THE EMERGENCY DEPARTMENT IN SURVEILLANCE OF ATTEMPTED-SUICIDE - FINDINGS AND METHODOLOGIC CONSIDERATIONS

The authors conducted one of the first active, population-based public health surveillance systems for detecting suicide attempts in the Uni ted States. Surveillance was conducted in all four hospital emergency departments serving a county suburban to Atlanta, GA, with a populatio n of 426,000. Emergency department staff gathered information from all patients who presented with an intentionally self-inflicted injury (s uicide attempt) or with thoughts about self-injury (suicidal ideation) . During an 18-month period in 1988 and 1989, 798 suicide attempt-rela ted patients were reported, for a rate of 124.7 per 100,000 county res idents per year. Females had a higher attempted suicide rate than male s, but males had a higher completed suicide rate. Ingestion of drugs o r poison was the most common method of attempted suicide (71.1 percent ), and use of firearms was the most common method of completed suicide (69.8 percent). In comparing reported cases with those found by revie wing emergency department log books, the authors found that the case r eports were 58 percent complete and that surveillance reporting was hi ghly representative of all cases requiring emergency transport. The au thors conclude that emergency department-based surveillance for attemp ted suicide is feasible. It can provide representative data that may b e used to monitor trends in attempted suicide and to define high-risk groups. Such surveillance may also allow timely detection of suicide a ttempt clusters, facilitating prompt intervention.