Suicide crisis calls to emergency services: Cohort profile and findings from a data linkage study in Queensland, Australia

Abstract

Background and Aims: Police and paramedics play a crucial role in responding to suicide crises in the community. However, little is known about the nature, extent, precipitating factors, pathways and outcomes of a suicide-related call to emergency services and what responses will most effectively and compassionately meet the needs of those in crisis. Partners in Prevention: Understanding and Enhancing First Responses to Suicide Crisis Situations (PiP) was established to address these knowledge gaps. Methods: This article describes (1) the methodology used to construct the PiP dataset, a population-wide linked dataset that investigates the characteristics and health pathways of individuals in Queensland who were the subject of a suicide-related call to police or paramedics; and (2) preliminary findings on service demand, demographics and health services utilisation. Results: We identified 219,164 suicide-related calls to Queensland Police Service or Queensland Ambulance Service that were made over the 3-year period 1 February 2014 to 31 January 2017. A total of 70,893 individuals were identifiable via records linkage. The cohort linked to more than 7,000,000 health records. We estimated that police or paramedics in Queensland received on average 209 calls per day, with increases year on year over the study period. Analysis of demographic data highlighted the heterogeneous nature of this cohort and important demographic variations between individuals in contact with police versus ambulance services. Discussion: The PiP dataset provides a strong foundation for a multi-modal dataset that can be built on over time, both cross-sectionally and longitudinally. Further linkages to Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and social care datasets are planned. Conclusion: Detailed population-level analysis that data linkage can provide is critical to improving understanding and responses to suicide crisis situations. The PiP study is a world first and provides a unique opportunity to improve responses to this public health problem.

Recent amendments to Queensland legislation make mental health presentations to hospital emergency departments more difficult to scrutinise

“…This simple accounting for routinely collected administrative information from highly reliable authorities yields a picture broadly consistent with the limited available published evidence for a generally rising trend in indicators of mental health crisis in the Queensland community. 2,5 Resource implications for QPS, QAS and Queensland Health hospital EDs warrant close examination. The implications of this research for persons subject to an EEA and brought for treatment to hospital EDs in Queensland also warrant close examination, especially as disclosure of intent to self-harm is a key criterion in the PHA for QPS or QAS intervention, as set out in Figure 1.…”

“…The implications of this research for persons subject to an EEA and brought for treatment to hospital EDs in Queensland also warrant close examination, especially as disclosure of intent to self-harm is a key criterion in the PHA for QPS or QAS intervention, as set out in Figure 1. 1,[3][4][5] If our perspective has merit, on the vast majority of occasions where a person experiences a major disturbance in mental capacity serious enough to warrant a legal intervention for involuntary treatment or care, crucial information is no longer publicly available. Given the serious circumstances involved, it is unfortunate that Queensland's new mental health legislation has reduced the opportunity for public scrutiny of information regarding the mental well-being of thousands of people.…”

Effects of Financial Expenditure of Prefectures/Municipalities on Regional Suicide Mortality in Japan

“…These tendencies were also consistent in analysing the dependent valuables with suicide mortality disaggregated by gender. Both police and ambulance systems play important roles in responding to suicide crises in the community [38]. Education and welfare expenditure also contributes to the prevention of suicide [26,39].…”

Optimal Care Pathways for People in Suicidal Crisis Who Interact with First Responders: A Scoping Review

“…Police and paramedics (hereafter ‘first responders’) play a crucial role in helping people through suicidal crises and facilitating appropriate intervention and follow up [ 5 ]. Results from a data linkage study in Queensland, Australia, identified that first responders receive in excess of 200 suicide related calls per day, and that over the three-year period from 2014–2017, there was an increase in suicide related calls of approximately 25% across police and ambulance services [ 6 ].…”

“…A suicidal crisis was defined as documented instances or accounts of suicidal ideation, voiced risk of suicide or self-harm, intentional self-harm, suicidal behaviours and suicide attempts [ 6 ]. Models refer to the overarching care type that is provided (e.g., co-responder; aftercare etc.)…”