Self-Mutilation and the Chronically Suicidal Patient: An Examination of the Frequent Visitor to the Psychiatric Emergency Room

Abstract

AbstractA retrospective chart review examined the records of all patients (n = 1580) seen in the emergency mental health service at a major teaching hospital during the time period June 30, 1985, through July 1, 1986. Twenty-four chronically “suicidal” patients were identified. Suicidality and chronicity were operationally defined as four or more visits, in which “suicidal” behavior was the primary presenting problem during the index year. The diagnostic and demographic characteristics of these patients were compared to a matched “nonsuicidal” control group of chronic emergency room visitors. Nineteen out of the 24 chronically “suicidal” patients had a history of self-mutilation, whereas none of the control group had any mention of self-mutilation or suicidal behavior in their charts (x2 = 26.42, df = 1, p < 0.01). These 24 “suicidal” patients, who comprised a little more than 1% of the patients seen that year in the psychiatric emergency service, accounted for over 12% of all psychiatric emergency room v...