Emergency department visits prior to suicide and homicide: Linking statewide surveillance systems

Julie Cerel, Michael D. Singleton, Margaret M. Brown, Sabrina V. Brown, Heather M. Bush, Candice J. Brancado

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Emergency departments (EDs) serve a wide range of patients who present at risk of impending suicide and homicide. Aims: Two statewide surveillance systems were probabilistically linked to understand who utilizes EDs and then dies violently within 6 weeks. Method: Each identified case was matched with four randomly selected controls on sex, race, date of birth, resident zip code, and date of ED visit vs. date of death. Matched-pair odds ratios were estimated by conditional logistic regression to assess differences between cases and controls on reported diagnoses and expected payment sources. Results: Of 1,599 suicides and 569 homicides in the 3-year study period, 10.7% of decedents who died by suicide (x = 13.6 days) and 8.3% who died by homicide (x = 16.3 days) were seen in a state ED within 6 weeks prior to death. ED attendees who died by suicide were more likely to have a diagnosis of injury/ poisoning diagnosis or mental disorder and more likely to have Medicare. Those who died by homicide were more likely to have a diagnosis of injury/poisoning and less likely to have commercial insurance. Conclusion: It is essential for research to further explore risk factors for imminent suicide and homicide in ED patients who present for psychiatric conditions and general injuries.

Original languageEnglish
Pages (from-to)5-12
Number of pages8
Issue number1
StatePublished - Jan 1 2016


  • Emergency
  • Homicide
  • Linkage
  • Suicide
  • Violent deaths

ASJC Scopus subject areas

  • Psychiatry and Mental health


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