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Older Adults at Suicide Risk Less Likely to Get ED Mental Health Referral

The demographic group with the highest rate of suicide is men over the age of 70, according to the World Health Organization. In the United States, nearly 8,000 older adults committed suicide in 2015, with the proportion of suicides higher among the elderly than the young.

That’s why a study published recently in the Journal of the American Geriatrics Society expressed concern that significantly fewer suicidal older adult patients who were discharged home from emergency departments received a mental health evaluation, when compared with similar younger adults. Older adult patients were defined in the study as those 60 years of age and older, and younger adult were patients defined as younger than 60 years.

“These findings highlight an important area for improvement in the treatment of older adults at risk for suicide,” write the authors.

The report notes that hospital EDs are caring for an increasing number of people with mental health concerns, including thoughts or actions related to suicide attempts. Statistics show that nearly half of the older adults who committed suicide had visited an ED in the year before their death.

To better understand the situation, the team led by Brown University researchers reviewed records from an ED with universal suicide risk screening. They focused on 800 patients, including 200 adults older than 60. They discovered the following:

  • 53% of older adults had a chief complaint involving “psychiatric behavior” (behavior relating to mental illness or its treatment), compared with 70% of those younger than 60.
  • 93% of older adults had documented suicidal thoughts in the previous two-week period compared with 79% percent of younger adults.
  • 17% of adults 60 and older reported attempting suicide in the previous two weeks compared with 23% of younger adults.
  • Less than 50% of older adults showing suicide warning signs after screening received a mental health evaluation, compared with 66% of younger adults showing warning signs.
  • Only 34% of older adults who had attempted suicide or had reported suicidal thoughts were referred to mental health professionals, compared with 60% of younger adults.