@article{ref1,
title="Self-reported usual care for self-directed violence during the 6 months before emergency department admission",
journal="Medical care",
year="2015",
author="Comtois, Katherine Anne and Kerbrat, Amanda H. and Atkins, David C. and Roy-Byrne, Peter P. and Katon, Wayne",
volume="53",
number="1",
pages="45-53",
abstract="BACKGROUND:: The literature describing the health services individuals receive before and following self-directed violence (SDV) is limited. <br><br>OBJECTIVES:: This study examines services received for the 6 months preceding admission to an urban county medical center emergency department (ED) for SDV. We predicted that individuals with at least 1 prior act of SDV in the past 6 months would have received more services than those for whom the index admission was their only recent act. <br><br>METHODS:: Participants were recruited from ED admissions during shifts selected to maximize representativeness. Participants (n=202) were interviewed using the Suicide Attempt Self-Injury Interview, Suicide Attempt Self-Injury Count, Treatment History Interview, Mini International Neuropsychiatric Interview, Brief Symptom Index, and SF-12. <br><br>RESULTS:: The majority of index acts of SDV (79%) were suicide attempts. The participants were characterized by low socioeconomic status, substantial symptomatology, low physical and mental health functioning, and multiple psychiatric diagnoses. In the preceding 6 months, 34% were admitted to a hospital and 56% received crisis services (including 44% in the ED). Although three quarters (76%) had seen an outpatient medical provider and most (70%) received psychotropic medications, less than half of the sample received psychiatric services (40%) or outpatient psychosocial treatment (48%). As predicted, utilization for most types of usual care was higher for those engaging in SDV in the 6 months preceding the index admission. <br><br>CONCLUSION:: Individuals admitted to this ED for SDV received inadequate outpatient psychosocial and psychiatric services despite severe illness and disability.<p /> <p>Language: en</p>",
language="en",
issn="0025-7079",
doi="10.1097/MLR.0000000000000252",
url="http://dx.doi.org/10.1097/MLR.0000000000000252"
}