Suicidal thoughts, self-harm sending more in U.S. to ER

These types of emergency room visits shot up 25.5 percent from 2017 to 2018, according to the U.S. Centers for Disease Control and Prevention.

By Steven Reinberg, HealthDay News

Men and women are flooding America's emergency rooms because of suicidal thoughts and injuries caused by harming themselves, federal health officials reported Thursday.

In fact, these types of emergency room visits shot up 25.5 percent from 2017 to 2018, according to the U.S. Centers for Disease Control and Prevention.


April Foreman, an executive committee member of the board of directors at the American Association of Suicidology and a suicide prevention coordinator at the VA Health System in Baton Rouge, La., wasn't surprised by the news.

"Nobody who's trying to figure out mental health care is going to tell you that we're being underutilized," she said. "There are huge wait times and it's really hard to get care.

"That means that more people are going to access mental health care in one of the few places that you can get it when you are in crisis, which is your emergency room, or even worse, with local law enforcement," said Foreman, who was not involved in the report.


She noted that in many places in the United States the police and local jails provide care for people who are suicidal.

And while the number of suicides is increasing dramatically, that represents only a small percent of those at risk, many of whom show up in emergency rooms seeking help, researchers say.

Millions of Americans are at high risk for suicide each year, Foreman said, and nearly 50,000 die by suicide.

"A couple of million will go on to attempt suicide each year, but there are 10 million people out there who hurt so badly that they want to die, and it's not OK to leave these people in pain," she said.

Of about 163 million U.S. emergency room visits between January 2017 and December 2018, more than 2 million involved suicidal thoughts, self-harm or both, according to the CDC report.

These emergency room visits increased among both men and women in most age groups, the researchers found.

The most substantial increases in emergency room visits for suicidal thoughts or self-harm were among younger age groups -- girls aged 10 to 19 years increased nearly 34 percent and boys 10 to 19 increased 62 percent.

The school season may be related to stress for vulnerable children and teens.


"Among children 10 to 19, a striking seasonal pattern for visits for suicidal ideation or self-directed violence was also seen, as visit rates were far lower in the summer months," said lead researcher Marissa Zwald, from the CDC's epidemic intelligence service.

The biggest increase in these emergency room visits was seen in the Midwest and Southeast, but rates also remained high in the West.

"Suicide prevention requires comprehensive and multi-sectoral approaches to address risk at individual, relationship, community and societal levels," Zwald said.

The report was published in the CDC's Morbidity and Mortality Weekly Report.

Foreman said that the root causes of the suicide epidemic aren't clear. But theories abound, placing the blame on social inequality, financial stress and feelings of helplessness.

"We don't know why the rates are at a historic high. I'll just tell you, we're not entirely sure what's happening here. What we can tell you is it's the only major cause of death that we don't aggressively fund research for," Foreman said.

"What's amazing to me is my average Uber driver is more confident about why people will kill themselves than me," she added.

Also, there are no standards for care, and little or no training is given in medical school, Foreman said. "We're not acting like we care," she said.


Moreover, when people leave the emergency room, little follow-up care is provided, and it's in the first three months after being discharged that the risk for a suicide attempt is the greatest, Foreman noted.

The bottom line, she said, is the need for more research, more trained mental health care providers, better access to care, more public pressure and awareness of this crisis.

"It's just discrimination," Foreman said. "We think that this kind of pain that kills you is less worthy of the same kind of science and public health mechanisms we use for the other things that kill you -- we just don't treat it the same."

More information

For more on suicide, see the U.S. National Institute on Mental Health.

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