SCREENING FOR SUICIDAL THOUGHTS AND BEHAVIORS AMONG OLDER PATIENTS VISITING THE EMERGENCY DEPARTMENT

Abstract

Depression, suicide ideation (SI) and suicide attempts (SA) are common among older adults, representing serious public health problems. Individuals with multiple comorbidities and frequent contact with hospital–based emergency departments (ED) may have elevated – but unrecognized – risk. To inform future interventions, we describe the prevalence of self-harm/SI/SA among older ED patients, including differences by age, sex, and race/ethnicity. We reviewed consecutive patient charts (2011–2014) at 8 EDs in 7 states, all with protocols to screen every patient for suicide risk. Among 142,534 patient visits, 23% were by patients aged ≥60 years. Documented screening for self-harm/SI/SA declined with age, from 81% in younger age groups to 68% among those aged ≥85 years. This decline may be due to age biases or to patient-level factors precluding screening (e.g., altered mentation). Our findings support the need for more detailed examination of the best methods for identifying – and treating – suicide risk among older adults.