Youth suicide-related visits in an emergency department serving rural counties: Implications for means restriction

A large proportion of suicide attempts result in injuries requiring medical attention, but little is known about youth presenting to rural emergency departments (EDs) for suicide-related behavior. We conducted a chart review of youth receiving mental health (MH) evaluations during 1994 in an ED serving rural counties. Forty percent of the these visits were for suicide-related events. These youth were more likely to be older, female and white than youth receiving MH evaluations for reasons not related to suicide. No differences were found on recent substance use, non-suicidal aggression, or MH service contact when comparing suicidal to non-suicidal youth. Youth receiving MH evaluations were homogenous with respect to suicide risk factors. Chart reviews provided no evidence that means restriction education was provided. We discuss broader implications of these findings for the role of means restriction in EDs.

[1]  M. Fendrich,et al.  Implementing means restriction education in urban EDs. , 1998, The American journal of emergency medicine.

[2]  J. Piotrowski,et al.  Child and adolescent suicide attempts: an opportunity for emergency departments to provide injury prevention education. , 1997, The American journal of emergency medicine.

[3]  J L Collins,et al.  Youth risk behavior surveillance--United States, 1995. , 1996, The Journal of school health.

[4]  L. Koonin,et al.  Abortion surveillance--United States, 1992. , 1996, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[5]  K. Kochanek,et al.  Advance report of final mortality statistics, 1991 , 1995 .

[6]  Arthur L. Kellermann,et al.  Gun Ownership as a Risk Factor for Homicide in the Home , 1993 .

[7]  C. Snow,et al.  Injury prevention instruction in the emergency department. , 1993, Annals of emergency medicine.

[8]  C. Zwerling,et al.  The Epidemiology of Firearm Deaths in Iowa, 1980-1990 , 1993 .

[9]  P. O'Carroll,et al.  The emergency department in surveillance of attempted suicide: findings and methodologic considerations. , 1993, Public health reports.

[10]  J. Osofsky,et al.  Chronic community violence: what is happening to our children? , 1993, Psychiatry.

[11]  D. Brent,et al.  Adolescent psychiatric inpatients' risk of suicide attempt at 6-month follow-up. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[12]  F P Rivara,et al.  Suicide in the home in relation to gun ownership. , 1992, The New England journal of medicine.

[13]  M. Weissberg,et al.  Suicide: risk factors and therapeutic considerations in the emergency department. , 1992, The Journal of emergency medicine.

[14]  David A. Brent,et al.  The presence and accessibility of firearms in the homes of adolescent suicides : a case-control study , 1991 .

[15]  S. Swedo,et al.  Can adolescent suicide attempters be distinguished from at-risk adolescents? , 1991, Pediatrics.

[16]  D. Fleming,et al.  Surveillance of attempted suicide among adolescents in Oregon, 1988. , 1991, American journal of public health.

[17]  M. Weissberg.  The meagerness of physicians' training in emergency psychiatric intervention , 1990, Academic medicine : journal of the Association of American Medical Colleges.

[18]  R. Centor,et al.  Risk factors for attempted suicide during adolescence. , 1989, Pediatrics.

[19]  A. Derrick,et al.  Comorbidity of mental disorders in the post-mortem diagnosis of completed suicide in children and adolescents. , 1988, Journal of affective disorders.

[20]  D. Brent,et al.  Alcohol, firearms, and suicide among youth. Temporal trends in Allegheny County, Pennsylvania, 1960 to 1983. , 1987, JAMA.