Attendance at the accident and emergency department in the year before suicide: Retrospective study

Abstract

Although many suicides are preceded by recent attendance at accident and emergency departments due to non-fatal self-harm, local mental health service records may show no recent contact. Suicide prevention might be enhanced were accident and emergency departments and mental health services to work together more closely.

Calls due to suicidal behaviour made to the prehospital, emergency department in Málaga: characteristics and associated factors

“…De hecho, los intentos de suicidio no se incluyen en las estadísticas oficiales, cuando cada vez existen más datos sobre su importancia como factores de riesgo [8][9][10][11][12][13][14] . Harris y Barraclough 15 realizaron un meta-análisis de los estudios de seguimiento de la mortalidad, estimando que quienes intentaron suicidarse tenían una probabilidad de 38 (quienes lo intentaron empleando cualquier método) a 40 (quienes lo intentaron por envenenamiento) veces mayor de cometer suicidio que quienes no presentaron ningún intento.…”

National differences between ED and ambulatory visits for suicidal ideation and attempts and depression

“…The difficulty in transferring psychiatric patients to inpatient facilities is a likely result of the sharp decrease in beds at mental health institutions combined with a concurrent increase in demand for mental health services [23]. Because most patients who present to the ED for self-harm will not successfully complete suicide in the following year, intervention for all is unrealistic [3]. Therefore, it is essential to develop methodologies to effectively identify high-risk patients.…”

“…Interventions such as psychosocial assessments and therapeutic interviews have shown promise in identifying high-risk patients and reducing the risk of self-harm. Gairin et al found that patients who received psychosocial assessment before discharge were more readily identified as high risk, and Kapur et al [24] found that a psychosocial assessment halved the risk of repetition of self-harm [3,20]. Furthermore, efforts to identify possible ambulatory-sensitive psychiatric visits and their determinants may assist policy makers in reducing the utilization of psychiatric visits on acute settings such as the ED.…”

“…In 2004, suicide was the 16th leading cause of death worldwide [2]. In the United States, suicide ranked as the fourth leading cause of death between the ages of 10 and 65 years [3]. Furthermore, these statistics do not capture the full impact of the disease, as there are additionally many unsuccessful suicide attempts with resulting injuries as well as visits to both the emergency department (ED) and psychiatric institutions for suicidal ideation.…”

Suicidio y Trastorno Mental

“…También existe relación entre suicidio y trastornos de alimentación en adolescentes mujeres, trastornos de conducta en hombres (límite y sociópata) y abuso de sustancias en ambos sexos (Bhatia & Bhatia, 2007 Existe mayor riesgo de suicidio en los primeros meses después de ser diagnosticado con algún trastorno afectivo (Castro-Díazet al, 2013), depresión psicótica y trastorno bipolar (Steele & Doey, 2007). El riesgo aumenta en los primeros días o semanas de inicio de un tratamiento farmacológico ya que en dicho período suele empeorar la sintomatología (Healy & Alfred, 2005;Perlis et al, 2007), y en los días siguientes al alta hospitalaria, sobre todo en aquellos que consultan en urgencias (Gairin, House, & Owens, 2003;Hansagi, Olsson, Hussain, & Onlén, 2008), reportando un riesgo 100 veces mayor (Ho, 2003) entre los tres días y la semana después de salir del hospital (Hunt et al, 2009). …”