Contact of parasuicide patients with the accident and emergency department

In a group of 82 consecutive parasuicide patients attending the St George's Hospital Accident and Emergency Department, London, England, 15 had attended the same department within the preceding 6 months. Thirteen of these 15 had also consulted their general practitioner during this time, as had a further 51 parasuicide patients. Only two out of the 82 patients, therefore, had had sole medical contact with the Accident and Emergency Department in the 6 months prior to their suicide attempt. This is the first such report from an accident and emergency department. It demonstrates that very few patients seek help from, or visit in isolation, this facility prior to a parasuicide episode as opposed to visiting their general practitioner whose importance is reaffirmed. The problems of identifying 'somatising' patients in an accident and emergency department are discussed.