Background: Characteristics and outcomes of patients presenting to Emergency Departments (EDs) have been under-examined. This paper describes the characteristics and risk of repeat suicidality among patients presenting to EDs with 1) suicidal ideation and 2) self-harm, compared to 3) controls in mental health crisis.
Methods:The Clinical Record Interactive Search tool identified 2211 patients who presented to three London EDs with suicidal ideation or self-harm, and 1108 control patients. All patients received a full psychosocial assessment. Chi-squared tests examined group characteristics. Cox regression models assessed the risk of re-presentation with suicidal ideation or self-harm within one year.Results: There were a higher proportion of females and individuals under the age of 25 in the self-harm group. Patients presenting with suicidal ideation or self-harm were more likely to be white, live in more deprived areas, and less likely to receive a psychiatric diagnosis within one year compared to controls. Risk of repeat suicidality within one year was 3-4 times higher in those with baseline suicidal ideation (adjusted HR=3.66, 95% CI 2.44-5.48) or self-harm (HR=3.53 95% CI 2.47-5.04) compared to controls.
Limitations:To be included patients needed to have a full psychosocial assessment.Incomplete records meant 21.4% of the sample was excluded. This will have introduced bias which might confound observed associations.
Conclusion:Individuals presenting with either suicidal ideation or self-harm have similar risk for re-presentation within one year. Both groups would benefit from personalised risk management plans and active follow-up to reduce the risk of repeat suicidal behaviour.