Suicide-related crisis presentations to a rural emergency department: A retrospective cohort study

Abstract

Objective The study sought to investigate the profile and characteristics of suicide-related crisis presentations and factors associated with repeat presentations to a rural hospital Emergency Department (ED). Method This retrospective cohort study examined suicide-related crisis presentation data from a rural ED for the years 2008–2018 inclusive. Descriptive statistical analyses included demographic characteristics and trends over time. Factors associated with increased likelihood to re-present to the ED for suicide-related crisis were identified using Odds Ratio analyses. Results First Nations People, adolescents and young adults were at increased risk of presentation. Suicidal crisis presentations had increased well beyond that which might be accorded to the catchment’s population increase and almost a third of presentations involved individuals re-presenting in suicide-related crisis. Repeat presentation was positively associated with younger age, less acute triage category, discharge to the community and leaving the ED before/during treatment. Conclusions This study illustrates the importance of flagging, follow-up and support of rural repeat presenters to reduce further suicidal behaviours and presentation. Findings support the need for culturally safe and appropriate interventions and follow-up services. It is recommended to extend approach this to non-ED settings.

Investment in community-based rural health care innovation to address health inequities in Australia

“…We echo Alston and Versace’s call for investment in hospital-based rural health research. Researchers in our School demonstrate the value of researchers and hospital-based clinicians working in partnership to inform service design 4 and implement interventions that improve health outcomes and reduce hospital admissions. 5 , 6 We especially agree that the dissemination of findings to inform opportunities for upscaling is crucial.…”

“…In partnership with organisations ranging from community health services, local councils, and the Royal Flying Doctors Service, our researchers are building the evidence for new approaches to the delivery of specialist care, health promotion, oral health care, health care for children in out-of-home care and end-of-life palliative care. 4 , 7 , 8 Where we have outcome data available, these context-specific approaches are improving patient satisfaction, health outcomes and reducing hospital admissions. These projects have often been funded by small grants yet are having a significant, meaningful and lasting impact on local communities.…”