Determination of treatment disposal for parasuicide patients in a German university hospital

Summary

Within the framework of a psychiatric liaison service attached to a medical emergency unit, initial assessment, immediate crisis intervention and referral to subsequent psychiatric after-care were provided for parasuicide patients. Of a total of 485 such cases admitted in 1981, 7% were discharged without a treatment recommendation, 74% were referred to psychiatric out-patient care and 18% were admitted to psychiatric hospitals. The characteristics of these three categories of patients were compared in order to examine the criteria of treatment disposal. The characteristics found to be associated with a recommendation for psychiatric treatment included old age, previous suicidal behaviour, previous or current psychiatric treatment and a strong intent to die, as inferred from the nature and circumstances of the suicidal behaviour. Sex, addictive behaviour and severity of intoxication were of minor importance in this respect. The treatment disposition revealed a liberal interpretation of the requirements for psychiatric treatment. As regards the outcome of this strategy of care, the frequency of repeated parasuicidal behaviour, though not of completed suicide, was lower than in comparable studies reported in the literature. The implications of these findings for future evaluative research are discussed.