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National analysis of hospital-presenting suicidal ideation and self-harm among males
Michael J Wilson1,2, Sadhbh J Byrne3, Krista Fisher1,2,4
1Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
Insights
Males presenting to emergency departments (EDs) for suicidal crisis often lack mental health service linkage. Emergency clinicians can improve suicide prevention by connecting these males to care.
Area of Science:
- Public Health
- Emergency Medicine
- Mental Health Services Research
Background:
- Rising rates of hospital presentations for suicidal crisis highlight the need for effective interventions.
- Males are disproportionately affected by suicide, particularly after emergency department (ED) contact for suicidal crisis.
Purpose of the Study:
- To characterize male presentations for suicidal ideation and self-harm acts in Irish EDs.
- To identify opportunities for suicide prevention among males accessing emergency care.
Main Methods:
- Analysis of national ED data (2018-2021) for male presentations.
- Examination of sociodemographic and age-related characteristics.
- Assessment of referral patterns to subsequent care.
Main Results:
- Males more frequently presented with suicidal ideation (56%) than self-harm (42%).
- Drug and alcohol overdose was the primary self-harm method.
- Most males presenting to EDs lacked prior mental health service connections.
Conclusions:
- EDs serve as a critical point for suicide prevention among males.
- Emergency clinicians can facilitate crucial links to mental health services for males post-crisis.
Objectives:
There is evidence of increasing rates of hospital presentations for suicidal crisis, and emergency departments (EDs) are described as an intervention point for suicide prevention. Males account for three in every four suicides in Ireland and are up to twice as likely as females to eventually die by suicide following a hospital presentation for suicidal crisis. This study therefore aimed to profile the characteristics of ED presentations for suicidal ideation and self-harm acts among males in Ireland, using clinical data collected by self-harm nurses within a dedicated national service for crisis presentations to EDs.
Methods:
Using ED data from 2018-2021, variability in the sociodemographic characteristics of male presentations was examined, followed by age-based diversity in the characteristics of presentations and interventions delivered. Finally, likelihood of onward referral to subsequent care was examined according to presentation characteristics.
Results:
Across 45,729 presentations, males more commonly presented with suicidal ideation than females (56% v. 44%) and less often with self-harm (42% v. 58%). Drug- and alcohol-related overdose was the most common method of self-harm observed. A majority of males presenting to ED reported no existing linkage with mental health services.
Conclusions:
Emergency clinicians have an opportunity to ensure subsequent linkage to mental health services for males post-crisis, with the aim of prevention of suicides.
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