Suicide risk following Emergency Department presentation with self-harm varies by hospital

Objectives A large proportion of those who die by suicide present to an Emergency Department (ED) with self-harm (SH) in the year before death. This study examines ‘does risk of death following ED presentation with SH vary according to hospital attended?’ Methods The Northern Ireland Self-Harm R...

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Main Authors: Siobhán Murphy, Dermot O'Reilly, Emma Ross, Aideen Maguire, Denise O'Hagan
Format: Article
Language:English
Published: Swansea University 2023-09-01
Series:International Journal of Population Data Science
Online Access:https://ijpds.org/article/view/2237
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author Siobhán Murphy
Dermot O'Reilly
Emma Ross
Aideen Maguire
Denise O'Hagan
author_facet Siobhán Murphy
Dermot O'Reilly
Emma Ross
Aideen Maguire
Denise O'Hagan
author_sort Siobhán Murphy
collection DOAJ
description Objectives A large proportion of those who die by suicide present to an Emergency Department (ED) with self-harm (SH) in the year before death. This study examines ‘does risk of death following ED presentation with SH vary according to hospital attended?’ Methods The Northern Ireland Self-Harm Registry provided data on SH presentations to 12 ED departments in NI between 2012-2019. Linkage to health and mortality records provided follow up to December 2019. Cox proportional hazards regression models were employed to assess mortality risk following presentation with SH among 12 ED departments in NI. Results Analysis of the 64,350 ED presentations for self-harm by 30,011 individuals confirmed a marked variation across EDs in proportion of patients receiving mental health assessment and likelihood of admission to general and psychiatric wards. There was a significant variation in suicide risk according to ED attended with the three-fold range between the lowest (HRadj 0.32 95%CIs 0.16, 0.67) and highest. These differences persisted even after adjustment for patient characteristics, variation in types of self-harm, and care management at the ED. Conclusion Management of SH cases in the ED is important, however, it is the availability, access and level of engagement with, care in the community rather than the immediate care at EDs that is most critical for patients presenting to ED with self-harm.
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spelling doaj.art-2d84a5560b494fa1b86059466b4de09e2023-12-03T01:11:27ZengSwansea UniversityInternational Journal of Population Data Science2399-49082023-09-018210.23889/ijpds.v8i2.2237Suicide risk following Emergency Department presentation with self-harm varies by hospitalSiobhán Murphy0Dermot O'Reilly1Emma Ross2Aideen Maguire3Denise O'Hagan4Queen's University, Belfast, United KingdomQueen's University, Belfast, United KingdomQueen's University, Belfast, United KingdomQueen's University, Belfast, United KingdomQueen's University, Belfast, United Kingdom; Public Health Agency, Belfast, United Kingdom Objectives A large proportion of those who die by suicide present to an Emergency Department (ED) with self-harm (SH) in the year before death. This study examines ‘does risk of death following ED presentation with SH vary according to hospital attended?’ Methods The Northern Ireland Self-Harm Registry provided data on SH presentations to 12 ED departments in NI between 2012-2019. Linkage to health and mortality records provided follow up to December 2019. Cox proportional hazards regression models were employed to assess mortality risk following presentation with SH among 12 ED departments in NI. Results Analysis of the 64,350 ED presentations for self-harm by 30,011 individuals confirmed a marked variation across EDs in proportion of patients receiving mental health assessment and likelihood of admission to general and psychiatric wards. There was a significant variation in suicide risk according to ED attended with the three-fold range between the lowest (HRadj 0.32 95%CIs 0.16, 0.67) and highest. These differences persisted even after adjustment for patient characteristics, variation in types of self-harm, and care management at the ED. Conclusion Management of SH cases in the ED is important, however, it is the availability, access and level of engagement with, care in the community rather than the immediate care at EDs that is most critical for patients presenting to ED with self-harm. https://ijpds.org/article/view/2237
spellingShingle Siobhán Murphy
Dermot O'Reilly
Emma Ross
Aideen Maguire
Denise O'Hagan
Suicide risk following Emergency Department presentation with self-harm varies by hospital
International Journal of Population Data Science
title Suicide risk following Emergency Department presentation with self-harm varies by hospital
title_full Suicide risk following Emergency Department presentation with self-harm varies by hospital
title_fullStr Suicide risk following Emergency Department presentation with self-harm varies by hospital
title_full_unstemmed Suicide risk following Emergency Department presentation with self-harm varies by hospital
title_short Suicide risk following Emergency Department presentation with self-harm varies by hospital
title_sort suicide risk following emergency department presentation with self harm varies by hospital
url https://ijpds.org/article/view/2237
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AT emmaross suicideriskfollowingemergencydepartmentpresentationwithselfharmvariesbyhospital
AT aideenmaguire suicideriskfollowingemergencydepartmentpresentationwithselfharmvariesbyhospital
AT deniseohagan suicideriskfollowingemergencydepartmentpresentationwithselfharmvariesbyhospital