Clinical Characteristics and Outcome of Emergency Department Referralsfor Suicidal First Nation Children and Adolescents from Northern Ontario:Preliminary Report

Abstract

Background: Global concern about high rates of suicidal behaviours and completed suicides amongst Indigenous and First Nations youth has led to concerted efforts in many countries to generate and implement culturally sensitive identification and prevention strategies. In Canada effort have been directed policy and clinical and Social level to address this issue, however there has been a surge of referrals for suicidal risk assessment of children and youth in the wake a publicized suicide crisis in remote Northern Ontario’ First Nations communities, 2 -3 hours by air from nearest psychiatric services. This case series describes demographic, clinical and psychosocial characteristic and outcome. Method: This is a naturistic descriptive case series of First Nation children and adolescents who were referred by the Emergency Department Physicians for suicidal behaviours and were assessed by a hospital based child and adolescent urgent psychiatric consult clinic over a 3 month period in 2016. Results: 17 children and adolescents were assessed, there were 83% (n=14) females and 17% (n=3) males, the mean age was 14 years and 23.5% lived with a birth parent. All were referred for suicide related behaviours and 23.5% (n=4) met criteria for Depression and or Anxiety. Less than a quarter were at grade level. Forty-one percent of patients reported substance/alcohol use/ abuse and 23.5% admitted to sexual abuse. Child protection agency was involved in 50%. Forty seven percent required short admission for crisis stabilization Conclusion: In addition to previously known factors, lack of adequate supervision confers significant risk for Emergency department visits for suicide related behaviours, especially in younger females.