- •What is the primary question addressed by this study?This national study examined patient, hospital, and regional factors associated with 7-day follow-up outpatient mental healthcare after hospitalization for suicidal ideation, suicide attempt, and deliberate self-harm.
- •What is the main finding of this study?Large differences in follow-up rates were observed for patients with any recent mental healthcare (43.7%) compared to patients with no recent mental healthcare (15.7%). Whereas length of stay and care in psychiatric hospitals were associated with higher odds of follow-up, among patients with no recent mental healthcare discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up.
- •What is the meaning of the finding?Timely follow-up is influenced by multiple patient, hospital, and community characteristics.
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Geriatric Psychiatry
- Preventing Suicide: A Global Imperative.2014
Centers for Disease Control and Prevention. Web-based injury statistics query and reporting system. Available at: https://www.cdc.gov/injury/wisqars/index.html. Accessed March 1, 2020.
- Suicide and suicide prevention in later life.FOCUS. 2013; 11: 39-47
- Suicide case-fatality rates in the United States, 2007 to 2014: a nationwide population-based study.Ann Intern Med. 2019; 171: 885-895
- Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.Int Psychogeriatr. 2017; 29: 1237-1245
- Suicidal intent and method of self-harm: a large-scale study of self-harm patients presenting to a general hospital.Suicide Life Threat Behav. 2015; 45: 732-746
Owens PL , McDermott KW , Lipari RN , et al. Emergency department visits involving suicidal ideation or suicide attempt, 2008–2017. HCUP Statistical Brief #263. September 2020. Agency for Healthcare Research and Quality, Rockville, MD. Available at: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb263-Suicide-ED-Visits-2008-2017.pdf. Accessed March 3, 2021.
- Seasonal trends in hospitalization of attempted suicide and self-inflicted injury in United States Adults.Cureus. 2020; 12 (e10830-e10830)
Owens PL, Fingar KR, Heslin KC, et al. Emergency department visits related to suicidal ideation, 2006–2013. HCUP Statistical Brief #220. January 2017. Agency for Healthcare Research and Quality, Rockville, MD. Available at:http://www.hcup-us.ahrq.gov/reports/statbriefs/sb220-Suicidal-Ideation-ED-Visits.pdf. Accessed March 10, 2021.
- Syndromic surveillance of suicidal ideation and self-directed violence – United States, January 2017-December 2018.MMWR. 2020; 69: 103-108
- Suicide rates among people discharged from non-psychiatric settings after presentation with suicidal thoughts or behaviours.Acta Psychiatr Scand. 2019; 9e023883
- Suicide rates after discharge from psychiatric facilities: a systematic review and meta-analysis.JAMA Psychiatry. 2017; 74: 694-702
- Association of suicide and other mortality with emergency department presentation.JAMA Netw Open. 2019; 2e1917571
- Best Practices in Care Transitions for Individuals With Suicide Risk: Inpatient Care to Outpatient Care.Education Development Center, Inc, Washington, DC2019
- Association of timely outpatient mental health services for youths after psychiatric hospitalization with risk of death by suicide.JAMA Netw Open. 2020; 3e2012887
National Committee for Quality Assurance. Follow-Up After Hospitalization for Mental Illness. Available at:http://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality/2017-table-of-contents/follow-up. Accessed February 27, 2021.
