title: Completed suicides and emergency psychiatric evaluations: the Louisville experience.
abstract: Suicide is one of the most serious outcomes of psychiatric illness, and the most extreme intervention (involuntary hospitalization) can be exercised if this event is likely. Despite this, the rate of suicide has remained fairly consistent at 1.1-1.4%. In an ongoing effort of identifying factors that can predict subsequent suicides, we retrospectively examined the records of individuals who completed suicides in Jefferson County, January 1997 through September 1998, and who were evaluated at the Emergency Psychiatric Service (EPS) at University of Louisville Hospital. Fifteen of the 132 (11.4%) subjects who completed suicide were evaluated at some point in time at EPS. Only 8 (6.1%) were seen within 60 days of the fatal event. This represents less than 0.1% of the total 9,469 patients seen at the EPS during this time period. No specific factors could be identified that predicted imminent suicide. Given the inaccuracy in being able to predict suicide, clinicians need to continue to be vigilant when assessing acutely distressed substance abusing or psychiatric patients.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Kentucky 40292, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Harris
authors.forename: J
authors.initials: J
authors.lastname: Holman
authors.forename: A A
authors.initials: AA
authors.lastname: Bates
authors.forename: Z
authors.initials: Z
authors.lastname: DeLima
authors.forename: E S
authors.initials: ES
authors.lastname: Howard
authors.forename: A
authors.initials: A
authors.lastname: Ivanenko
authors.forename: R J
authors.initials: RJ
authors.lastname: Lunsford
authors.forename: W A
authors.initials: WA
authors.lastname: James
authors.forename: R S
authors.initials: RS
authors.lastname: el-Mallakh
mesh_terms: D000328:Adult; D015897:Comorbidity; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors; D000092864:Suicide Prevention