Background: Suicide is a severe public health problem, in 2008 the Italian ministerial recommendation n° 4 on the management of suicide defined key areas for the identification of suicidal risk in hospital wards. The guidelines are important in defining professional liability issues, in line with Law 24 of 8/3/2017 ‘Gelli-Bianco’. Our study aimed to investigate the appropriateness of the official documents on suicide prevention delivered by Italian hospitals and their compliance with the ministerial recommendation.

Methods: The Italian hospitals’ public procedures on suicide prevention issued between 2008 and 2019 (n = 33) were retrieved thorough web search and further evaluated according to their compliance with the 2008 Italian ministerial recommendations.

Results: The guidelines documents were generally in line with the ministerial recommendation. However, we found a lack of implementation in the specific training of health professionals. Most guidelines provided no risk stratification, nor specific procedures for different risk degrees or diagnoses. More than half of the documents did not report standardised tools for the assessment of suicidal risk.

Conclusions: The public procedures on suicide prevention in Italian hospitals present general indications, leaving room for interpretation. Public procedures should be implemented with greater attention to the elements of judgement in the assessment of suicidal risk.

• KEY POINTS

• Procedures for suicide prevention are of uttermost importance for psychiatrist working in hospital.

• Standards in suicide risk evaluations are needed.

• Comparison between procedures can improve risk assessment and evaluation

背景：自杀是一个严重的公共卫生问题，2008年意大利关于自杀管理的第4号部长级建议确定了确定医院病房自杀风险的关键领域。根据2017年8月3日“ Gelli-Bianco”第24号法律，该指南对于定义专业责任问题非常重要。我们的研究旨在调查意大利医院提供的有关预防自杀的正式文件是否适当以及是否符合部长级建议。

方法：通过 网络搜索检索2008年至2019年间发布的意大利医院自杀预防公共程序（n = 33），并根据其对2008年意大利部长级建议的遵守情况进行进一步评估。

结果：指南文件总体上与部长级建议相符。但是，我们发现在卫生专业人员的特定培训中缺乏实施。大多数指南都没有提供风险分层，也没有提供针对不同风险程度或诊断的特定程序。超过一半的文件没有报告用于评估自杀风险的标准化工具。

结论：意大利医院的预防自杀的公共程序具有一般适应症，有解释的余地​​。在执行自杀风险评估时，公共程序应更加重视判断要素。

• 关键点

• 预防自杀的程序对于在医院工作的精神科医生至关重要。

• 需要制定自杀风险评估标准。

• 程序之间的比较可以改善风险评估和评估