- Variation of follow-up rate after psychiatric hospitalization of medicare beneficiaries by hospital characteristics and social determinants of health.Am J Geriatr Psychiatry. 2019; 27: 138-148
- Healthcare Spending and the Medicare Program.MedPAC, Washington, DC2019
- Age differences in suicide risk screening and management prior to suicide attempts.Am J Geriatr Psychiatry. 2019; 27: 604-608
- Screening for suicidal thoughts and behaviors in older adults in the emergency department.J Am Geriatr Soc. 2016; 64: e72-e77
- Physicians are less willing to treat suicidal ideation in older patients.J Am Geriatr Soc. 2000; 48: 188-192
- Treatment of elderly and other adult patients for depression in primary care.J Am Geriatr Soc. 2003; 51: 1554-1562
- Treatment initiation for new episodes of depression in primary care settings.J Gen Intern Med. 2018; 33: 1283-1291
- Why are hospital doctors not referring to consultation-liaison psychiatry?—A systemic review.BMC Psychiatry. 2016; 16: 390
- Disparities in treatment of older adults with suicide risk in the emergency department.J Am Geriatr Soc. 2017; 65: 2272-2277
- Frequency of lethal means assessment among emergency department patients with a positive suicide risk screen.Psychiatry Res. 2018; 260: 30-35
United States Census Bureau. Older People Projected to Outnumber Children for First Time in US History. Available at:https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html?mod=article_inline. Accessed March 13, 2021.
- Preventing Suicide: A Technical Package of Policies, Programs, and Practice.National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA2017
Joint Commission. National patient safety goal for suicide prevention. R3 Report Issue 18: 2019.
- Self-harm, suicidal ideation, and attempted suicide in older adults: a national study of emergency department visits and follow-up care.Am J Geriatr Psychiatry. 2020; 28: 646-658
- Factors associated with timely follow-up care after psychiatric hospitalization for youths with mood disorders.Psychiatr Serv. 2016; 67: 324-331
- Emergency treatment of deliberate self-harm.Arch Gen Psychiatry. 2012; 69: 80-88
- Suicide in older adults with and without known mental illness: results from the National Violent Death Reporting System, 2003-2016.Am J Prev Med. 2020; 58: 584-590
- Health care contacts in the year before suicide death.J Gen Intern Med. 2014; 29: 870-877
- Suicide rates in relation to health care access in the United States: an ecological study.J Clin Psychiatry. 2006; 67: 517-523
- Individual and area-level factors correlated with death by suicide in older adults.Prev Med. 2015; 75: 44-48
- Mapping suicide mortality in Ohio: a spatial epidemiological analysis of suicide clusters and area level correlates.Prev Med. 2018; 106: 177-184
- Hours and miles: patient and health system implications of transfer for psychiatric bed capacity.West J Emerg Med. 2016; 17: 783-790
- Associations between mental health shortage areas and county-level suicide rates among adults aged 25 and older in the USA, 2010 to 2018.Gen Hosp Psychiatry. 2021; 70: 44-50
- Health Care Systems, Networks, Alliances, Health Organizations, Agencies, & Providers.AHA Press, Washington, DC2014
- Area Health Resource File (AHRF).Quality Resource Systems, Fairfax, VA2017
- Comorbidity measures for use with administrative data.Med Care. 1998; 36: 8-27
- Meta-analysis of suicide rates in the first week and the first month after psychiatric hospitalisation.BMJ Open. 2019; 9e023883
- Association of suicide and other mortality with emergency department presentation.JAMA Netw Open. 2019; 2: 1917571-e1917571
- Outpatient follow-up care and risk of hospital readmission in schizophrenia and bipolar disorder.Psychiatr Serv. 2017; 68: 1239-1246
- Family involvement in psychiatric hospitalizations: associations with discharge planning and prompt follow-up care.Psychiatr Serv. 2019; 70: 860-866
- Effect of scheduling a post-discharge outpatient mental health appointment on the likelihood of successful transition from hospital to community-based care.J Clin Psychiatry. 2020; 81: 20m13344
- Psychiatric inpatient discharge planning practices and attendance at aftercare appointments.Psychiatr Serv. 2016; 68: 92-95
- Self-harm in a primary care cohort of older people: incidence, clinical management, and risk of suicide and other causes of death.Lancet Psychiatry. 2018; 5: 905-912
