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Background <p>Self-harm and suicide attempts are frequent causes of emergency department (ED) visits and are strongly associated with an elevated suicide risk. Early psychiatric evaluation in the ED can help reduce repeated self-harm; however, the relationship between presentation timing and psychiatric consultations remains unclear. This study aimed to explore the association between ED visit timing and the likelihood of psychiatric referrals among patients presenting with self-harm or suicide attempts in Japan.</p> Methods <p>This multicenter, registry-based cohort study analyzed data from the JAPAN Registry of Self-Harm and Suicide Attempt from December 1, 2022, to December 31, 2023. Patients presenting to EDs with intentional self-harm or suicide attempts were included. The primary outcome was psychiatric consultation within one day of presentation, analyzed by day and time of presentation using multiple logistic regression, adjusting for potential confounders.</p> Results <p>Of the 1,721 patients analyzed, the median age was 33 years, and 1,127 (65.5%) were female. A total of 1,199 patients (69.7%) received psychiatric consultations, while 522 (30.3%) did not receive a consultation within the next day after presentation. Hospital presentations on Saturdays (adjusted OR, 0.39; 95% CI, 0.20–0.75) and during 4 p.m. to 8 p.m. (adjusted OR, 0.47; 95% CI, 0.24–0.91) were associated with lower likelihoods of psychiatric consultations, using Monday and the 8 a.m. to 12 p.m. period as the reference, respectively.</p> Conclusions <p>Hospital presentations on Saturdays or evening hours were associated with reduced likelihoods of psychiatric consultations, highlighting disparities in access to care during off-hours. These findings may help inform efforts to improve resource allocation and flexible staffing to ensure timely and consistent psychiatric care in ED settings.</p> Clinical trial number <p>Not applicable.</p>

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Timing of emergency department presentation and psychiatric consultation after self-harm or suicide attempts: a registry-based study in Japan

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月18日

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  • Shunta Jinno,
  • Tetsuya Yumoto,
  • Takashi Hongo,
  • Hiromasa Yakushiji,
  • Takafumi Obara,
  • Tsuyoshi Nojima,
  • Hiromichi Naito,
  • Takashi Yorifuji,
  • Atsunori Nakao

摘要

Background

Self-harm and suicide attempts are frequent causes of emergency department (ED) visits and are strongly associated with an elevated suicide risk. Early psychiatric evaluation in the ED can help reduce repeated self-harm; however, the relationship between presentation timing and psychiatric consultations remains unclear. This study aimed to explore the association between ED visit timing and the likelihood of psychiatric referrals among patients presenting with self-harm or suicide attempts in Japan.

Methods

This multicenter, registry-based cohort study analyzed data from the JAPAN Registry of Self-Harm and Suicide Attempt from December 1, 2022, to December 31, 2023. Patients presenting to EDs with intentional self-harm or suicide attempts were included. The primary outcome was psychiatric consultation within one day of presentation, analyzed by day and time of presentation using multiple logistic regression, adjusting for potential confounders.

Results

Of the 1,721 patients analyzed, the median age was 33 years, and 1,127 (65.5%) were female. A total of 1,199 patients (69.7%) received psychiatric consultations, while 522 (30.3%) did not receive a consultation within the next day after presentation. Hospital presentations on Saturdays (adjusted OR, 0.39; 95% CI, 0.20–0.75) and during 4 p.m. to 8 p.m. (adjusted OR, 0.47; 95% CI, 0.24–0.91) were associated with lower likelihoods of psychiatric consultations, using Monday and the 8 a.m. to 12 p.m. period as the reference, respectively.

Conclusions

Hospital presentations on Saturdays or evening hours were associated with reduced likelihoods of psychiatric consultations, highlighting disparities in access to care during off-hours. These findings may help inform efforts to improve resource allocation and flexible staffing to ensure timely and consistent psychiatric care in ED settings.

Clinical trial number

Not applicable.