Attendance at the accident and emergency department in the year before suicide: Retrospective study

Isaura Gairin · Allan O. House · David Owens

262 citations0/0 files storedThe British Journal of Psychiatry

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Suicide and Self-Harm Studies Psychiatric care and mental health services Homicide, Infanticide, and Child Abuse

Abstract

BACKGROUND: The National Confidential Inquiry into suicides in England and Wales found that a quarter of suicides are preceded by mental health service contact in the year before death. However, visits to accident and emergency departments due to self-harm may not lead to a record of mental health service contact. Aims To determine the proportion of suicides preceded by accident and emergency attendance in the previous year. METHOD: We obtained the list of probable suicides in Leeds for a 38-month period, and examined the records from the city's accident and emergency departments for a year before each death. RESULTS: Eighty-five (39%) of the 219 people who later died by suicide had attended an accident and emergency department in the year before death, 15% because of non-fatal self-harm. Final visits due to self-harm were often shortly before suicide (median 38 days), but the National Confidential Inquiry recorded about a fifth of them as 'not in contact' with local mental health services. CONCLUSIONS: Although many suicides are preceded by recent attendance at accident and emergency departments due to non-fatal self-harm, local mental health service records may show no recent contact. Suicide prevention might be enhanced were accident and emergency departments and mental health services to work together more closely.

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References

2002Fatal and non-fatal repetition of self-harm 1999Suicide within 12 months of contact with mental health services: national clinical survey 1988Suicide, and Other Causes of Death, Following Attempted Suicide 1998Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition 2003The National Suicide Prevention Strategy for England 1997Mental disorders and suicide in Northern Ireland 1997Trends in deliberate self-harm in Oxford, 1985–1995

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2012Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993–2008 2017National Trends in Suicide Attempts Among Adults in the United States 2016Epidemiology and trends in non-fatal self-harm in three centres in England, 2000–2012: findings from the Multicentre Study of Self-harm in England 2017Suicide Following Deliberate Self-Harm 2005Mortality and Further Suicidal Behaviour After an Index Suicide Attempt: a 10-Year Study 2019Suicide following presentation to hospital for non-fatal self-harm in the Multicentre Study of Self-harm: a long-term follow-up study

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