Objective:

This study estimated national annual trends and characteristics of emergency department visits for suicide attempts and intentional self-harm in the United States from 2011 to 2020.

Methods:

Data were from the National Hospital Ambulatory Medical Care Survey, an annual cross-sectional national sample survey of emergency departments. Visits for suicide attempts and intentional self-harm were identified using discharge diagnosis codes (ICD-9-CM for 2011–2015; ICD-10-CM for 2016–2020) or reason-for-visit codes. The annual proportion of emergency department visits for suicide attempts and intentional self-harm was estimated.

Results:

The weighted number of emergency department visits for suicide attempts and intentional self-harm increased from 1.43 million, or 0.6% of total emergency department visits, in 2011–2012 to 5.37 million, or 2.1% of total emergency department visits in 2019–2020 (average annual percent change, 19.5%, 95% CI=16.9, 22.2). Visits per capita increased from 261 to 871 visits per 100,000 persons (average annual percent change, 18.8%, 95% CI=17.6, 20.0). The increase in visits was widely distributed across sociodemographic groups. While suicide attempt and intentional self-harm visits were most common among adolescents, adults age 65 or older demonstrated the largest increase (average annual percent change, 30.2%, 95% CI=28.5, 32.0). Drug-related diagnoses were the most common co-occurring diagnosis among suicide attempt and intentional self-harm visits. Despite the rise in emergency department visits for suicide attempts and intentional self-harm, less than 16% included an evaluation by a mental health professional.

Conclusions:

A significant national increase in emergency department visits for suicide attempts and intentional self-harm occurred from 2011 to 2020, as a proportion of total emergency department visits and as visits per capita. These trends underscore an urgent need to improve the continuum of mental health care for individuals with suicidal symptoms.

中文翻译：

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自杀未遂和故意自残就诊急诊的全国趋势

 客观的：

本研究估计了 2011 年至 2020 年美国因自杀未遂和故意自残而就诊的全国年度趋势和特征。

 方法：

数据来自全国医院流动医疗调查，这是一项全国急诊科年度横断面抽样调查。使用出院诊断代码（2011-2015 年为 ICD-9-CM；2016-2020 年为 ICD-10-CM）或就诊原因代码来识别自杀未遂和故意自残的就诊。估计了每年因自杀未遂和故意自残而到急诊室就诊的比例。

 结果：

因自杀未遂和故意自残而到急诊科就诊的加权人数从 2011-2012 年的 143 万人次（占急诊科就诊总数的 0.6%）增加到 2019-2020 年的 537 万人次，占急诊科就诊总数的 2.1%（平均年变化百分比，19.5%，95% CI=16.9，22.2）。人均就诊次数从每 10 万人 261 次增至 871 次（年平均百分比变化，18.8%，95% CI=17.6，20.0）。访问量的增加广泛分布在各个社会人口群体中。虽然自杀未遂和故意自残就诊在青少年中最为常见，但 65 岁或以上的成年人增幅最大（年平均百分比变化，30.2%，95% CI=28.5，32.0）。与药物相关的诊断是自杀未遂和故意自残就诊中最常见的同时发生的诊断。尽管因自杀未遂和故意自残而去急诊室就诊的人数有所增加，但只有不到 16% 的人接受了心理健康专业人士的评估。

 结论：

从 2011 年到 2020 年，全国因自杀未遂和故意自残而就诊的急诊人数显着增加，占急诊科就诊总数的比例和人均就诊人数均显着增加。这些趋势强调迫切需要改善有自杀症状的个人的心理健康护理的连续性。