• Depression is a major public health problem as a leading predictor of functional disability and mortality.

• Optimal depression treatment improves outcome for most patients.

• Most adults with clinical significant depression never see a mental health professional but they often see a primary care physician.

• A physician who is not a psychiatrist misses the diagnosis of depression 50% of times.

• All depressed patients must be specifically enquired about suicidal ideations.

• Suicidal ideation is a medical emergency.

• Risk factors for suicide are known psychiatric disorders, medical illnesses, prior history of suicidal attempts or family history of attempted suicide.

• The demographic reasons include older age, male gender, marital status (widowed or separated) and living alone.

• About 1 million people commit suicide every year globally.

• Around 79% of patients who commit suicide contact their primary care provider in the last one year before their death and only one-third contact their mental health service provider.

• Twice as many suicidal victims had contacted their primary care provider as against the mental health provider in the last month before suicide.

• Suicide is the 10th leading cause of death worldwide and accounts for 1.2% of all deaths.

• The suicide rate in the US is 10.5 per 100,000 people.

• In the US, suicide is increasing in middle-aged adults.

• There are 10 to 40 non–fatal suicide attempts for every one completed suicide.

• The majority of suicides completed in US are accomplished with fire arm (57%); the second leading method of suicide in US is hanging for men and poisoning in women.

• Patients with prior history of attempted suicide are 5–6 times more likely to make another attempt.

• Fifty percent of successful victims have made prior attempts.

• One of every 100 suicidal attempt survivors will die by suicide within one year of the first attempt.

• The risk of suicide increases with increase in age; however, young adults and adolescents attempt suicide more than the older.

• Females attempt suicide more frequently than males but males are successful three times more often.

• The highest suicidal rate is amongst those individuals who are unmarried followed by those who are widowed, separated, divorced, married without children and married with children in descending order.

• Living alone increases the risk of suicide.

• Unemployed and unskilled patients are at higher risk of suicide than those who are employed.

• A recent sense of failure may lead to higher risk.

• Clinicians are at higher risk of suicide.

• The suicidal rate in male clinicians is 1.41 and in female clinicians it is 2.27.

• Adverse childhood abuse and adverse childhood experiences increase the risk of suicidal attempts.

• The first step in evaluating suicidal risk is to determine presence of suicidal thoughts including their concerns and duration.

• Management of suicidal individual includes reducing mortality risk, underlying factors and monitoring and follow up.

• Major risk for suicidal attempts is in psychiatric disorders, hopelessness and prior suicidal attempts or threats.

• High impulsivity or alcohol or other substance abuse increase the risk.