A recently release national study of Medicaid found the majority of adolescents who do self harm do not get a mental health assessment when they visit the emergency room or outpatient mental health care in the month follow the emergency department visit.

Deliberate self-harm is the most common reason for emergency department visits among younger people in the United States. According to the study, 80 to 90 percent of young people who deliberately harm themselves meet criteria for at least one psychiatric disorder.


“Emergency department personnel can play a unique role in suicide prevention by assessing the mental health of patients after deliberate self-harm and providing potentially life-saving referrals for outpatient mental health care,” said lead study author D. Jeff Bridge, in a statement. “However, the coordination between emergency services for patients who deliberately harm themselves and linkage with outpatient mental health treatment is often inadequate.”

Dr. Bridge and his colleagues found that only 39 percent of all patients who are discharged back into the community, received a mental assessment while in the emergency room.

Researchers believe a higher amount of mental screenings for patients committing self harm, will only lower the number of suicides, as suicide risk is highest immediately after a case of deliberate self harm.

“Our findings suggest that the decision to provide emergency mental health assessment is dictated less by the clinical characteristics of individual patients and more by staffing patterns or established emergency department evaluation protocols,” Dr. Bridge said.“This study highlights the need for strategies to promote emergency department mental health assessments, strengthening the training of physicians in pediatric mental health and adolescent suicide prevention and timely transitions to outpatient mental health care.”

The study was conducted at Nationwide Children’s Hospital and is published in the American Academy of Child & Adolescent Psychiatry.