Brief Article
Copyright ©2013 Baishideng. All rights reserved.
World J Psychiatr. Jun 22, 2013; 3(2): 34-40
Published online Jun 22, 2013. doi: 10.5498/wjp.v3.i2.34
Treatment priority for suicide ideation and behaviours at an Australian emergency department
Allison Milner, Kairi Kõlves, Keili Kõlves, Beverley Gladman, Diego De Leo
Allison Milner, Kairi Kõlves, Keili Kõlves, Diego De Leo, Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland 4122, Australia
Beverley Gladman, Queensland Centre for Mental Health Research, The Park, Wacol, Queensland 4076, Australia
Author contributions: All authors contributed to this work; Milner A, Kõlves K and De Leo D designed the research; Milner A, Kõlves K, Gladman B and Kõlves K performed the research; Milner A analyzed the data; Milner A, Kõlves K and De Leo D wrote the paper; all authors contributed to the final draft of this paper.
Correspondence to: Diego De Leo, DSc, Professor, Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Mt Gravatt Campus, 176 Messines Ridge Rd, Brisbane, Queensland 4122, Australia. d.deleo@griffith.edu.au
Telephone: +61-7-37353379 Fax: +61-7-37353450
Received: March 1, 2013
Revised: May 13, 2013
Accepted: May 16, 2013
Published online: June 22, 2013
Processing time: 110 Days and 8.2 Hours
Abstract

AIM: To investigate the treatment priority given to self-harmers presenting to a hospital emergency department (ED) in Queensland, Australia, over the period 2005-2010.

METHODS: The main outcome measure of this study was the treatment priority given to persons presenting with suicide ideation and communication (SIC) or self-harming behaviour. Treatment priority was measured using the Australasian Triage Scale, which ranks patients from 1 (in need of immediate treatment) to 5 (assessment and treatment to start within 120 min). Ordered logistic regression was used to assess the broad demographic and treatment-related factors associated with more urgent triage categories and to investigate which methods of non-fatal suicidal behaviour (NFSB) were prioritised as most urgent.

RESULTS: Most cases of NFSB were between 15 and 34 years. A larger proportion of persons presenting for SIC were aged 35 to 44 years. Over 50% of male presentations and 38% of female presentations were for SIC. Those cases prioritised as being more urgent had significantly greater odds of being older, presented after an act of self-harm rather than SIC, and had used multiple methods of NFSB. These individuals also had greater odds of being male and having made past presentations for SIC or NFSB. Among males, those presenting after ingestion of drugs had the greatest odds of receiving immediate attention compared to SIC. “Cutters” were considered as the least “urgent” subjects, and had a greatest risk of waiting 60 to 120 min for treatment compared to suicide ideators. Among females, those presenting with chemicals, poisons and gases had the greatest odds of receiving immediate attention compared to SIC. Females who presenting after cutting themselves had lower odds of receiving immediate treatment than those who presented with SIC.

CONCLUSION: ED staff seems to judge the urgency of cases based on demographic factors such as age and gender, as well as method of NFSB.

Keywords: Suicide ideation, Non-fatal suicidal behaviour, Emergency department, Treatment priority

Core tip: Emergency department (ED) staff judge the urgency of cases based on demographic factors such as age and gender, as well as method of non-fatal suicidal behaviour. Those who overdose on drugs are often prioritised for treatment sooner than those who presented after self-cutting or suicide ideation. These results highlight the need for specialised interventions for persons presenting to an ED for suicidality.