Child maltreatment and onset of emergency department presentations for suicide-related behaviors.
Child Abuse Negl
; 36(6): 542-51, 2012 Jun.
Article
in En
| MEDLINE
| ID: mdl-22749614
ABSTRACT
OBJECTIVES:
To determine whether the rates of a first presentation to the emergency department (ED) for suicide-related behavior (SRB) are higher among children/youth permanently removed from their parental home because of substantiated maltreatment than their peers. To describe the health care settings accessed by these children/youth before a first SRB presentation to help design preventive interventions.METHODS:
A population-based (retrospective) cohort of 12-17-year-olds in Ontario, Canada was established. Children/youth removed from their parental home because of the above noted maltreatment (n=4683) and their population-based peers (n=1,034,546) were individually linked to administrative health care records over time to ascertain health service use and subsequent ED presentations for SRB during follow-up. Person-time incidence rates were calculated and Cox regression models used to estimate adjusted hazard ratios (HR) and corresponding 95% confidence intervals (CI).RESULTS:
After controlling for demographic characteristics and prior health service use, maltreated children/youth were about five times more likely to have a first ED presentation for SRB compared to their peers, in both boys (HR 5.13, 95% CI 3.94, 6.68) and girls (HR 5.36, 95% CI 4.40, 6.54).CONCLUSIONS:
Children/youth permanently removed from their parental home because of substantiated child maltreatment are at an increased risk of a first presentation to the ED for SRB. The prevention of child maltreatment and its recurrence and the promotion of resilience after maltreatment has occurred are important avenues to study toward preventing ED SRB presentations in children/youth. Provider and system level linkages between care sectors may prevent the need for such presentations by providing ongoing environmental support.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Suicide, Attempted
/
Patient Acceptance of Health Care
/
Child Abuse
/
Self-Injurious Behavior
/
Emergency Service, Hospital
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
Child Abuse Negl
Year:
2012
Document type:
Article
Affiliation country:
Canada