Back to Search
Start Over
The association of acute alcohol use and dynamic suicide risk with variation in onward care after psychiatric crisis
- Source :
- Drug and Alcohol Review
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Introduction Despite the association of alcohol use with recurrent suicidal acts, individuals attempting suicide after drinking alcohol face barriers accessing crisis care following emergency assessment, demonstrated by higher odds of inpatient admission for those whose suicide attempt did not feature alcohol. This disparity may be due to suicidality dissipating more rapidly after a suicide attempt involving alcohol. We investigated the effect of acute alcohol use and ongoing suicidality on onward care decisions after emergency assessment. Methods We analysed electronic health records of 650 suicidal adults detained under Section 136 of the Mental Health Act (1983, amended 2007) for up to 36 h at a London psychiatric emergency care centre. We used logistic regression to estimate the association of acute alcohol use and ongoing suicidality (including their interaction) with admission to psychiatric hospital. Results Fifteen percent of previously intoxicated detainees expressed suicidal intent at detention end, compared to 24% of detainees who had not used alcohol prior to detention. Compared to those who were not previously intoxicated and not suicidal at detention end, acute alcohol use was associated with reduced odds of admission amongst those no longer suicidal (AOR 0.4, 95% CI 0.2, 0.6). Where suicidality persisted, odds of admission rose; however, the magnitude of increase when in combination with prior alcohol use (AOR 3.6, 95% CI 1.9, 7.1) was under half that of when alcohol was not involved (AOR 8.2, 95% CI 3.5, 19.1). Discussion and Conclusions Acute alcohol use is associated with transient suicidality, but this only partially accounts for disparities in care following suicide attempts.
- Subjects :
- Adult
Hospitals, Psychiatric
medicine.medical_specialty
psychiatric‐emergency‐services
Health (social science)
Alcohol Drinking
Mental Health Act
030508 substance abuse
Medicine (miscellaneous)
Suicide, Attempted
Alcohol
Logistic regression
Acute alcohol
Suicidal Ideation
Odds
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Risk Factors
Humans
Medicine
Psychiatric hospital
030212 general & internal medicine
Association (psychology)
Psychiatry
suicide
electronic‐health‐records
Original Paper
Suicide attempt
business.industry
patient‐discharge
Original Papers
Hospitalization
chemistry
0305 other medical science
business
Subjects
Details
- ISSN :
- 14653362 and 09595236
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Drug and Alcohol Review
- Accession number :
- edsair.doi.dedup.....78a5c75ec80e53dc52036ba6ad873b9e