Predictors of emergency department visits for suicidal ideation and suicide attempt. (March 2020)

• Record Type: Journal Article
• Authors: Gentil, Lia; Huỳnh, Christophe; Grenier, Guy; Fleury, Marie-Josée
• Is Part Of: Psychiatry research. Volume 285(2020)
• Publication Date: 2020-03
• Subjects: Predictors -- Emergency department visits -- Suicidal ideation -- Suicide attempt -- Mental health -- Substance related disorders -- Mental disorders; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2020.112805
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Need factors most strongly predict ED use in suicidal ideation and suicide attempt. Personality disorders predict ED use in suicidal ideation and suicide attempt. Alcohol use and drug-induced disorders increased odds of ED use in suicide attempt. Lack of MH interventions decreased the odds of ED use for suicide attempt. Depression and age (12–17 yrs.) increased the odds of ED use for suicide ideation. Abstract: Objectives: This study investigated predictors of emergency department (ED) visits for suicidal ideation and suicide attempt in 2014–15 among patients at six Quebec emergency departments (ED), using administrative data. Methods: Participants ( n = 11, 778) used ED for suicidal ideation (30.4%); suicide attempt (7.0%); or other reasons (61.7%). A multinomial logistic regression was performed using variables described by the Andersen Behavioral Model. Results: The odds of ED visits for suicidal ideation or suicide attempt was high for adjustment disorders, personality disorders, and prior ED consultations for mental health (MH) reasons, but lower for schizophrenia spectrum and other psychotic disorders, illness acuity levels 3–5 (low severity), and 3+ consultations with outpatient psychiatrists. The odds of visiting ED for suicidal ideation increased in depressive disorders, and in the 12–17 year age range, but decreased in association with 1–2 outpatient psychiatrist consultations. The odds of suicide attempt also increased with alcohol use disorders and drug-induced disorders, but decreased with specific MH interventions at local community health services centers. Conclusion: increasing access to ambulatory care, and care continuity in outreach programs for acute MH disorders, including substance-related disorders, may reduce ED visits for suicidal ideation and suicide attempt, while improving overall service delivery.