Gairin Isaura, House Allan, Owens David
Yorkshire Centre for Forensic Psychiatry, Wakefield. Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, UK.
Br J Psychiatry. 2003 Jul;183:28-33. doi: 10.1192/bjp.183.1.28.
The National Confidential Inquiry into suicides in England and Wales found that a quarter of suicides are preceded by mental health service contact in the year before death. However, visits to accident and emergency departments due to self-harm may not lead to a record of mental health service contact. Aims To determine the proportion of suicides preceded by accident and emergency attendance in the previous year.
We obtained the list of probable suicides in Leeds for a 38-month period, and examined the records from the city's accident and emergency departments for a year before each death.
Eighty-five (39%) of the 219 people who later died by suicide had attended an accident and emergency department in the year before death, 15% because of non-fatal self-harm. Final visits due to self-harm were often shortly before suicide (median 38 days), but the National Confidential Inquiry recorded about a fifth of them as 'not in contact' with local mental health services.
Although many suicides are preceded by recent attendance at accident and emergency departments due to non-fatal self-harm, local mental health service records may show no recent contact. Suicide prevention might be enhanced were accident and emergency departments and mental health services to work together more closely.
英格兰和威尔士全国自杀机密调查发现，四分之一的自杀者在死亡前一年曾与心理健康服务机构接触。然而，因自残前往急诊部门就诊可能不会留下心理健康服务接触记录。目的：确定前一年有过急诊就诊经历的自杀者比例。
我们获取了利兹市38个月期间可能的自杀者名单，并查阅了每位死者死亡前一年该市急诊部门的记录。
在后来自杀身亡的219人中，有85人（39%）在死亡前一年去过急诊部门，其中15%是因为非致命性自残。因自残的最后一次就诊往往在自杀前不久（中位数为38天），但全国自杀机密调查将其中约五分之一记录为“未与当地心理健康服务机构接触”。
尽管许多自杀者在近期因非致命性自残去过急诊部门，但当地心理健康服务记录可能显示近期并无接触。如果急诊部门和心理健康服务机构能更紧密合作，或许能加强自杀预防工作。
