Citation

Gentil L, Huynh C, Grenier G, Fleury MJ. Psychiatry Res. 2020; 285: e112805.

Affiliation

Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montréal, Québec H4H 1R3, Canada; Institut universitaire sur les dépendances, 950 Louvain East, Montréal, Québec H2M 2E8, Canada; Psychiatry Department, McGill University, Canada. Electronic address: flemar@douglas.mcgill.ca.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.psychres.2020.112805

PMID

32035375

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.

Copyright © 2020 Elsevier B.V. All rights reserved.

Language: en

Keywords

Emergency department visits; Mental disorders; Mental health; Predictors; Substance related disorders; Suicidal ideation; Suicide attempt