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Research Trends

Aboriginal and Non-Aboriginal Emergency Department Presentations Involving Suicide-Related Thoughts and Behaviors

Characteristics and Discharge Arrangements

Published Online:April 28, 2020https://doi.org/10.1027/0227-5910/a000675

Abstract

Abstract.Background: Rates of hospital admission for suicide-related thoughts and behaviors (SRTBs) are elevated in the Northern Territory (NT) of Australia, especially by Aboriginal people, but very little is known about emergency department (ED) presentations. Aim: We aimed to profile ED presentations in the NT involving SRTBs by Indigenous status and compare discharge arrangements. Method: Logistic regression analyses were performed on data from electronic patient records of consecutive ED presentations involving SRTBs. Results: During the study period, 167 presentations were observed. Aboriginal patients were more likely to present from remote areas and to report substance misuse and family conflict or violence compared with non-Aboriginal patients. In both groups, males were more likely than females to be admitted as were persons presenting with self-harm compared with those who had suicidal thoughts only. No differences in discharge arrangements were identified by Indigenous status. Limitations: The small scale of the study and use of administrative records points to the need for further research to improve the quality of the evidence. Conclusion: While presentations by high-risk groups are more likely to be admitted for further care, the assessment of psychosocial risks and needs in EDs is vital to informing decisions for aftercare that support recovery in the community for Aboriginal patients and patients discharged from EDs.

References

  • Adams, N. (1999). Near hanging. Emergency Medicine, 11(1), 17–21. 10/b7hjqd First citation in articleCrossref, Google Scholar

  • Anderson, I., Robson, B., Connolly, M., Al-Yaman, F., Bjertness, E., King, A., … Yap, L. (2016). Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration): A population study. The Lancet, 388(10040), 131–157. 10/f3prhx First citation in articleCrossref Medline, Google Scholar

  • Australian Bureau of Statistics (ABS). (2013). Australian demographic statistics, June 2013 (Cat. no. 3101.0). Canberra, Australia: Author. First citation in articleGoogle Scholar

  • Australian Bureau of Statistics (ABS). (2014). Indigenous status standard, 2014, Version 1.5. Canberra, Australia: Author. First citation in articleGoogle Scholar

  • Australian Bureau of Statistics (ABS). (2018a). Estimates of Aboriginal and Torres Strait Islander Australians, June 2016 (Cat. no. 3238.0.55.001). Canberra, Australia: Author. First citation in articleGoogle Scholar

  • Australian Bureau of Statistics (ABS). (2018b). Suicide in Australia, causes of death, Australia, 2016 (Cat. no. 3303.0). Canberra, Australia: Author. First citation in articleGoogle Scholar

  • Boots, R. J., Joyce, C., Mullany, D. V., Anstey, C., Blackwell, N., Garrett, P. M., … Alexander, N. (2006). Near-hanging as presenting to hospitals in Queensland: Recommendations for Practice. Anaesthesia and Intensive Care, 34(6), 736–745. 10/gfx5xv First citation in articleCrossref Medline, Google Scholar

  • Borges, G., Cherpitel, C. J., Orozco, R., Ye, Y., Monteiro, M., Hao, W., & Benegal, V. (2017). A dose–response estimate for acute alcohol use and risk of suicide attempt. Addiction Biology, 22(6), 1554–1561. 10/f9p7gr First citation in articleCrossref Medline, Google Scholar

  • Canetto, S. S., & Sakinofsky, I. (1998). The gender paradox in suicide. Suicide and Life-Threatening Behavior, 28(1), 1–23. 10.1111/j.1943-278X.1998.tb00622.x First citation in articleCrossref Medline, Google Scholar

  • Carroll, R., Metcalfe, C., & Gunnell, D. (2014). Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis. Plos One, 9(2), e89944. 10.1371/journal.pone.0089944 First citation in articleCrossref Medline, Google Scholar

  • Carter, G., Page, A., Large, M., Hetrick, S., Milner, A. J., Bendit, N., … Christensen, H. (2016). Royal Australian and New Zealand College of Psychiatrists clinical practice guideline for the management of deliberate self-harm. Australian & New Zealand Journal of Psychiatry, 50(10), 939–1000. 10/gdf379 First citation in articleCrossref Medline, Google Scholar

  • Chunduri, S., Browne, S., Pollio, D. E., Hong, B. A., Roy, W., Roaten, K., … North, C. S. (2017). Suicide risk assessment and management in the psychiatry emergency service: Psychiatric provider experience and perceptions. Archives of Suicide Research, 23(1), 1–14. 10/gc6zvk First citation in articleCrossref, Google Scholar

  • Davidson, J. A. (2003). Presentation of near-hanging to an emergency department in the Northern Territory. Emergency Medicine, 15(1), 28–31. First citation in articleCrossref Medline, Google Scholar

  • De Leo, D., Sveticic, J., & Milner, A. (2011). Suicide in Indigenous people in Queensland, Australia: Trends and methods, 1994–2007. Australian & New Zealand Journal of Psychiatry, 45(7), 532–538. 10/dbb366 First citation in articleCrossref Medline, Google Scholar

  • Dudgeon, P., Calma, T., & Holland, C. (2017). The context and causes of the suicide of Indigenous people in Australia. Journal of Indigenous Wellbeing, 2(2), 5–15. First citation in articleGoogle Scholar

  • Dudgeon, P., & Holland, C. (2018). Recent developments in suicide prevention among the Indigenous peoples of Australia. Australasian Psychiatry, 26(2), 1–4. 10/gc47vg First citation in articleCrossref, Google Scholar

