Every year in the U.S., suicide attempts lead to more than 316,572 hospital admissions, according to a study published in the American Psychiatric Association’s journal in March. But a portion of those people seen at hospitals for suicide attempts say they weren’t actually trying to kill themselves.
Stephen O’Connor, a psychologist and researcher at the University of Louisville, conducted a study at Vanderbilt University Medical Center of people who where admitted after attempting suicide.
“About every third person was denying they’d made a suicide attempt, even though a lot of the evidence pointed toward that they probably did come in after a suicide attempt,” O’Connor said.
He wanted to find out what happened to those people who denied attempting suicide.
“You only have a brief window of time to help them,” O’Connor said.
O’Connor's study found that people who denied they’d attempted suicide were 10 times more likely than those who admitted it to be discharged home from the hospital — rather than being sent to a mental health facility.
He said the finding is important because it means there’s a missed opportunity for a mental health provider to help the person before sending them home.
The study looked at the medical records of 128 people who’d come to Vanderbilt University Medical Center’s emergency room because of self-inflicted gunshot wounds between 2012 and 2015. The study found that 29 percent of people who came to the emergency room with a self-inflicted gunshot wound denied that they’d made a suicide attempt.
O’Connor said hospitals usually give patients referrals for outpatient mental health providers if they suspect a gunshot wound was the result of an attempted suicide. But mental health providers at the hospital can also provide quick interventions that could work to get them to that outpatient care.
“You can do some things that are potentially life saving. There are brief interventions [to] increase motivation to engage in outpatient care," he said.
When emergency room staff at the University of Louisville Hospital suspect a self-inflicted gunshot wound is an attempted suicide, Eugenia Brikker is on-call to come in and evaluate the person. She said many of the findings from O'Connor's small study ring true for the people she sees in the ER. She said patients who have no documented history of a suicide attempt or mental health diagnosis are more likely to deny trying to do themselves harm.
“They are more likely to say that they were not trying to kill themselves,” Brikker said.
In addition to the brief interventions O’Connor mentioned, Brikker said it’d be ideal if a mental health provider could check in with the patient when they return for a follow-up on their physical wound. She noted, however, that most primary care offices aren't set up that way.
“When they go into to have their wound examined, wraparound services would include a mental health provider, and evaluate how they’re doing in terms of is there any presence of depression, if they’re having any anxiety or anything that could predispose them to self-harm,” Brikker said.
O’Connor said future research should look at barriers to getting honest responses from people who attempt suicide, especially if they fear being involuntarily admitted to a psychiatric hospital.
O’Connor also said there are other interventions that could happen before discharge, including making sure guns are not easily available to people who've survived self-inflicted gunshot wounds.
“To make sure that if people are not at their best, that they don’t have as much risk as something impulsive happening, like shooting themselves,” O’Connor said.
