Impact of the COVID-19 pandemic and subsequent social restrictions on ambulance calls for suicidal and nonsuicidal self-harm: A population-based study in Osaka prefecture, Japan

Aim Self-harm is a common ambulance call and is potentially affected by the COVID-19 pandemic. The aim of this study was to investigate whether the incidence of ambulance transport due to self-harm increased in 2020. Methods We undertook a population-based observational study using a database from the Osaka prefectural government. Ambulance transport of patients due […]

Mental disorder symptom among public safety personnel in Canada

Background: Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and […]

Examining the use of police and ambulance data in suicide research: A systematic scoping review of data linkage studies

Background: Police and paramedics are often the first to respond to individuals in suicide crisis and have an important role to play in facilitating optimal care pathways. Yet, little evidence exists to inform these responses. Data linkage provides one approach to examining this knowledge gap. Aim: We identified studies that examined suicide behaviors and linked to police or […]

Mental health service use, suicide behavior, and emergency department visits among rural US veterans who received video-enabled tablets during the COVID-19 pandemic

Objective  To evaluate the association between the escalated distribution of the US Department of Veterans Affairs’ (VA’s) video-enabled tablets during the COVID-19 pandemic and rural veterans’ mental health service use and suicide-related outcomes. Design, Setting, and Participants  This retrospective cohort study included rural veterans who had at least 1 VA mental health care visit in calendar year […]

Demographics of mental healthcare presentations in a northwest Ontario emergency department

Objectives Providing emergency mental health services for populations in remote rural areas of Canada is challenging. Program needs are distinct. We describe the emergency mental health workload and service needs at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) in northwest Ontario. Methods Emergency department (ED) data were collected for mental health, addiction and […]

Emergency department encounters among youth suicidal thoughts or behaviors during the COVID-19 pandemic.

IMPORTANCE Population-level reports of suicide-related emergency department (ED) encounters among youth during the COVID-19 pandemic are lacking, along with youth characteristics and preexisting psychiatric service use. OBJECTIVE To characterize population-level and relative change in suicide-related ED encounters among youth during the COVID-19 pandemic compared with 2019. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study evaluated ED […]

Mental health service use before and after a suicidal crisis among children and adolescents in a United States national Medicaid sample

Introduction: Mental health follow-up after an emergency department (ED) visit for suicide ideation/attempt is a critical component of suicide prevention for young people. Methods: We analyzed 2009 to 2012 Medicaid Analytic EXtract for 62,139 treat-and-release ED visits and 30,312 ED-to-hospital admissions for suicide ideation/attempt among patients ages 6 to 17 years. We used mixed-effects logistic regression models […]

Childhood adversity, suicidality, and non-suicidal self-injury among children and adolescents admitted to emergency departments

Purpose: This population-based study explored the associations between childhood adversity and admission to emergency departments (EDs) with non-suicidal self-injury (NSSI) and with a suicide attempt. Methods: A nationally representative cross-sectional sample of 5-17-year-olds admitted to EDs (N = 143,113,677) from 2006 to 2015 was utilized to assess the associations between childhood adversities, NSSIs, and suicide attempts. Results: ED […]

Emergency department visits for suspected suicide attempts among persons aged 12-25 years before and during the COVID-19 pandemic United States: January 2019-May 2021

Summary What is already known about this topic? During 2020, the proportion of mental health–related emergency department (ED) visits among adolescents aged 12–17 years increased 31% compared with that during 2019. What is added by this report? In May 2020, during the COVID-19 pandemic, ED visits for suspected suicide attempts began to increase among adolescents […]

Alcohol dependence and heavy episodic drinking are associated with different levels of risk or death or repeat emergency service attendance

Background Alcohol use is a multidimensional risk factor for suicidal behaviour. However, suicide prevention strategies often take ‘one-size-fits-all’ approaches to alcohol use, reflecting an evidence base built on unidimensional measures. Latent Class Analysis can use a range of measures to differentiate distinct patterns of alcohol using behaviour and their associated risks. Methods We analysed Electronic […]

Suicide as a hidden contributor to the opioid crisis and the role that primary care and emergency medicine play in addressing it

Deaths from overdose have risen dramatically over the past decade, driven mainly by opioids. In response, the Centers for Disease Control and Prevention released guidance on safe prescribing, safe storage of medications, Medication-Assisted Treatment (MAT), and the use of Naloxone to reverse an overdose. Even with this guidance, overdose deaths continue to rise. Suicide prevention […]

