Most Teens Who Self-Harm Are Not Evaluated for Mental Health in ER

Researchers say suicide risk is highest soon after such an incident

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121814.html
(*this news item will not be available after 05/10/2012)

By Mary Elizabeth Dallas

Friday, February 10, 2012

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FRIDAY, Feb. 10 (HealthDay News) -- Most children and teens who deliberately injure themselves are discharged from emergency rooms without an evaluation of their mental health, a new study shows.
The findings are worrisome since risk for suicide is greatest right after an episode of deliberate self-harm, according to researchers at Nationwide Children's Hospital in Columbus, Ohio.
The researchers also found the majority of these kids do not receive any follow-up care with a mental health professional up to one month after their ER visit.
"Emergency department personnel can play a unique role in suicide prevention by assessing the mental health of patients after deliberate self-harm and providing potentially lifesaving referrals for outpatient mental health care," said lead study author Jeff Bridge, principal investigator at the hospital's Center for Innovation in Pediatric Practice, in a news release. "However, the coordination between emergency services for patients who deliberately harm themselves and linkage with outpatient mental health treatment is often inadequate."
For the study in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers examined Medicaid data for adolescents aged 10 to 19 years. Only 39 percent of the patients discharged after trying to harm themselves received a mental health assessment in the emergency department.
Only about half of the children who had visited the ER for a mental health-related reason within the previous 60 days received a mental health evaluation during their visit to the ER for self-harm.
Up to 90 percent of young people who deliberately harm themselves meet criteria for at least one psychiatric disorder, particularly mood disorders, the researchers said.
The U.K.'s National Institute for Health and Clinical Excellence recommends that people who show up in an emergency room for self-harm should receive a mental health evaluation before being released from the hospital.
"This study highlights the need for strategies to promote emergency department mental health assessments, strengthening the training of physicians in pediatric mental health and adolescent suicide prevention and timely transitions to outpatient mental health care," Bridge said.

SOURCE: Nationwide Children's Hospital, news release, Jan. 30, 2012

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