Registration, psychiatric evaluation and adherence to psychiatric treatment after suicide attempt.
Persons who are treated at hospital after attempted suicide comprise a high-risk group for suicide. The proposal for a National Programme for Prevention of Suicide and Suicide Attempt in Denmark recommends that all persons who attempt suicide should be offered treatment and that treatment should be implemented, using a supportive and guiding principle. The aim of the present study is to investigate whether patients receive psychiatric evaluation after a suicide attempt, and whether they receive the psychiatric treatment to which they are referred. In the Copenhagen Hospital Corporation in four emergency rooms and six intensive care units, we investigated all referrals in the period 1 February 2001 to 1 May 2001 with Contact Code 4 (self-harm) and selected diagnostic codes likely to be used in cases of self-poisoning, strangulation, drowning and wrist-cutting. We found that only 37% of the contacts to the emergency room were correctly coded with Reason for Contact Code 4 in Nomesco's classification of external causes of injuries. A psychiatric evaluation was planned for almost all patients, but 18% of the patients never reached the evaluation that had been planned to take place in a psychiatric emergency. Only few patients were not referred to any treatment at all, but among the patients referred to psychiatric treatment, only those admitted involuntarily received treatment in 100% of the planned cases. For outpatient treatment in the suicide prevention clinic, the percentage that attended planned treatment within the first week after the suicide attempt was especially low (57%). It is recommended that the quality of Reason for Contact Coding be improved, that patients who have attempted suicide be approached assertively, and that the supportive and guiding principle be used in securing them treatment.
Nordentoft
Merete
M
Department of Psychiatry, Bispebjerg Hospital, Copenhaven, Denmark. merete.nordentoft@dadlnet.dk
Søgaard
Mette
M
D000328:Adult; D003718:Denmark; D004637:Emergency Services, Psychiatric; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D010349:Patient Compliance; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*; D016312:Treatment Refusal / Q000523:psychology*