Is suicide risk taken seriously in heavy drinkers who harm themselves?

Objective: The aim of the study was to examine whether a known history of h eavy drinking adversely in influences the assessment and management of deli berate self-harm (DSH) by accident and emergency department staff. Method: Standard assessment forms on a consecutive series of 909 DSH cases were examined. Estimated suicide risk and clinical management were compared in patients who reported high (more than 7 units per day) and low/moderate alcohol intake. Results: Heavy drinkers had higher rates of several risk factors for suicid e. They were more likely to be judged as at high risk of suicide and furthe r self-harm, and were more likely to receive clinical management appropriat e to people at high risk. However, a logistic regression analysis revealed that it was not alcohol use itself but risk factors that were more common i n heavy drinkers that predicted clinical management. Conclusion: The results suggest that heavy drinkers are in general judged t o be at higher risk of suicide and managed accordingly. However, training f or accident and emergency department staff should emphasize the importance of alcohol as an independent risk factor for suicide.