Suicide Risk after Emergency Department Visit

Emergency department patients presenting with intentional self-harm or suicidal thoughts are at increased risk of suicide in the year after their visit.

Researchers used data on California residents who visited emergency departments in the state between January 2009 and December 2011. They divided the patients into three groups: (1) those presenting with deliberate self-harm, (2) those with at least one visit for suicidal thoughts but no visits for self-harm, and (3) a reference group that included a 5% random sample of all other patients. Using death certificates, the researchers calculated age-, sex- and race/ethnicity-adjusted standardized mortality ratios for suicide in the year after an emergency department visit in each patient group.

The analysis found that patients seen for self-harm had a suicide mortality ratio more than 50 times higher than the reference group. Patients seen for suicidal thoughts had a suicide mortality ratio more than 30 times higher than the reference group.

These results suggest a need for widespread implementation of suicide risk screening and intervention in emergency departments, particularly for patients presenting with intentional self-harm or suicidal thoughts.

Goldman-Mellor, S., Olfson, M., Lidon-Moyano, C., & Schoenbaum, M. (2019). Association of suicide and other mortality with emergency department presentation. JAMA Network Open, 2(12), e1917571.