Journal article
Mental health and substance use clinical risk factors associated with emergency department and emergency medical services involvement among decedents of suicide by poisoning
Injury prevention, Vol.31(4), pp.312-320
08/2025
DOI: 10.1136/ip-2025-045677
PMID: 40541534
Abstract
ObjectiveTo examine mental health and substance use dependence (MH/SUD) clinical risk factors for emergency medical services (EMS) or emergency department (ED) involvement among decedents of suicides by poisoning.MethodsWe used a multiyear cross-sectional study design (2013–2021) to identify single suicides by poisoning within the National Violent Death Reporting System. MH/SUD risk factors assessed included the history of attempting suicide, history of MH/SUD conditions and treatment and current MH/SUD condition recognition and treatment. We tested each MH/SUD risk factor for associations with EMS or ED involvement as outcomes using logistic regression, and whether urban/rural residency modified these relationships.FindingsOf the 31 237 suicide decedents identified, 86.5% of decedents had EMS involvement and 22% had ED involvement. MH/SUD clinical risk factors associated with EMS involvement included current MH problem (aOR 1.15; 95% CI 1.07 to 1.30) and some evidence of increased history of attempted suicide (aOR 1.10; 95% CI 0.99 to 1.21) and current SUD problem (aOR 1.10; 95 CI 0.99 to 1.23). MH/SUD clinical risk factors associated with ED involvement included history of both attempting suicide (aOR 1.20; 95% CI 1.11 to 1.30) and MH/SUD treatment (aOR 0.80; 95% CI 0.74 to 0.86). Rural areas had lower EMS involvement (aOR 0.73; 95% CI 0.66 to 0.80) but higher ED involvement (aOR 1.09; 95% CI 1.01 to 1.18); however, there was no evidence of effect modification by rurality.ConclusionsIndividuals with MH/SUD risk factors, especially prior suicide attempts, are more likely to require first responder involvement. Additionally, rural areas show some unique patterns in EMS and ED involvement that should be considered in public health and emergency medical planning.
Details
- Title: Subtitle
- Mental health and substance use clinical risk factors associated with emergency department and emergency medical services involvement among decedents of suicide by poisoning
- Creators
- J Priyanka Vakkalanka - University of IowaVictor A. Soupene - University of Iowa Health CareAzeemuddin Ahmed - University of Iowa Health CareJonathan Davis - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Injury prevention, Vol.31(4), pp.312-320
- DOI
- 10.1136/ip-2025-045677
- PMID
- 40541534
- NLM abbreviation
- Inj Prev
- ISSN
- 1353-8047
- eISSN
- 1475-5785
- Publisher
- BMJ Publishing Group Ltd
- Grant note
- Centers for Disease Control and Prevention Foundation (http://dx.doi.org/10.13039/100020365)
- Language
- English
- Electronic publication date
- 06/20/2025
- Date published
- 08/2025
- Academic Unit
- Occupational and Environmental Health; Epidemiology; Emergency Medicine; Injury Prevention Research Center
- Record Identifier
- 9984832087502771
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