J Korean Med Sci.  2022 Aug;37(31):e245. 10.3346/jkms.2022.37.e245.

National Implementation of Emergency Department-Based Followup Program for Suicidal Attempts

• Kim TH
• Song KJ
• Shin SD
• Hong KJ
• Lee JK

• KMID: 2532320
• DOI: http://doi.org/10.3346/jkms.2022.37.e245

Abstract

Background
Death by suicide is a major public health problem. To provide multidisciplinary support to patients who attempted suicide, emergency department (ED)-based psychiatric screening and intervention programs were offered. We traced the long-term survival outcome of patients visiting the ED after suicide attempts using the national death certificate registration database.
Methods
A retrospective observational study was conducted using a database of patients from “Psychiatric Crisis Response Centers” (PCRC) of 27 EDs between January 2013 and August 2015. Patients who visited the ED after attempting suicide were screened and interviewed by social workers from the PCRC. The database was merged with the national death certificate database to trace the death and cause of death of the patients until December 2018. The characteristics and outcomes were compared based on the patient’s compliance with the follow-up case management program.
Results
Of the 12,544 interviewed patients, the data of 9,587 patients were successfully matched with data from the death certificate database. Death by suicide was higher in the noncompliance group (4.5% vs. 12.4%, P < 0.001); however, death caused by factors other than suicide did not differ between groups (4.8% vs. 4.9%, P = 0.906).
Conclusion
Suicide resulted in a lower long-term mortality rate among patients who complied with the follow-up case management session in the ED-based brief psychiatric intervention and follow-up program.

Keyword

Psychiatric Intervention; Suicide; Survival Outcome

Figure

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  Fig. 1 Process of study enrollment.

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  Fig. 2 Mortality rate by cause of death based on the number of case management sessions.

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