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Suicidal Behavior Patterns and Correlates in High-Risk Adults After Emergency Department Discharge: A One-Year
Ana Rabasco1,2, Julia Browne3,4, Zachary Kunicki1
1Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Suicide & Life-Threatening Behavior
|March 31, 2026
Summary
Adults discharged from the emergency department (ED) with suicidal thoughts need continued support. Risky alcohol use and prior psychiatric hospitalizations are linked to worsening suicidal behavior post-discharge.
Area of Science:
- Emergency Medicine
- Psychiatry
- Public Health
Background:
- The period after emergency department (ED) discharge poses a significant risk for suicidal behavior.
- This study focuses on adults presenting to the ED with active suicidal thoughts and behaviors.
Purpose of the Study:
- To examine factors associated with suicidal behavior patterns one year after ED discharge.
- To identify predictors differentiating suicidal behavior trajectories in adults.
Main Methods:
- 863 adults with active suicidal thoughts/behaviors were followed for one year post-ED discharge.
- Participants were categorized into 'none', 'worsening', 'improving', or 'persistent' suicidal behavior groups.
- Binary logistic regression analyzed factors distinguishing between groups with different follow-up behaviors.
Main Results:
- The most common patterns were no suicidal behavior (52.7%) or improving behavior (24.7%).
- Risky alcohol use and previous psychiatric hospitalization predicted worsening suicidal behavior compared to no suicidal behavior.
- No specific factors differentiated the improving from the persistent suicidal behavior groups.
Conclusions:
- Individuals with active suicidal ideation, alcohol use, and past psychiatric hospitalization require enhanced post-ED discharge support.
- Targeted interventions may help prevent future suicide attempts in high-risk populations.
- Further research is needed to understand factors distinguishing persistent from improving suicidal behavior.
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