title: The characteristics, management, and aftercare of patients with suicide attempts who attended the emergency department of a general hospital in northern Taiwan.
abstract: BACKGROUND
  Suicide is a serious public health problem worldwide. The emergency department (ED) is often the first place of contact with medical and mental health care for suicidal patients. This study aimed to determine the characteristics, management, and aftercare of patients who attempted suicide and then were taken to the ED of a general hospital in Taipei, Taiwan.
  
  
  METHODS
  Our study was a cross-sectional retrospective study that consecutively recruited patients with suicide attempts attended to the ED of a general hospital from June 2004 to May 2005. The patients' medical information and records pertaining to their emergency visit were subsequently reviewed.
  
  
  RESULTS
  Overall, 481 persons were recruited into our study. The male:female ratio of total surviving attempters was approximately 1:4 and the average age was 33.6 [standard deviation (SD) 12.3] years. The most frequently observed general characteristics from which participants suffered were mental illness (73.1%) and interpersonal problems (76.1%). Nearly all patients (91.7%) received ED on-site psychosocial assessments from social workers (SWs) and psychiatrists in 84.2% and 53.4% of cases, respectively. Less than half of patients (45.1%) were referred to psychiatric outpatient aftercare, and only 26.1% contacted the psychiatric outpatient clinics after discharge from the ED. The stated reasons for psychiatric outpatient referral were associated with interpersonal problems, current psychiatric illness, the ED on-site psychiatrist consultation, and admission to medical, surgical, or psychiatric wards. However, individuals with interpersonal problems, previous psychiatric intervention, and ED on-site psychiatrist consultation were significantly more likely to attend outpatient psychiatric aftercare.
  
  
  CONCLUSIONS
  Individuals who harmed themselves had a high rate of psychiatric morbidity and interpersonal problems. However, their adherence to psychiatric outpatient aftercare was low. Improved identification of the needs of patients with suicidal tendencies who did not attend outpatient services will have implications for future services provided to this patient population, and will better enable medical personnel to most effectively assist in suicide attempt interventions.
authors.affiliation: Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Chen-Ju
authors.initials: CJ
authors.lastname: Lin
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Hsin-Chin
authors.initials: HC
authors.lastname: Lu
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Mackay Junior College of Medicine, Nursing & Management, Taipei, Taiwan, ROC.
authors.forename: Fang-Ju
authors.initials: FJ
authors.lastname: Sun
authors.affiliation: Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Chun-Kai
authors.initials: CK
authors.lastname: Fang
authors.affiliation: Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Shu-I
authors.initials: SI
authors.lastname: Wu
authors.affiliation: Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Mackay Junior College of Medicine, Nursing & Management, Taipei, Taiwan, ROC. Electronic address: maryliuyip@gmail.com.
authors.forename: Shen-Ing
authors.initials: SI
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D003419:Crisis Intervention; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013406:Suicide, Attempted; D013624:Taiwan
keywords: aftercare; attempted suicide; crisis intervention; hospital emergency service; referral and consultation