Suicide is the 9th leading cause of death in Canada, and a common reason for patients to present to Canadian emergency departments (ED). Little knowledge exists around Canadian emergency physicians (EPs) current practices and barriers to screening for suicidal thoughts (ST). Methods: We developed a web-based survey on suicide knowledge, which was pilot tested by two emergency physicians and one psychiatrist for clarity and content. The survey was distributed via email to attending physician

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... ers of the Canadian Association of Emergency Physicians. Data were described using counts, means, medians and interquartile ranges. Results: 193 EPs responded to the survey (response rate 16%), with 42% of EPs practicing in Ontario. 35% of EPs were female, the mean age was 48 (95% CI 47.3-48.7), and mean years in practice was 17 (95% CI 16.3-17.7). Academic practice location was reported by 55% of EPs, and 81% reported access to an inpatient psychiatry service. 142 EPs (82%) reported no protocol for screening for ST in their ED. Of EPs reporting an existing protocol, the most common practice was routine screening at triage (43%). The most commonly identified screening tools were HEADS-ED (25%) and PHQ-9 (21%). 70% of EPs felt the ED was a good place for screening for ST, yet 66% identified slower clinical care as a potential barrier. A strong commitment to treatment and follow up was identified by 68% of EPs as a necessary requirement to implementing ST screening in their ED. A targeted 2-4 question screen was the preferred screening option for 62% of EPs responding. Conclusion: A majority of EPs report no protocol for screening for ST in their ED, yet identify the ED as a good place for screening efforts. Potential barriers to widespread ST screening in the ED include a strong commitment to patient treatment and follow up, and diminished clinical efficiency.