Patterns of re-presentations to Tasmanian emergency departments for suicidal behaviour

OBJECTIVE: To examine sociodemographic and episode-of-care characteristics among individuals presenting with suicidal behaviour who re-present to emergency departments in Tasmania, Australia. METHODS: Emergency department presentations related to suicidal behaviour from 1 January 2017 to 31 December 2023 were identified across four public hospitals in Tasmania. The primary outcome of interest was the number, rate and risk of re-presentations, defined as a subsequent visit within 7 days, 28 days or at any time during the study period. Analyses also assessed the total presentation frequency per individual across these timeframes. Concordance in episode-of-care characteristics, including arrival mode, was compared between the index and first re-presentation. RESULTS: A total of 12,659 presentations related to suicidal behaviour were recorded among 7,426 Tasmanian individuals, of which 5,409 had a single presentation, and 2,017 had one or more re-presentations. Re-presentation within 7 days, 28 days and across the study period was associated with younger age, higher triage urgency and specific departure modalities. The highest concordance between index and repeat presentations was observed for arrival by ambulance (51.63%), afternoon arrival (40.33%), triage category 3 (66%) and leaving at own risk after clinician assessment (65.05%). Individuals with multiple re-presentations were more likely to be female and from lower socioeconomic areas. CONCLUSIONS: Re-presentations to the emergency department for suicidal behaviour were more common among younger individuals, those triaged as more urgent and those who left the emergency department without seeing a health professional. Higher re-presentation rates were also observed among females and individuals from disadvantaged socioeconomic areas. These findings highlight key sociodemographic and care-related factors that can inform targeted interventions, improved service planning and enhanced mental health resource allocation to reduce repeat emergency department presentations.