Suicide Attempt Presentations at the Emergency Department: Outcomes From a Pilot Study Examining Precipitating Factors in Deliberate Self-Harm and Issues in Primary Care Physician Management

Abstract

The aim of this study was to examine the psychosocial precipitating factors of people presenting to the emergency department (ED) due to attempted suicide. Demographic, diagnostic and service use data were collected for a 6-week period. All patients were referred for primary care physician (PCP) management, with a sample followed up for secondary analysis of precipitants to self-harm and follow-up outcomes. Results of the study showed that key psychosocial stressors that triggered suicidality were relationship issues and recent unemployment, with depression present in 92% of cases. While 83% of patients followed attended their first PCP appointment, 50% discontinued by 3 months. The conclusion of this study is that psychosocial crises and depression are key factors in suicide attempts. Assertive crisis intervention, facilitated linkage to community services, and greater monitoring are recommended.

Keywords:

• attempted suicide
• emergency
• practice-based research
• follow-up
• primary care

Acknowledgments

This work was carried out at Western Hospital, Emergency Department, Gordon Street, Footscray, Victoria, Australia 3011.

We acknowledge former colleagues in the development of the pilot: John Balla, David Barton, Graeme Meadows, Nicole Amsing, and Peter Kelly.