Prolonged emergency department length of stay for US pediatric mental health visits (2005-2015)

BACKGROUND AND OBJECTIVES: Children seeking care in the emergency department (ED) for mental health conditions are at risk for prolonged length of stay (LOS). A more contemporary description of trends and visit characteristics associated with prolonged ED LOS at the national level is lacking in the literature. Our objectives were to (1) compare LOS trends for […]

Suicide among the emergency medical systems occupation in the United States

Introduction Suicide claimed 47,173 lives in 2017 and is the second leading cause of death for individuals 15–34 years old. In 2017, rates of suicide in the United States (US) were double the rates of homicide. Despite significant research funding toward suicide prevention, rates of suicide have increased 38% from 2009 to 2017. Recent data […]

Experience of emergency department use among persons with a history of adverse childhood experiences

Background: Adverse childhood experiences (ACEs) are associated with increased morbidity and mortality, lower levels of distress tolerance, and greater emotional dysregulation, as well as with increased healthcare utilization. All these factors may lead to an increased use of emergency department (ED) services. Understanding the experience of ED utilization among a group of ED users with high […]

‘It’s changed how we have these conversations’: Emergency department clinicians’ experiences implementing firearms and other lethal suicide methods counseling for caregivers of adolescents

Counseling parents to reduce access to firearms and other potentially lethal suicide methods is commonly known as lethal means counseling (LMC). The current study explores the experiences that emergency department-based behavioural health clinicians described having as they provided lethal means counseling to parents of adolescents at risk for suicide. Clinicians were purposively sampled from four […]

Patient-related factors associated with an increased risk of being a reported case of preventable harm in first-line health care: A case-control study

Background: Patient safety issues in primary health care and in emergency departments have not been as thoroughly explored as patient safety issues in the hospital setting. Knowledge is particularly sparse regarding which patients have a higher risk of harm in these settings. The objective was to evaluate which patient-related factors were associated with risk of harm […]

The perspectives of adults with suicidal ideation and behaviour regarding their interactions with nurses in mental health and emergency services: A systematic review

Background In contemporary healthcare, both community and inpatient mental health and emergency services are important help-seeking avenues for persons with suicidal ideation and behaviour. Regarding nursing practice in these services, there is a strong focus on assessing and managing suicide risk. Within this clinical context, the perspectives of persons with suicidal ideation and behaviour are […]

Advocacy opportunities for pediatricians and emergency physicians to prevent youth suicide

Suicide is the second leading cause of death among youth aged 10-19 years in the United States. Pediatricians and emergency physicians have the opportunity to contribute to youth suicide prevention in their daily practice. Moreover, clinicians can advocate for local practice improvements and national policies to achieve a broader population-based impact on youth suicide reduction. […]

A comparison of self-harm presentations to emergency services: Nonsuicidal self-injury versus suicide attempts

Background: In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the distinction between nonsuicidal self-injury (NSSI) and suicide attempts (SA) is highlighted in the section of conditions for further study. Aims: The objective of this study was to examine the correlates of people who presented to emergency departments (ED) with NSSI compared with those who presented with […]

Outreach psychiatric emergency service: Characteristics of patients with suicidal behavior and subsequent policy

Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. […]

Factors affecting collaborations between a tertiary-level emergency department and community-based mental healthcare center for managing suicide attempts

Background Community-based active contact and follow-up are known to be effective in reducing the risk of repeat suicide attempts among patients admitted to emergency departments after attempting suicide. However, the characteristics that define successful collaborations between emergency departments and community-based mental healthcare centers in this context are not well known. Methods This study investigated patients […]

Suicide among ambulance service staff: A review of coroner and employment records

Background: There is growing evidence to suggest that suggest that Ambulance Service (AS) staff may be at increased risk for suicide, however few studies have explored risk factors within this occupational group. Aim: To investigate factors commonly associated with ambulance staff suicides. Method: Eleven AS trusts across England and Wales (UK) were asked to return […]

Effect of a motivational interviewing-based intervention on initiation of mental health treatment and mental health after an emergency department visits among suicidal adolescents: A randomized clinical trial

OBJECTIVE To examine whether a motivational interviewing–based intervention increases linkage of adolescents to outpatient mental health services and reduces depression symptoms and suicidal ideation in adolescents seeking emergency care for non–mental health–related concerns who screen positive for suicide risk. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, adolescents aged 12 to 17 years who […]