Depression and Attempted Suicide: A Study of 91 Cases Seen in a Casualty Department

In recent years there has been a steady and alarming increase in the prevalence of attempted suicide (Aitken, Buglass and Kreitman, 1969). Though all cases of attempted suicide may be regarded as a distress signal, only a proportion of such cases are seriously mentally ill. The problem of their assessment and organization of appropriate treatment is becoming an increasing burden on the psychiatric services. The Hill Report (1968) recommended that all cases should be admitted to special poisoning treatment centres which have continuous psychiatric cover. In towns where there are medical schools this may be a feasible proposition, and such a centre has been in operation in Edinburgh for a number of years (Matthew, Proudfoot, Brown and Aitken, 1969). In the Aberdeen region all cases are treated in the city casualty department and are assessed by the staff of the Professorial Psychiatric Unit, which is less than a mile away. Seven day cover is provided by a duty rota, each doctor being on call for a period of twenty-four hours. In a non-university town with less staff available such an efficient service may not be possible, and Crammer (1969) has suggested that a questionary administered by the house officer in the casualty department might serve as a satisfactory screening procedure.