Suicide risk following Emergency Department presentation with self-harm varies by hospital

ObjectivesA large proportion of those who die by suicide present to an Emergency Department (ED) with self-harm (SH) in the year before death. This study examines ‘does risk death following ED presentation SH vary according hospital attended?’
 MethodsThe Northern Ireland Self-Harm Registry provided data on presentations 12 departments NI between 2012-2019. Linkage health and mortality records follow up December 2019. Cox proportional hazards regression models were employed assess among NI.
 ResultsAnalysis 64,350 for 30,011 individuals confirmed a marked variation across EDs patients receiving mental assessment likelihood admission general psychiatric wards. There was significant attended three-fold range lowest (HRadj 0.32 95%CIs 0.16, 0.67) highest. These differences persisted even after adjustment patient characteristics, types self-harm, care management at ED.
 ConclusionManagement cases is important, however, it availability, access level engagement with, community rather than immediate that most critical presenting self-harm.