Citation

Chitty KM, Cvejic RC, Heintze T, Srasuebkul P, Morley K, Dawson A, Carter G, Dinh M, Buckley NA, Trollor JN. Crisis 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, International Association for Suicide Prevention, Publisher Hogrefe Publishing)

DOI

10.1027/0227-5910/a000880

PMID

36073254

Abstract

Aims: We investigated the association between problematic use of alcohol and/or drugs (PUAD) and the incidence, urgency, and mode of discharge for a subsequent episode of self-harm (SH) or suicidal ideation (SI).

METHODS: This was a retrospective population-based cohort study of individuals admitted to hospital for an index episode of SH/SI (2010-2014) using linked data from hospital admissions and emergency department (ED) presentations. The outcome variables were (1) subsequent presentation to the ED for SH/SI, (2) triage category, and (3) mode of departure. Key predictors were PUAD.

RESULTS: In total, 23,007 individuals were admitted to hospital for an index SH/SI, of whom 8% had a subsequent presentation to an ED for SH/SI within a year. The odds of subsequent presentation was increased in those with problematic alcohol use (AOR 1.62, 95% CI 1.36, 1.92), drug use (AOR 1.28, 95% CI 1.07, 1.53), and mental health diagnoses (AOR 1.63, 95% CI 1.44, 1.85). Those with problematic alcohol use were more likely to be assigned to the most urgent triage categories (AOR 1.84, 95% CI 1.32, 2.56). Limitations: Defining SH and PUAD using administrative data is challenging, and the true prevalence is likely to be underestimated.

CONCLUSION: The findings underscore the importance of drug health intervention as a key component of self-harm prevention.

Language: en

Keywords

emergency department; alcohol; administrative health data; deliberate self-harm; drugs; hospitalzation; linked data