Emergency Department (ED)/Comprehensive Psychiatric Emergency Program (CPEP)
In an Office of Mental Health 2016 internal analysis of New York Incident Management Reporting System (NIMRS) and Medicaid claims data,¹ among the 1,643 individuals receiving care within the New York State mental health system who attempted or died by suicide, there were 1,527 visits to psychiatric hospitals and emergency departments less than 6 months prior to suicidal behavior. More than half (53%) of these visits occurred less than 30 days prior to the suicidal behavior, consistent with nationwide trends. A similar trend occurs within the general New York State population: a significant proportion of individuals who die by suicide are seen in inpatient or ED settings not long before their deaths. In another internal analysis crosswalking the state’s all payer hospital dataset, Statewide Planning and Research Cooperative System (SPARCS), and Vital Statistics (2013-14), there were a total of 3,564 suicides; 452 (13%) had an inpatient discharge and 415 (12%) had an ED discharge within seven days of their suicide. It is estimated that up to 8% of patients presenting to medical EDs have active suicidal ideation, most of which goes undetected.2,3 Like inpatient units, CPEPs and EDs see high volumes of suicidal patients but inconsistently deliver suicide specific assessment and intervention, missing opportunities to triage or treat those at greatest risk.
- New York State Office of Mental Health. New York State Incident Management and Reporting System (NIMRS) and Medicaid claims data crosswalk, 2016.
- Ilgen MA, Walton MA, Cunningham RM, et al. Recent suicidal ideation among patients in an inner-city emergency department. Suicide Life Threat Behav. 2009;39:5 508-517.
- Claassen CA, Larkin GL. Occult suicidality in an emergency department population. Br J Psychiatry.