Thoughts of suicide and self-harm: A national study on young people presenting to non-paediatric acute hospitals in Ireland.

Background: In Ireland, acute hospital emergency departments (ED) become the default service for youth aged 16 to 18 years; and in the absence of paediatric EDs, for youth under 16 years. No previous research has explored adolescent presentations to non-paediatric hospitals with thoughts of self-harm or suicide at a national level.Aim: This study examines child and adolescent self-harm and suicidal ideation-related presentations to 24 non-paediatric hospital EDs in Ireland.Method: National data from a dedicated ED service for a suicidal crisis were used. Descriptive analyses were run for four age bands (≤ 15, 16-17, 18-19, and all other adults < 20 years), based on sociodemographic characteristics, clinical information, and type of self-harm or ideation.Results: Between 2018 and 2022, the National Clinical Programme for Self-Harm and Suicide-related Ideation (NCPSHI) clinicians assessed 53 359 presentations due to self-harm and suicide-related ideation. Among those 15 years and younger, 1.7% presented for self-harm, 0.9% for suicidal ideation, and 0.2% for self-harm ideation. Among the 16-17-year-olds, 3.4% presented with self-harm and 1.6% for suicidal ideation. Presentations for self-harm decreased with age, while suicide-related ideation increased. Cutting was most common among the youngest group (23%), and overdose was more frequent among 16 to 17-year-olds. Notably, 41% of those 15 year and younger were already attending mental health services.Conclusions: Our findings highlight that a significant number of adolescents with a self-harm-related crisis attend non-paediatric acute hospitals in Ireland. Careful initial assessment and transitional care are needed to ensure that youth at risk of suicide and/or mental illness are referred to appropriate services.