New national research highlights the need for careful initial assessment and transitional care to ensure that youth at risk of suicide and/or mental illness are referred to appropriate services

Congratulations to UCD School of Medicine’s Professor Fiona McNicholas, and her collaborators across UCC, RCSI and the HSE on their recently published research in the Journal of Child & Adolescent Mental Health. The paper is titled ‘Thoughts of suicide and self-harm: A national study on young people presenting to non-paediatric acute hospitals in Ireland’ and it examines child and adolescent self-harm and suicidal ideation-related presentations to 24 non-paediatric hospital emergency departments in Ireland.

Abstract

Background: In Ireland, acute hospital emergency departments (ED) become the default service for youth aged 16 to 18 years; and in the absence of paediatric EDs, for youth under 16 years. No previous research has explored adolescent presentations to non-paediatric hospitals with thoughts of self-harm or suicide at a national level.

Aim: This study examines child and adolescent self-harm and suicidal ideation-related presentations to 24 non-paediatric hospital EDs in Ireland.

Method: National data from a dedicated ED service for a suicidal crisis were used. Descriptive analyses were run for four age bands (≤ 15, 16-17, 18-19, and all other adults < 20 years), based on sociodemographic characteristics, clinical information, and type of self-harm or ideation.

Results: Between 2018 and 2022, the National Clinical Programme for Self-Harm and Suicide-related Ideation (NCPSHI) clinicians assessed 53 359 presentations due to self-harm and suicide-related ideation. Among those 15 years and younger, 1.7% presented for self-harm, 0.9% for suicidal ideation, and 0.2% for self-harm ideation. Among the 16–17-year-olds, 3.4% presented with self-harm and 1.6% for suicidal ideation. Presentations for self-harm decreased with age, while suicide-related ideation increased. Cutting was most common among the youngest group (23%), and overdose was more frequent among 16 to 17-year-olds. Notably, 41% of those 15 year and younger were already attending mental health services.

Conclusions: Our findings highlight that a significant number of adolescents with a self-harm-related crisis attend non-paediatric acute hospitals in Ireland. Careful initial assessment and transitional care are needed to ensure that youth at risk of suicide and/or mental illness are referred to appropriate services.

The full paper can be accessed here.