Co-Occurring Substance Use and Psychiatric Disorders in Psychiatric Emergency Services: Suicidality, Substance Use,...

Psychiatric and substance use disorders commonly co-occur, yet treatment is often siloed. To improve treatment utilization for individuals with co-occurring disorders in the psychiatric setting it important to understand current practices. This study analyzed adults seen by community-based psychiatric emergency services with co-occurring disorders to identify: (1) reason for visit; (2) prevalence of suicidality and past attempts; (3) whether suicidality predicted future psychiatric emergency department (ED) presentation.

Retrospective chart review of patients seen by the Boston Emergency Services Team with first encounters between 2017-2021 (N = 352).

The sample had an average age of 38 years old, 66% male, 57% White. Thirty-eight percent of patients reported suicidal ideation (SI), of whom 25% described SI involving overdose. Sixty patients had attempted suicide, 35 by overdose. In a Cox Regression model, suicidality in the first visit did not predict future psychiatric ED use.

The high co-occurrence of SUDs with suicidality indicates the importance of screening and intervention in specialty mental health and addiction treatment settings.