ABSTRACT
Background
The main objective of this study was to describe the characteristics of older Emergency Department (ED) patients consulting for suicidal ideation/suicide attempts. The secondary objective was to explore material and social deprivation status in those patients.
Methods
We used data from a Public Health Agency of Canada specialized mental health database. Older adults (≥ 65 years old) were included if they consulted in a participating ED between 2020 and 2022 for suicidal ideations or suicide attempts. Medical archivists collected relevant sociodemographic and clinical information from patients’ medical records using a standardized form. The Material and Social Deprivation Index was used to describe socioeconomic status Low Deprivation (Q1)–High Deprivation (Q5).
Results
Of 1352 consultations (2.3%), the mean age was 74.1 ± 7.2; 58.9% were aged 65–74 and 57.8% were female. Most lived at home (66.8%), arrived by ambulance (65.3%), and had a mental health history (91.2%). Most patients received multidisciplinary management, with 94.2% of patients who attempted suicide being assessed by a psychiatrist, and 72.1% were hospitalized. 638 (47.2%) had a suicide plan, and 190 (14.1%) attempted suicide. The most common method of suicide attempts was poisoning (suicide attempts: 76% plan: 31%). 24.3% of patients came from deprived areas (Q5). Social deprivation was also severe, with Q4 and Q5 patients accounting for nearly 50% of all patients.
Conclusion
Suicidal behaviors are a serious concern among older ED patients. This study characterizes the clinical presentation and ED trajectories of older adults with suicidal ideation or behavior. These descriptive data can inform future research on care transitions and emergency care models for mental health crises in later life.