Time Trends in Emergency Department Visits for Suicide-Related Behaviours by Girls and Boys in Alberta

Objective: In Canada, emergency departments (EDs) are a frontline setting for treating suicide-related behaviours (SRBs) among adolescents, yet description of national trends in ED SRB visits is lacking. We determined whether the SRB incidence rate and method patterns between 2002 and 2010 previously shown for Ontario adolescents were also experienced in Alberta. Method: A retrospective, population-based study of ED visits for SRBs (self-poisoning or self-injury, irrespective of suicidal intent) by 12- to 17-year-olds was conducted using administrative health care data from 104 EDs across Alberta, Canada. Incidence rates and 95% confidence intervals (CIs) were calculated and graphed. Rate ratios (RRs) comparing rates between time periods (2002-2005 and 2006-2010) and corresponding 95% CIs were estimated. Changes in SRB methods were also described. The time periods chosen were based on published Ontario trends. Results: Decreases in yearly incidence rates levelled off after 2005. Crude RRs indicated a rate decrease in 2006 to 2010 for boys (RR, 0.77; 95% CI, 0.65 to 0.90) and girls (RR, 0.80; 95% CI, 0.67 to 0.95). From 2002 to 2010, the proportion of SRB visits for self-poisoning decreased (girls, –13%; boys, –10%) while visits for self-cutting increased (girls, +13%; boys, +14%). Conclusions: Alberta trends were similar to those previously published for Ontario. Determining if the trends and observed changes are associated with mental health care access or availability and/or provincial suicide prevention strategies would contextualize these findings and could shape future prevention efforts. Lack of identification of suicidal intent and exclusion of fatal SRB are limitations of the current study.