Emergency Department Presentations and Youth Suicide: A Case-Control Study

Area of Science:

• Public Health
• Emergency Medicine
• Psychiatry

Background:

• Suicide remains a leading cause of death among youth.
• Emergency departments (EDs) are critical points of contact for at-risk youth.
• Understanding ED diagnoses associated with suicide is crucial for prevention.

Purpose of the Study:

• To investigate associations between emergency department diagnoses and suicide among youth.
• To inform emergency care practices for suicide prevention in young populations.

Main Methods:

• A case-control study utilizing data from the Office of the Chief Coroner and all EDs in Ontario, Canada.
• Cases included youth aged 10-25 who died by suicide with a prior ED contact.
• Controls were age-matched individuals with ED contact.

Main Results:

• Youth diagnosed with mental health problems in the ED had elevated suicide risk, particularly those with self-inflicted injuries (hanging, strangulation, suffocation) and mood/psychotic disorders in males.
• Other significant risk factors included undetermined injuries, poisonings, and assaults.
• A substantial proportion of cases had recent ED contact, within 106 days.

Conclusions:

• Timely identification and treatment of mental health problems in the ED are essential.
• Youth with self-harm and males with mood/psychotic disorders are key targets for suicide prevention.
• EDs should be vigilant for youth presenting with undetermined events, unintentional poisonings, and assaults.