Emergency departments could help reduce youth suicide risk

A study of over 15,000 youth with self-inflicted injury treated in Emergency Departments (EDs) found that around 25 percent were seen in the ED within 90 days before or 90 days after injury, pointing to an opportunity for ED-based interventions, such as suicide risk screening, safety planning, and linkage to services. Nearly half of ED visits after the self-inflicted injury encounter were for mental health issues.

“Self-inflicted injury is an important predictor of suicide risk,” said Samaa Kemal, MD, MPH, emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago, who was the lead author on the study published in JAMA Network Open. “Our study suggests that Emergency Departments could have life-saving impact if they treat youth not only in the moment of crisis but intervene to extend care into the future. It would be critical to screen for suicide risk, talk to families about removing from the home or locking up anything that could be lethal to their child, like guns, and connect patients to follow-up care.”

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

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

Limited access to pediatric mental healthcare most likely drives greater ED utilization among rural and publicly insured youth, which underscores a significant health inequity, added Dr. Kemal.

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

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

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is a nonprofit organization committed to providing access to exceptional care for every child. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine. Emergency medicine-focused research at Lurie Children’s is conducted through the Grainger Research Program in Pediatric Emergency Medicine.