Trends in emergency health care due to suicidal behaviour in youth and adult populations

Abstract

Background and Objectives

Since the outbreak of the COVID-19 pandemic, there has been a significant increase in mental health-related ED visits, especially in child and adolescent population. This study aims to analyze trends in emergency care for mental health, including suicidal behaviour, in adolescents over seven years, and compare them with adults.

Methods

This observational and retrospective study included 33,376 visits, involving 12,159 individuals, to the ED for mental health issues between 2015 and 2021 from two hospitals in Madrid (Hospital Fundación Jiménez Díaz and Hospital Rey Juan Carlos). Sociodemographic and clinical data were collected from electronic health records. Logistic regression models were used to identify factors associated with presentations for suicidal behavior, with odds ratios (OR) and 95 % confidence intervals (95 %CI).

Results

In adults, presenting to the emergency department for suicidal behaviour was significantly associated with family history of suicide (OR=1.497, 95 %CI [1.250–1.794]), higher number of previous suicide attempts (OR=1.376, 95 %CI [1.331–1.422]), and substance intoxication (OR=1.317, 95 %CI [1.132–1.533. In children and adolescents, previous suicide attempts (OR=1.803, 95 %CI [1.485–2.189]), being female (OR=1.848, 95 %CI [1.281–2.666]) and older age (OR=1.113, 95 %CI [1.015–1.222]) were associated with higher odds of presenting for suicidal behaviour. Neurodevelopmental disorders were also significantly associated with increased odds of presenting for suicidal behaviour (OR=5.328, 95 %CI [2.353–12.063]), while psychotic disorders (OR=0.133, 95 %CI [0.032–0.548]) and anxiety disorders (OR=0.282, 95 %CI [0.128–0.622]) were linked to lower odds. In contrast to adults, the percentage of ED visits for suicidal behaviour in children and adolescents increased steadily over the study period, peaking at 30.3 % in 2020

Conclusion

These findings underscore the need for age- and gender-specific approaches in the management and prevention of suicidal crises in mental health emergency settings, with special attention to past suicidal behavior and family history as critical risk factors.