Association between suicide attempt and previous healthcare utilization among homeless youth

Abstract

Introduction:The purpose of this study was to examine the association between prior emergency department (ED) visit or hospitalization and subsequent suicide attempt among homeless youth aged 10-17 years old.Methods: With New York statewide databases, a case-control design was conducted. Cases and controls were homeless patients with an ED visit or hospitalization due to suicide attempt (cases) or appendicitis (controls) between April and December. We examined ED and inpatient records for 90 days prior to the visit for suicide attempt or appendicitis. The primary exposure variable was prior healthcare utilization for any reason other than the following four reasons: mental health disorder, substance use, self-harm, and other injuries. Multivariable logistic regression models, with year fixed effect and hospital random effect, were used.Results: A total of 335 cases and 742 controls were identified. Cases had lower odds of prior healthcare utilization for any reason other than the four reasons listed above. (adjusted Odds Ratio [aOR]: 0.53, p-value = 0.03). Conclusions:The association between prior healthcare utilization and decreased risk of suicide attempt among homeless youth may be due to comprehensive care provided during healthcare utilization. It may also reflect the presence of a social network that provided a protective effect.

Suicidal Behaviors and Risk Taking Among Homeless Individuals: A Systematic Review and Meta-Analysis

“…Moreover, for cross-sectional studies, total scores were rated as "unsatisfactory" (0-2) "satisfactory" (3) "good" (4) or "very good" (5). Ten studies were rated as being of high quality (Aquin et al, 2017;Bommersbach, 2020;Fitzpatrick et al, 2007;Fulginiti et al, 2022;Goldstein et al, 2012;Hadland et al, 2015;Lee et al, 2017;Sakai-Bizmark et al, 2022;Schinka et al, 2018;Tsai et al, 2019), eleven studies were rated as being of good quality (Barr et al, 2017;Dietz, 2011;Eynan et al, 2002;Frederick et al, 2012;Gentil et al, 2021;Kidd, 2006;Molnar et al, 1998;Okamura et al, 2014;Oppong Asante et al, 2017;Panadero et al, 2018;Prigerson et al, 2003), and two studies were rated as being of satisfactory quality (Noël et al, 2016;Vázquez et al, 2019). (Supplementary File 2).…”

“…The main reasons for exclusion were as follows: 12 studies did not meet the quality appraisal score (3%), and 260 studies utilized a non-quantitative methodology or did not report parametric measurements such as coefficients or odd ratios of relative risks of determinants of study outcomes (97%). Following these exclusions, 23 studies remained for meta-analysis (Aquin et al, 2017;Barr et al, 2017;Bommersbach, 2020;Dietz, 2011;Eynan et al, 2002;Fitzpatrick et al, 2007;Frederick et al, 2012;Fulginiti et al, 2022;Gentil et al, 2021;Goldstein et al, 2012;Hadland et al, 2015;Kidd, 2006;Lee et al, 2017;Molnar et al, 1998;Noël et al, 2016;Okamura et al, 2014;Oppong Asante et al, 2017;Panadero et al, 2018;Prigerson et al, 2003;Sakai-Bizmark et al, 2022;Schinka et al, 2012;Tsai et al, 2019;Vázquez et al, 2019) (Figure 1).…”