By Dennis Thompson
MedicineNet.com
Originally published on May 25, 2012
Doctors have long known that some kids suffering severe emotional turmoil find relief in physical pain -- cutting or burning or sticking themselves with pins to achieve a form of release.
But researchers now are questioning whether enough is being done to reach out to these young people and help them before they do themselves irreparable damage.
One study this year found that six of every 10 adolescents who went to an emergency room for treatment after harming themselves were released without receiving a
mental health assessment or any follow-up mental health care. The findings were reported in the February issue of the
Journal of the American Academy of Child & Adolescent Psychiatry.
Here is a link to the summary of this article.
The original research is below.
by Jeffrey Bridge, Steven Marcus, and Mark Olfson
Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 2 , Pages 213-222.e1, February 2012
Objective
Little is known about the mental health care received by young people after an episode of deliberate self-harm. This study examined predictors of emergency department (ED) discharge, mental health assessments in the ED, and follow-up outpatient mental health care for Medicaid-covered youth with deliberate self-harm.
Method
A retrospective longitudinal cohort analysis was conducted of national 2006 Medicaid claims data supplemented with the Area Resource File and a Substance Abuse and Mental Health Services Administration Medicaid policy survey of state policy characteristics focusing on ED treatment episodes by youth 10 to 19 years old for deliberate self-harm (n = 3,241). Rates and adjusted risk ratios (ARR) of discharge to the community, mental health assessments in the ED, and outpatient visits during the 30 days after the ED visit were assessed.
Results
Most patients (72.9%) were discharged to the community. Discharge was inversely related to recent psychiatric hospitalization (ARR 0.75, 99% confidence interval [CI] 0.63–0.90). Thirty-nine percent of discharged patients received a mental health assessment in the ED and a roughly similar percentage (43.0%) received follow-up outpatient mental health care. Follow-up mental health care was directly related to recent outpatient (ARR 2.58, 99% CI 2.27–2.94) and inpatient (ARR 1.33, 99% CI 1.14–1.56) mental health care and inversely related to Hispanic ethnicity (ARR 0.78, 99% CI 0.64–0.95) and residence in a county with medium-to-high poverty rates (ARR 0.84, 99% CI 0.73–0.97).
Conclusions
A substantial proportion of young Medicaid beneficiaries who present to EDs with deliberate self-harm are discharged to the community and do not receive emergency mental health assessments or follow-up outpatient mental health care.
Doctors have long known that some kids suffering severe emotional turmoil find relief in physical pain -- cutting or burning or sticking themselves with pins to achieve a form of release.