The Incidence of Suicide Completion Among Patients Seeking Mental Health Care at a Pediatric Emergency Department: A Retrospective Cohort Study
1) What is the incidence rate of suicide among pediatric patients who have presented to the pediatric emergency department between 2005 and 2015 for mental health concerns?
-hypothesis: We expect the incidence rate to be around 2%, based on a study that examined suicide completion rate (1.5%) among adults seeking mental health service at a general emergency department (Finkelstein et al., 2014).
2) Which PED disposition decision demonstrates higher rate of suicide completion, when adjusted for other patient factors (age, sex, SES, etc)?
-hypothesis: We expect those who are hospitalized would show higher rate of suicide completion, based on a study that showed greater levels of hospitalization among suicide completers for psychiatric reasons compared to control groups (Renaud et al., 2009).
3) What is the duration between the time last seen at PED and the time of suicide?
-hypothesis: We expect the majority of suicide to be within five years from the last visit to the PED, based on a study that showed the median time of suicide for adult ED mental health patients to be 5.3 years (Finkelstein et al., 2014).
4) How will the incidence rate of suicide compare between the study cohort (patients who have visited the PED for mental health concerns) and the comparison group (non-mental health visits)?
-hypothesis: We expect the suicide completion rate to be higher in the PED mental health visits, since mental health concerns is a risk factor for subsequent suicide.