Children and Young People Presenting in a Pediatric Emergency Department in North-West England in Suicidal Crisis: An Exploratory Case Series Study

Suicide is a leading cause of death among children and young people (CYP) worldwide, and rates have been increasing in recent years. However, while evidence exists regarding factors associated with suicide and self-harm, there is limited information publicly available on the CYP who present in suicidal crisis. This is a case series study of CYP (aged 8-16) experiencing suicidal crisis who presented in an Emergency Department at a pediatric hospital in North-West England between March 2019 and March 2021 (n = 240). Clinical records were extracted and audited to explore demographic data, methods of recording patient attendance, the clinical pathways available and the patterns of pathway usage, and differences in CYP presentations before and after the COVID-19 pandemic. Attendees were mostly White females, with a mean age of 13.5 years, and 24% had a diagnosed special educational need. Social/social problems was the most commonly used code for recording attendance (38%), and pathways varied depending on code used. A range of parental and familial factors were also identified. There were more CYP presenting with self-harm in addition to suicide ideation after the pandemic began (43 vs 27% pre-pandemic). This study provides the first clear insight into CYP who seek help at a North-West Emergency Department for suicidal crisis, and work is now needed to develop effective prevention strategies tailored toward the groups most at-risk.

Automated summary

Suicide is a major cause of death among children and young people globally, and the rates have been increasing in recent years. However, there is limited information available about children and young people in suicidal crisis. This study investigated cases of suicidal crisis among children and young people aged 8-16 who presented at an Emergency Department in a pediatric hospital in North-West England between March 2019 and March 2021. The majority of attendees were white females with a mean age of 13.5 years, and 24% had a diagnosed special educational need. The most commonly used code for recording attendance was social/social problems, and the pathways varied depending on the code used. Various parental and familial factors were also identified. There was a higher proportion of attendees presenting with self-harm in addition to suicide ideation after the COVID-19 pandemic began.