Study identifies risks for repeated self-poisoning - Children's National

Intentional self-poisoning among children and adolescents carries serious risks, with nearly half of patients requiring medical intervention. Alarmingly, recurrence is seen in one out of every eight patients. Findings in a new study in Pediatrics led by Children's National Hospital highlight the key risk factors for repeat self-poisoning and underscore the urgent need for targeted prevention strategies.

The big picture

"Youth suicide rates have been increasing over the past two decades," Ilana Lavina, MD, pediatric emergency medicine attending physician and lead author, said. "The COVID-19 pandemic acutely exacerbated this trend, reflected in a skyrocketing rate of emergency department visits for mental health concerns, including suicide attempts. With this unprecedented youth mental health crisis, it is imperative to find ways to meet the needs of pediatric patients seeking care for mental and behavioral health concerns."

Among 6 to 17-year-olds seen in a pediatric emergency department between March 2020 and March 2023, repeat visits were not uncommon. Recurrence was most often associated with prior psychiatric diagnosis, history of sexual abuse and self-injurious behavior.

In addition to the broader trend of increasing frequency of emergency department visits for suicide attempts, there has also been an alarming uptrend in the frequency of intentional self-poisoning among youth.

Why it matters

The findings lay the groundwork for tangible and feasible efforts for harm prevention. By identifying factors associated with recurrent episodes of intentional self-poisoning.

"We hope that our findings will benefit patients by allowing us to identify those who are at elevated risk of morbidity associated with recurrent intentional self-poisoning to ensure that they receive preventative interventions such as connection to mental health services and lethal means counseling," Dr. Lavina explained. "Our findings may also help to guide clinicians in counseling families about medication safety in their home."

What's next

The team at Children's National is working to implement patient-centered interventions. They continually strive to improve the experience of patients who present with mental and behavioral health emergencies through cross-department collaborations.

Additional authors from Children's National: Rachel H. F. Margolis, PhD, LICSW; Kristen A. Breslin, MD, MPH; Emma Whitmyre, PhD; Shilpa J. Patel, MD, MPH