Suicide 30 to 50 Times Higher After ED Visit for Self-Harm, Suicidal Ideation
Findings seen among patients presenting with self-harm and suicidal ideation in California
TUESDAY, Dec. 17, 2019 (HealthDay News) -- Emergency department patients presenting with deliberate self-harm or suicidal ideation are at substantially increased risk for suicide in the year following discharge, according to a study published online Dec. 13 in JAMA Network Open.
Sidra Goldman-Mellor, Ph.D., from the University of California in Merced, and colleagues examined the one-year incidence of suicide and other mortality among emergency department patients (2009 through 2011) who presented with nonfatal deliberate self-harm, suicidal ideation, or any other chief concern. Sociodemographic and clinical factors associated with suicide mortality risk were examined.
The researchers identified 648,646 individuals (mean [SD] age, 43.8 years; 54.1 percent women) who visited a California emergency department. In the year after index presentation, the rates of suicide deaths per 100,000 person-years were 693.4 deaths among 83,507 individuals presenting with deliberate self-harm (standardized mortality ratio [SMR], 56.8), 384.5 deaths among 67,379 individuals presenting with suicidal ideation but not self-harm (SMR, 31.4), and 23.4 deaths among 497,760 reference patients (SMR, 1.9). The rates of suicide mortality were higher among men (deliberate self-harm: 1,011.1 deaths per 100,000 person-years; suicidal ideation: 539.8 deaths; reference: 36.6 deaths), people aged 65 years or older (deliberate self-harm: 1,919.5 deaths; suicidal ideation: 691.2 deaths; reference: 28.6 deaths), and non-Hispanic white patients (deliberate self-harm: 914.1 deaths; suicidal ideation: 511.6 deaths; reference: 33.8 deaths) versus their respective referent groups.
"The process of planning for emergency department discharge may present opportunities to help ensure safe transitions to continuing outpatient mental health care and to consider broader risk for unintentional injury and other causes of premature mortality," the authors write.