Outcomes following suicidal crisis among hazardous and harmful alcohol users in the Crisis Resolution Team

John Robins, Katherine Morley, Richard Hayes, Megan Pritchard, Daisy Kornblum, Nicola Kalk

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Abstract

Despite associations between alcohol use and suicidal acts, little research measures prognoses of alcohol-using patients treated by Crisis Resolution Teams (CRTs), an intensive community-based intervention. We estimated the association of alcohol use amongst patients accepted following suicidal acts or ideation in four London-based Crisis Resolution Teams, with death-by-any-cause or recontact with crisis care.

We analysed the electronic health records of 1615 CRT patients accepted following suicidal acts or ideation over 38 months, following STROBE guidelines. Using logistic regression we estimated the association of alcohol use (indicated by risk-assessment, AUDIT or ICD-10 diagnosis) with death-or-recontact at (i) 30-days and (ii) 1-year after treatment start, adjusted for age, sex, ethnicity, psychiatric diagnosis and severity of need.

Hazardous, harmful, or dependent drinking was identified in 270 cases at baseline (16.7%); 73 (4.5%) were alcohol dependent. By 1-year, 622 patients (38.5%) had recontacted crisis care or died. After adjustment, alcohol use at a hazardous, harmful or dependent level was not associated with increased odds of death-or-recontact at 30-days (AOR 1.17, 95%CI 0.73,1.88) or 1-year (AOR 1.17, 95%CI 0.85,1.60).

Patients with hazardous, harmful and dependent alcohol use are a small proportion of CRT patients, despite being more commonly encountered in emergency settings from which patients may be referred to CRTs, indicating a potential gap in provision. Those who are included in CRT are not at increased risk of death or recontact within one year of treatment, suggesting that their inclusion can work, at least in a sample with predominantly hazardous or harmful alcohol use.
Original languageEnglish
JournalInternational Journal Of Mental Health Nursing
Publication statusPublished - 3 Jan 2023

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