Aboriginal and non-aboriginal emergency department presentations involving suicide-related thoughts and behaviors: Characteristics and discharge arrangements

Background: Rates of hospital admission for suicide-related thoughts and behaviors (SRTBs) are elevated in the Northern Territory (NT) of Australia, especially by Aboriginal people, but very little is known about emergency department (ED) presentations. Aim: We aimed to profile ED presentations in the NT involving SRTBs by Indigenous status and compare discharge arrangements. Method: Logistic regression analyses were performed on data from electronic patient records of consecutive ED presentations involving SRTBs. Results: During the study period, 167 presentations were observed. Aboriginal patients were more likely to present from remote areas and to report substance misuse and family conflict or violence compared with non-Aboriginal patients. In both groups, males were more likely than females to be admitted as were persons presenting with self-harm compared with those who had suicidal thoughts only. No differences in discharge arrangements were identified by Indigenous status. Limitations: The small scale of the study and use of administrative records points to the need for further research to improve the quality of the evidence. Conclusion: While presentations by high-risk groups are more likely to be admitted for further care, the assessment of psychosocial risks and needs in EDs is vital to informing decisions for aftercare that support recovery in the community for Aboriginal patients and patients discharged from EDs.