts, and the lack of specific and sensible tests towards suicide behavior and risk of suicide attempts raises the importance of the need of further investigation towards this area. This evidence would then help the clinician in his work at emergencies wards and provide better healthcare towards preventing new suicide attempts.

The authors have not supplied their declaration of competing interest.