ED visits for suicide attempts, self-harm on the rise

Visits to the emergency department (ED) for suicide attempts and intentional self-harm have significantly increased from 2011 to 2020, as a proportion of total ED visits and as visits per capita, results of a US study have shown.

A team of investigators obtained data from the National Hospital Ambulatory Medical Care Survey, an annual cross-sectional national sample survey of EDs. They then identified visits for suicide attempts and intentional self-harm using discharge diagnosis codes (ICD-9-CM for 2011‒2015; ICD-10-SM for 2016‒2020) or reason-for-visit codes.

Subsequently, the investigators estimated the annual proportion of ED visits for suicide attempts and intentional self-harm.

The weighted number of ED visits for suicide attempts and intentional self-harm rose from 1.43 million (0.6 percent of total ED visits) in 2011‒2012 to 5.37 million (2.1 percent of total ED visits) in 2019‒2020. The average annual percent change was 19.5 percent (95 percent confidence interval [CI], 16.9‒22.2).

Visits per capita also increased from 261 to 871 visits per 100,000 individuals, with an average annual percent change of 18.8 percent (95 percent CI, 17.6‒20.0). This surge in ED visits was widely distributed across different sociodemographic groups.

Most suicide attempt and intentional self-harm visits were driven by adolescents, but adults aged ≥65 years showed the highest increase, with an average annual percent change of 30.2 percent (95 percent CI, 28.5‒32.0). The most frequent co-occurring diagnosis among ED visits for suicide attempt and intentional self-harm was drug-related diagnoses.

Notably, despite the increase in ED visits for suicide attempts and intentional self-harm, <16 percent were evaluated by a mental health professional.

“These trends underscore an urgent need to improve the continuum of mental healthcare for individuals with suicidal symptoms,” the authors said.