Emergency Department Use Following Self-Harm and Suicide Ideation: An Analysis of the Influence of Cultural and/or Linguistic Diversity Using Data From the Self-Harm Monitoring System for Victoria (2012-2019).
Gowri Rajaram, Jo Robinson, Lu Zhang and 1 others
PMID 39252169WHAT IT FOUND
Only 1.3% of self-harm or suicide ideation ED presentations were coded as CALD, yet those patients were more often admitted.
First re-presentation was similar, but all re-presentations were lower.
Key findings
01Of 15 606 presentations, 202 (1.3%) were coded as CALD, made by 150 persons.
02CALD presentations were more often for suicide ideation (131, 64.9%) than self-harm (71, 35.2%).
03CALD people were more likely to be admitted to a ward or mental health unit, and had a 24% lower likelihood of re-presenting at any time point.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 1.3% of presentations were coded as CALD, and the study says this likely undercounted the true proportion. CALD status came from triage notes, often only language, so second-generation migrants and broader cultural identity may be missed. The CALD group was small, with 202 presentations by 150 persons, so subgroup differences could not be examined. The analysis used one hospital, stopped before the COVID-19 pandemic, did not capture deaths, and may have missed presentations to other services. Gender/sex was recorded inconsistently and combined, which may have conflated biological sex and gender identity.
The easy way to misread this
Do not read the 24% lower likelihood of re-presenting as proof that CALD people need less follow-up. The study says barriers may deter further help-seeking, and CALD status was likely undercounted in triage notes.