Attendance at the accident and emergency department in the year before suicide: Retrospective study

Abstract

BackgroundThe National Confidential Inquiry into suicides in England and Wales found that a quarter of suicides are preceded by mental health service contact in the year before death. However, visits to accident and emergency departments due to self-harm may not lead to a record of mental health service contact.AimsTo determine the proportion of suicides preceded by accident and emergency attendance in the previous year.MethodWe obtained the list of probable suicides in Leeds for a 38-month period, and examined the records from thecity's accident and emergency departments for a year before each death.ResultsEighty-five (39%) of the 219 people who later died by suicide had attended an accident and emergency department in the year before death, 15% because of non-fatal self-harm. Final visits dueto self-harm were often shortly before suicide (median 38 days), but the National Confidential Inquiry recorded about a fifth of them as‘not in contact’ with local mental health services.ConclusionsAlthough many suicides are preceded by recent attendance at accident and emergency departments due to non-fatal self-harm, local mental health service records may show no recent contact. Suicide prevention might be enhanced were accident and emergency departments and mental health services to work together more closely.