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Self-Harm, Suicidal Ideation, and Attempted Suicide in Older Adults: A National Study of Emergency Department Visits and Follow-Up Care.

Authors :
Schmutte T
Olfson M
Xie M
Marcus SC
Source :
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2020 Jun; Vol. 28 (6), pp. 646-658. Date of Electronic Publication: 2019 Dec 10.
Publication Year :
2020

Abstract

Objective: Emergency department visits for self-harm and suicidal ideation have increased for US older adults. The purpose of this study was to examine discharge disposition, clinical recognition of mental disorder, and 30-day follow-up mental health outpatient care of older adults treated in emergency departments for suicide attempt (SA), suicidal ideation (SI), or deliberate self-harm (DSH).<br />Methods: Retrospective cohort analysis using 2015 Medicare claims for adults ≥65 years of age with suicide-related emergency encounters (N = 52,383). Demographic, clinical, and service use characteristics from claims were merged with county-level Area Health Resource File data. Rates and adjusted risk ratios were assessed for discharge to the community, mental health diagnosis in the emergency department, and outpatient mental health visits with 30 days after the emergency encounter.<br />Results: Encounters for SA (7.8%) and SI (17.2%) were less likely than those for DSH (29.1%) to be discharged to the community. Among community discharges, SA (95.6%) and SI (95.1%) encounters were more likely than DSH (52.3%) encounters to be diagnosed with a mental disorder in the emergency department. Encounters for SA (52.1%) and SI (59.9%) were also more likely than DSH (31.3%) encounters to receive follow-up mental care.<br />Conclusions: Although most older adults treated in EDs for suicide-related reasons are hospitalized, a substantial proportion of patients discharged back to the community do not receive follow-up mental healthcare within 30 days.<br /> (Copyright © 2019 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1545-7214
Volume :
28
Issue :
6
Database :
MEDLINE
Journal :
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
Publication Type :
Academic Journal
Accession number :
31917069
Full Text :
https://doi.org/10.1016/j.jagp.2019.12.003