Non-presentation at hospital following a suicide attempt: a national survey
Fabrice Jollant (a1) (a2) (a3) (a4), Keith Hawton (a5), Guillaume Vaiva (a6) (a7) (a8), Christine Chan-Chee (a9)Enguerrand du Roscoat (a9) (a10)Christophe Leon (a9)Informations sur l’auteur affichées
(a1)1 Department of psychiatry, University of Paris (Paris-Descartes University), Paris, France
(a2) 2 GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
(a3) 3 McGill Group for Suicide Studies, McGill University, Montréal, Canada
(a4) 4 CHU de Nîmes, Nîmes, France
(a5) 5 Department of Psychiatry, Centre for Suicide Research, University of Oxford, Warneford Hospital, Oxford, UK
(a6) 6 Department of Psychiatry, University of Lille, Lille, France
(a7) 7 Academic Hospital (CHU) of Lille, Lille, France
(a8) 8 SCA Laboratory CNRS-UMR 91-93, Lille, France
(a9) 9 National Agency of Public Health (Santé Publique France), Saint-Maurice, France
(a10) 10 LAPPS, EA 4386, Université Paris Ouest Nanterre-La Défense, Nanterre, France
DOI: https://doi.org/10.1017/S0033291720002305
Publié en ligne par Cambridge University Press: 03 Juillet 2020
Background
A few previous studies suggest that a large number of individuals do not present at hospital following a suicide attempt, complicating recurrence prevention and prevalence estimation.
MethodsData were extracted from a regular phone survey in representative samples of the French population aged 18–75 years old. Five surveys between 2000 and 2017 collected data about the occurrence of a previous suicide attempt and subsequent care contacts. A total of 102,729 individuals were surveyed. Among them, 6,500 (6.4%) reported a lifetime history of suicide attempt.
Results
Following their last suicide attempt, 39.3% reported they did not present to hospital (53.4% in 18–24 year-olds), with limited changes in rates with time. Risk factors for non-presentation were being male [adjusted odds ratio = 1.3, 95% confidence interval (1.1–1.5)], living with someone [1.2 (1.0–1.4)], being a non-smoker [1.4 (1.2–1.6)], and being younger at time of attempt [0.97 (0.96–0.98) per year]. Of those who did not present to hospital, only 37.7% reported visiting a doctor or a psychiatrist/psychologist after their act v. 67.1% in those who presented to hospital (as a second health contact). In both cases, half disclosed their act to someone else. Prevalence rates of suicide attempts reported in community were 4.6 times higher than those in hospital administrative databases.
Conclusions
This survey at a national level confirmed that a large proportion of individuals does not go to the hospital and does not meet any health care professionals following a suicidal act. Assessment of unmet needs is necessary.
https://www.cambridge.org/core/journals/psychological-medicine/article/nonpresentation-at-hospital-following-a-suicide-attempt-a-national-survey/AC0BF1DB18837128174A4A69604A2616#
