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Non-presentation at hospital following a suicide attempt: a national survey

Published online by Cambridge University Press:  03 July 2020

Fabrice Jollant
Affiliation:
Department of psychiatry, University of Paris (Paris-Descartes University), Paris, France GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France McGill Group for Suicide Studies, McGill University, Montréal, Canada CHU de Nîmes, Nîmes, France
Keith Hawton
Affiliation:
Department of Psychiatry, Centre for Suicide Research, University of Oxford, Warneford Hospital, Oxford, UK
Guillaume Vaiva
Affiliation:
Department of Psychiatry, University of Lille, Lille, France Academic Hospital (CHU) of Lille, Lille, France SCA Laboratory CNRS-UMR 91-93, Lille, France
Christine Chan-Chee
Affiliation:
National Agency of Public Health (Santé Publique France), Saint-Maurice, France
Enguerrand du Roscoat
Affiliation:
National Agency of Public Health (Santé Publique France), Saint-Maurice, France LAPPS, EA 4386, Université Paris Ouest Nanterre-La Défense, Nanterre, France
Christophe Leon
Affiliation:
National Agency of Public Health (Santé Publique France), Saint-Maurice, France
Corresponding

Abstract

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.

Methods

Data 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.

Type
Original Articles
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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