TY - JOUR PY - 2011// TI - Emergency department contact prior to suicide in mental health patients JO - Emergency medicine journal A1 - Da Cruz, Damian A1 - Pearson, Anthony A1 - Saini, Pooja A1 - Miles, C. A1 - While, David A1 - Swinson, Nicola A1 - Williams, Angela A1 - Shaw, Jon A1 - Appleby, Louis A1 - Kapur, Navneet SP - 467 EP - 471 VL - 28 IS - 6 N2 - Objectives To describe attendance at emergency departments (EDs) in the year prior to suicide for a sample of mental health patients. To examine the characteristics of those who attended (particularly those who attended frequently) prior to suicide. Design Case review of ED records for 286 individuals who died within 12 months of mental health contact in North West England (2003-2005). Method Cases identified through the National Confidential Inquiry into Suicide were checked against regional EDs to establish attendance in the year prior to death. Records were examined to establish the number of attendances, reason for the final, non-fatal attendance, treatment offered and outcome. Results One hundred and twenty-four (43%) individuals had attended the ED at least once in the year prior to their death, and of these, 35 (28%) had attended the ED on more than three occasions. These frequent attenders died by suicide significantly sooner after their final, non-fatal attendance than other attenders. A clinical history of alcohol misuse was also associated with early death following ED attendance. Conclusions Over 40% of our clinical sample attended an ED in the year prior to death, and some individuals attended particularly frequently. EDs may therefore represent an important additional setting for suicide prevention in mental health patients. The majority of attendances prior to suicide were for self-harm or to request psychiatric help. Clinicians should be alert to the risk associated with such presentations and to the possible association between frequent attendance and suicide.

Language: en

LA - en SN - 1472-0205 UR - http://dx.doi.org/10.1136/emj.2009.081869 ID - ref1 ER -