- Zero to 50,000—the 20th anniversary of the hospitalist.N Engl J Med. 2016; 375: 1009-1011
- Impact of hospitalists on the efficiency of inpatient care and patient satisfaction: a systematic review and meta-analysis.J Community Hosp Intern Med Perspect. 2019; 9: 121-134
- Association of hospitalist care with medical utilization after discharge: evidence of cost shift from a cohort study.Ann Intern Med. 2011; 155: 152-159
- Impact of hospitalist vs. non-hospitalist services on length of stay and 30-day readmission rate in hip fracture patients.Hosp Pract. 2019; 47: 24-27
- Psychiatric hospitalists and continuity of care: a comparison of two models.J Psychiatric Pract. 2010; 16: 170-176
- Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists.JAMA Intern Med. 2017; 177: 1781-1787
- Understanding facilitators and barriers to care transitions: insights from project ACHIEVE site visits.Jt Comm J Qual Patient Saf. 2017; 43: 433-447
- Understanding self-harm in older people: a systematic review of qualitative studies.Aging Ment Health. 2018; 22: 289-298
- Risk factors for repetition and suicide following self-harm in older adults: multicentre cohort study.Br J Psychiatry. 2012; 200: 399-404
- Suicide attempt as a risk factor for completed suicide: even more lethal than we knew.Am J Psychiatry. 2016; 173: 1094-1100
- Risk of suicide following deliberate self-poisoning.JAMA Psychiatry. 2015; 72: 570-575
- County context and mental health service utilization by older Hispanics.Gerontologist. 2019; 59: 456-464
- Regional variation of racial disparities in mental health service use among older adults.Gerontologist. 2013; 53: 618-626
- Racial and ethnic differences in mental health service utilization in suicidal adults: a nationally representative study.J Psychiatr Res. 2018; 107: 114-119
- Geriatric emergency department innovations: transitional care nurses and hospital use.J Am Geriatr Soc. 2018; 66: 459-466
- The geriatric floating interdisciplinary transition team.J Am Geriatr Soc. 2010; 58: 364-370
American Hospital Association. Telehealth Fact Sheet. Available at: https://www.aha.org/system/files/2019-02/fact-sheet-telehealth-2-4-19.pdf. Accessed January 10, 2021.
- Facility and state-level factors associated with telemental health (TMH) adoption among mental health facilities in the United States.J Telemed Telecare. 2021; 27: 244-257
Totten AM, Hansen RN, Wagner J, et al. Telehealth for Acute and Chronic Care Consultations. Comparative Effectiveness Review No. 216. (Prepared by Pacific Northwest Evidence-based Practice Center under Contract No. 290–2015-00009-I.) AHRQ Publication No. 19-EHC012-EF. Rockville, MD: Agency for Healthcare Research and Quality; April 2019. Available at: https://doi.org/10.23970/AHRQEPCCER216. Accessed April 3, 2021.
- Geriatric telepsychiatry: systematic review and policy considerations.Am J Geriatr Psychiatry. 2019; 27: 109-127
- Telepsychiatry for inpatient consultations at a separate campus of an academic medical center.Telemed J E Health. 2016; 22: 572-576
- Telepsychiatry consultation for medical and surgical inpatient units.Psychosomatics. 2018; 59: 62-66
- A scoping review of interventions for older adults transitioning from hospital to home.J Am Geriatr Soc. 2021; : 1-13https://doi.org/10.1111/jgs.17323
- Patient satisfaction with geriatric psychiatry services via video teleconference.Am J Geriatr Psychiatry. 2020; 28: 491-494
- Differences in hospitalizations between fee-for-service and medicare advantage beneficiaries.Med Care. 2019; 57: 8-12
- Analysis of drivers of disenrollment and plan switching among medicare advantage beneficiaries.JAMA Intern Med. 2019; 179: 524-532
- Characteristics of decedents in medicare advantage and traditional medicare.JAMA Intern Med. 2016; 176: 1020-1023
- How medicare advantage has impacted mental health service utilization.Am J Geriatr Psychiatry. 2016; 24: S168-S169
- A systematic review of validated methods for identifying suicide or suicidal ideation using administrative or claims data.Pharmacoepidemiol Drug Saf. 2012; 21: 174-182
- Emergency department and inpatient coding for self-harm and suicide attempts: validation using clinician assessment data.Int J Methods Psychiatr Res. 2017; 26: e1559