An Examination of Non-Suicidal Self-Injury, Healthcare Utilization, and Quality of Life in the 12-Months After Screening Positive for Suicide Risk in the Emergency Department

Objective This study aimed to examine the impact of suicide interventions on secondary outcomes, such as non-suicidal self-injury (NSSI), potentially suicide-related ED visits and hospitalizations, behavioral health interactions, and quality of life (QOL).Method Data were analyzed from 1,376 adults, who screened positive for suicide risk as part of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study, a quasi-experimental, eight-center study, conducted from 2010–2013. Participants were enrolled across three phases: Treatment as Usual (TAU), Universal Screening (US), and Universal Screening + Intervention (Intervention). Outcomes were assessed during the 12-month follow-up period.Results Participants in the Intervention phase reported fewer potentially suicide-related hospitalizations during the 12-months follow-up compared with those in the TAU or US phases. Intervention participants also reported more behavioral health interactions via phone at follow-up than those in TAU. Additional factors associated with secondary outcomes are discussed.Conclusion Suicide interventions implemented in the ED may have benefits beyond reducing suicide behavior, including reduction in potentially suicide-related hospitalizations and increased engagement with behavioral health services by phone. These findings highlight the potential for ED-based suicide prevention strategies to influence broader health outcomes.