Suicide in a psychiatric emergency room population

Twenty-two suicides were identified in a series of 5,284 psychiatric emergency room patients, yielding a suicide rate of 111.1 per 100,000 "patient-years at risk"--more than seven times the age- and sex-adjusted rate for the general population. Subpopulations at high risk were white people, men, depressed and schizophrenic patients, substance abusers, and patients with multiple emergency room visits. No patients had killed themselves immediately after an emergency room visit, but several had killed themselves without following through on a referral from the emergency room to another facility for treatment. The authors discuss the implications of these findings for emergency room practice and for further research.