Suicide in a psychiatric emergency room population.

Twenty-two suicides were identified in a series of 5,284 psychiatric emergency room patients, yielding a suicide rate of 1 1 1 . 1 per 1 00,000 “patient-years at risk”-more than seven times the age- and sexadjusted rate for the general population. Subpopulations at high risk were white people, men, depressed and schizophrenic patients, substance abusers, and patients with multiple emergency room visits. No patients had killed themselves immediately after an emergency room visit, but several had killed themselves without following through on a referral f rom the emergency room to another facility for treatment. The authors discuss the implications of these findings for emergency room practice and for further research. (Am J Psychiatry 140:459-462, 1983) Psychiatric Case Register Project in New York State, identified suicides in a series of emergency room patients seen after earlier suicide attempts and convincingly demonstrated that this subpopulation of emergency room patients was at high risk for eventual suicide. That study did not, however, allow assessment of risk for the overall population of psychiatric emergency room patients or for other segments of that population. Identification of suicides in a large series of unselected psychiatric emergency room patients in the present study made analyses possible. Examination of the individual cases identified allowed assessment of suicide in relation to the emergency services and referrals provided.