This audit retrospectively analysed data from 376 files of patients who had presented to the ED in Waikato Hospital, Hamilton, following an attempted suicide between 1 July 2015 to 30 June 2016. The auditors evaluated the quality of psychiatric risk assessments conducted by Mental Health & Addiction Services staff members in the ED, to determine adherence to the New Zealand Ministry of Health Clinical Practice Guidelines for Deliberate Self Harm. The analysis found that clinicians routinely focused on the historical features of the suicide attempt presentation and failed to record judgements about future suicidal behaviours. Fewer than half of the cases recorded interactions with family members. The guideline with the lowest level of adherence was that requiring clinicians to check whether Māori patients wanted culturally appropriate services during the assessment and treatment planning; <10% of the clinical records reported following this guideline.