Emergency departments can help reduce the risk of suicide among young people

A study of more than 15,000 youth with self-inflicted injuries who presented to the emergency department (ED) found that approximately 25% were seen in the ED within 90 days before or 90 days after the injury, suggesting an opportunity for ED-based interventions such as suicide risk screening, safety planning, and linkage to services. Nearly half of ED visits after self-inflicted injury were for mental health issues.

“Self-inflicted injuries are a significant predictor of suicide risk,” said Samaa Kemal, MD, MPH, an emergency physician at Ann & Robert H. Lurie Children’s Hospital in Chicago, who was the lead author of the study published in 2009. JAMA Network Opened.

“Our research suggests that emergency departments could have a lifesaving impact if they not only treat young people in times of crisis but also intervene to expand care in the future. It would be crucial to screen for suicide risk, talk to families about removing or locking up anything that could be deadly to their child, such as weapons, and connect patients with follow-up care.”

Dr. Kemal and colleagues also found that approximately 70% of children in the study received care in general EDs, as opposed to EDs in children’s hospitals.

“The interventions we propose are brief and can be performed in any ED, even in hospitals without pediatric mental health facilities,” said Dr. Kemal.

Limited access to mental health care for children is likely leading to greater emergency department use among rural and public insurance youth, pointing to significant health care disparities, Dr. Kemal said.

“In communities without easy access to mental health care, EDs can refer children to pediatricians for follow-up,” she said. “Most importantly, amid the current crisis in youth mental health, the care these children receive in the ED should be focused on their future safety.”

Co-authors from Lurie Children’s were Jennifer A. Hoffmann, MD, MS, Kenneth A. Michelson, MD, and Elizabeth R. Alpern, MD, MSCE.