  • Elliott-Farrelly, T. (2004). Australian Aboriginal suicide: The need for an Aboriginal suicidology? Australian E-Journal for the Advancement of Mental Health, 3(3), 138–145. 10/db87sn First citation in articleCrossref, Google Scholar

  • Gee, G. J., Dudgeon, P., Schultz, C., Hart, A., & Kelley, K. (2014). Aboriginal and Torres Strait Islander social and emotional wellbeing. In P. DudgeonH. MilroyR. Walker (Eds.), Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (2nd ed., pp. 55–68). Canberra, Australia: Telethon Institute of Child Health/Kulunga Research Network. First citation in articleGoogle Scholar

  • Han, J., Batterham, P. J., Calear, A. L., & Randall, R. (2018). Factors influencing professional help-seeking for suicidality: A systematic review. Crisis, 39(3), 175–196. 10.1027/0227-5910/a000485 First citation in articleLink, Google Scholar

  • Harrison, J. E., & Henley, G. (2014). Suicide and hospitalised self-harm in Australia: Trends and analysis. (Cat. no. INJCAT 169). Canberra, Australia: Australian Institute of Health and Welfare (AIHW). First citation in articleGoogle Scholar

  • Hawton, K. (2016). Psychiatric assessment and management of deliberate self-poisoning patients. Medicine, 44(2), 103–105. 10/gfx5wm First citation in articleCrossref, Google Scholar

  • Hickey, L., Hawton, K., Fagg, J., & Weitzel, H. (2001). Deliberate self-harm patients who leave the accident and emergency department without a psychiatric assessment: A neglected population at risk of suicide. Journal of Psychosomatic Research, 50(2), 87–93. 10.1016/S0022-3999(00)00225-7 First citation in articleCrossref Medline, Google Scholar

  • Hunter, E., & Harvey, D. (2002). Indigenous suicide in Australia, New Zealand, Canada, and the United States. Emergency Medicine, 14(1), 14–23. First citation in articleCrossref Medline, Google Scholar

  • Hunter, E., & Milroy, H. (2006). Aboriginal and Torres Strait Islander suicide in context. Archives of Suicide Research, 10(2), 141–157. 10.1080/13811110600556889 First citation in articleCrossref Medline, Google Scholar

  • Leckning, B. A., Li, S. Q., Cunningham, T., Guthridge, S., Robinson, G., Nagel, T., & Silburn, S. (2016). Trends in hospital admissions involving suicidal behaviour in the Northern Territory, 2001-2013. Australasian Psychiatry, 24(3), 300–304. 10.1177/1039856216629838 First citation in articleCrossref Medline, Google Scholar

  • McClatchey, K., Murray, J., Rowat, A., & Chouliara, Z. (2017). Risk factors for suicide and suicidal behavior relevant to emergency health care settings: A systematic review of post-2007 reviews. Suicide and Life-Threatening Behavior, 47(6), 729–745. 10.1111/sltb.12336 First citation in articleCrossref Medline, Google Scholar

  • Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2013). The epidemiology of suicide and suicidal behavior. In M. K. NockG. BorgesY. Ono (Eds.), Suicide: Global perspectives from the WHO World Mental Health Surveys (pp. 5–32). Cambridge, UK: Cambridge University Press. First citation in articleGoogle Scholar

  • Parker, R., & Ben-Tovim, D. I. (2002). A study of factors affecting suicide in Aboriginal and ‘other' populations in the Top End of the Northern Territory through an audit of coronial records. Australian & New Zealand Journal of Psychiatry, 36(3), 404–410. First citation in articleCrossref Medline, Google Scholar

  • Pisani, A. R., Murrie, D. C., & Silverman, M. M. (2016). Reformulating suicide risk formulation: From prediction to prevention. Academic Psychiatry, 40(4), 623–629. 10/f8wgwq First citation in articleCrossref Medline, Google Scholar

  • Shand, F. L., Batterham, P. J., Chan, J. K. Y., Pirkis, J., Spittal, M. J., Woodward, A., & Christensen, H. (2018). Experience of health care services after a suicide attempt: Results from an online survey. Suicide and Life-Threatening Behavior, 48(6), 779–787. 10/gcskqn First citation in articleCrossref Medline, Google Scholar

  • Silverman, M. M., Berman, A. L., Sanddal, N. D., O'Carroll, P. W., & Joiner, T. E. (2007). Rebuilding the Tower of Babel: A revised nomenclature for the study of suicide and suicidal behaviors Part 2: Suicide-related ideations, communications, and behaviors. Suicide and Life-Threatening Behavior, 37(3), 264–277. 10/bxqm8v First citation in articleCrossref Medline, Google Scholar

  • StataCorp. (2017). Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC. First citation in articleGoogle Scholar

  • Steeg, S., Emsley, R., Carr, M., Cooper, J., & Kapur, N. (2018). Routine hospital management of self-harm and risk of further self-harm: Propensity score analysis using record-based cohort data. Psychological Medicine, 48(2), 315–326. 10/gbjg8x First citation in articleCrossref Medline, Google Scholar

  • Tsey, K., Whiteside, M., Haswell-Elkins, M., Bainbridge, R., Cadet-James, Y., & Wilson, A. (2010). Empowerment and Indigenous Australian health: A synthesis of findings from Family Wellbeing formative research. Health & Social Care in the Community, 18(2), 169–179. 10/bq255w First citation in articleCrossref Medline, Google Scholar

  • Vale, A., & Bradberry, S. (2016). Management of poisoning: Initial management. Medicine, 44(2), 97–98. 10/gfx5wn First citation in articleCrossref, Google Scholar