Citation

El-Qawaqzeh K, Colosimo C, Bhogadi SK, Magnotti LJ, Hosseinpour H, Castanon L, Nelson A, Ditillo M, Anand T, Joseph B. J. Am. Coll. Surg. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1097/XCS.0000000000000716

PMID

37057829

Abstract

BACKGROUND: Psychiatric inpatient hospitalization is nearly always indicated for patients with recent suicidal behavior. We aimed to assess the factors associated with receiving mental health services during hospitalization or on discharge among survivors of suicide attempts in trauma centers. STUDY DESIGN: A 3-year analysis of the 2017-2019 ACS-TQIP. Adults (≥18 years) presenting following suicide attempts were included. Patients who died, those with ED discharge disposition, those with superficial lacerations, and who were transferred to non-psychiatric care facilities were excluded. Backward stepwise regression analyses were performed to identify predictors of receiving mental health services (inpatient psychiatric consultation/psychotherapy, discharge/transfer to a psychiatric hospital, or admission to a psychiatric distinct unit of a hospital).

RESULTS: 18,701 patients were identified, 56% received mental health services. Mean age was 40 ± 15 years, 72% were males, 73% were White, 57% had a preinjury psychiatric comorbidity, and 18% were uninsured. 43% had moderate to severe injuries (ISS>8), and most common injury was cut/stab (62%), followed by blunt mechanisms (falls, lying in front of a moving object, and intentional MVCs) (18%) and firearm injuries (16%). On regression analyses, Black race, Hispanic ethnicity, male gender, younger age, and positive admission alcohol screen were associated with lower odds of receiving mental health services (p<0.05). Increasing injury severity, being insured, having preinjury psychiatric diagnosis, and positive admission illicit drug screen were associated with higher odds of receiving mental health services (p<0.05).

CONCLUSION: Significant disparities exist in the management of survivors of suicide attempts. There is a desperate need for improved access to mental health services. Further studies should focus on delineating the cause of these disparities, identifying the barriers, and finding solutions.

Language: en