An Examination of Non-Suicidal Self-Injury, Healthcare Utilization, and Quality of Life in the 12-Months After Screening Positive for Suicide Risk in the Emergency Department

OBJECTIVE: This study aimed to examine the impact of suicide interventions on secondary outcomes, such as non-suicidal self-injury (NSSI), potentially suicide-related ED visits and hospitalizations, behavioral health interactions, and quality of life (QOL). METHOD: Data were analyzed from 1,376 adults, who screened positive for suicide risk as part of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study, a quasi-experimental, eight-center study, conducted from 2010-2013. Participants were enrolled across three phases: Treatment as Usual (TAU), Universal Screening (US), and Universal Screening + Intervention (Intervention). Outcomes were assessed during the 12-month follow-up period. RESULTS: Participants in the Intervention phase reported fewer potentially suicide-related hospitalizations during the 12-months follow-up compared with those in the TAU or US phases. Intervention participants also reported more behavioral health interactions via phone at follow-up than those in TAU. Additional factors associated with secondary outcomes are discussed. CONCLUSION: Suicide interventions implemented in the ED may have benefits beyond reducing suicide behavior, including reduction in potentially suicide-related hospitalizations and increased engagement with behavioral health services by phone. These findings highlight the potential for ED-based suicide prevention strategies to influence broader health outcomes.