Correlates of Attempted Suicide from the Emergency Room of 2 General Hospitals in Montreal, Canada

Rahme, Elham; Low, Nancy; Lamarre, Suzanne; Daneau, Diane; Habel, Youssef; Turecki, Gustavo; Bonin, Jean‐Pierre; Morin, Suzanne N; Szkrumelak, Nadia; Singh, Santokh; Lesage, Alain

doi:10.1177/0706743716639054

Cited by 16 publications

(17 citation statements)

References 45 publications

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“…Individuals that attempted suicide identified by only nurses triage notes were included. Similar findings showed that more than half of attempted suicide presentations remained "silent" (went undetected) if nurses' notes were ignored (Daneau, 2016;Rahme et al, 2016). Another strength is that our study can be reproduced in all Quebec's hospital and probably any Canadian hospital since the medical records systems respond to provincial and even Canadian accreditation standards.…”

Section: Discussionsupporting

confidence: 54%

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Measuring Quality of Care Received by Suicide Attempters in the Emergency Department

Rassy¹,

Daneau

Larue

et al. 2020

Archives of Suicide Research

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Context: Audits conducted on medical records have been traditionally used in hospitals to assess and improve quality of medical care but have yet to be properly integrated and used for suicide prevention purposes. We aimed to (1) revise a quality of care grid and adapt it to an adult population of suicide attempters and (2) identify quality of care deficits in managing adult suicide attempters at the emergency department (ED) in two different Montreal university hospitals. Methods: An existing checklist for quality of medical and social care in the ED was adapted. A systematic search and data extraction of all suicide attempters in two different Montreal university hospitals were then conducted. All identified individuals who attempted suicide were fully reviewed and quality of care was assessed. Results: Eleven criteria were kept by the expert focus group in the revised grid that was then used to rate 369 individuals that attempted suicide. Suicide risk assessment was only present in 63% of attempters before discharge. Although family history was documented for 90% of attempters, in only 41% of the cases were interviews conducted with relatives. Most discharged patient lacked proper follow-up considering 11% of their relatives received written information on resources in case of need. Discussion: Paper records may be used to systematically assess the quality of care for suicide attempters seen in ED. Results reiterate the need for better suicide prevention strategies for these individuals. The checklist proved to be an excellent assessment of best practices or identification of possible improvements.

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Section: Discussionsupporting

confidence: 54%

“…These 369 individuals were identified from a total of 5746 reviewed charts. The details of this process is thoroughly described in Rahme et al (2016).…”

Section: Systematic Search Data Extraction and Coding Manual Developmentioning

confidence: 99%

Measuring Quality of Care Received by Suicide Attempters in the Emergency Department

Rassy¹,

Daneau

Larue

et al. 2020

Archives of Suicide Research

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“…As our sensitivity analyses showed similar risk patterns of suicide attempt and suicidal death by mental disorders, and the risk patterns of suicide attempt and suicidal death across males and females as existed in the literature, such combination was justifiable. While we used ICD-9 and ICD-10 case definitions for suicide diagnostic data contained in the administrative databases (DAD and mortality database), as recommended by Statistics Canada, the diagnostic data are likely to underestimate the prevalence of suicide, specifically attempts ( Rahme et al, 2016 ), since not all attempts require hospitalization. This could have diluted the observed association biased towards the null.…”

Section: Discussionmentioning

confidence: 99%

Mental disorders and subsequent suicide events in a representative community population

Adhikari

Metcalfe

Bulloch

et al. 2020

Journal of Affective Disorders

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“…Since health care is primarily a provincial/territorial responsibility, much of the data from EDs is housed in clinical information systems such as electronic health records (EHRs). Studies from several provinces have shown that extracting ED data on suicidal behaviour from clinical databases is feasible [ 64 – 66 ]. However, provincial/territorial EHR systems are varied, and some do not use standardized codes for diagnoses, making it difficult to accurately and consistently capture cases of self-injury.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies of emergency department visits used “suicide-related behaviour” and “self-harm” with inclusive definitions that captured non-fatal suicide attempts due to self-poisoning or self-injury, along with events with undetermined intent [ 65 , 86 ]. Inclusive definitions are used by national statistical agencies because ICD codes under-estimate suicide attempts by more than 50% [ 61 , 66 , 87 ].…”

Section: Introductionmentioning

confidence: 99%

Tracking progress in suicide prevention in Indigenous communities: a challenge for public health surveillance in Canada

et al. 2018

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Indigenous peoples in Canada experience disproportionate rates of suicide compared to non-Indigenous populations. Indigenous communities and organizations have designed local and regional approaches to prevention, and the federal government has developed a national suicide prevention framework. However, public health systems continue to face challenges in monitoring the population burden of suicide and suicidal behaviour. National health data systems lack Indigenous identifiers, do not capture data from some regions, and do not routinely engage Indigenous communities in data governance. These challenges hamper efforts to detect changes in population-level outcomes and assess the impact of suicide prevention activities. Consequently, this limits the ability to achieve public health prevention goals and reduce suicide rates and rate inequities.This paper provides a critical analysis of the challenges related to suicide surveillance in Canada and assesses the strengths and limitations of existing data infrastructure for monitoring outcomes in Indigenous communities. To better understand these challenges, we discuss the policy context for suicide surveillance and examine the survey and administrative data sources that are commonly used in public health surveillance. We then review recent data on the epidemiology of suicide and suicidal behaviour among Indigenous populations, and identify challenges related to national surveillance.To enhance capacity for suicide surveillance, we propose strategies to better track progress in Indigenous suicide prevention. Specifically, we recommend establishing an independent community and scientific governing council, integrating Indigenous identifiers into population health datasets, increasing geographic coverage, improving suicide data quality, comprehensiveness, and timeliness, and developing a platform for making suicide data accessible to all stakeholders. Overall, the strategies we propose can build on the strengths of the existing national suicide surveillance system by adopting a collaborative and inclusive governance model that recognizes the stake Indigenous communities have in suicide prevention.

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Correlates of Attempted Suicide from the Emergency Room of 2 General Hospitals in Montreal, Canada

Cited by 16 publications

References 45 publications

Measuring Quality of Care Received by Suicide Attempters in the Emergency Department

Measuring Quality of Care Received by Suicide Attempters in the Emergency Department

Mental disorders and subsequent suicide events in a representative community population

Tracking progress in suicide prevention in Indigenous communities: a challenge for public health surveillance in Canada

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