Affiliation:
1. National Addiction Centre Institute of Psychiatry, Psychology & Neuroscience (IOPPN) King's College London London UK
2. South London and Maudsley NHS Foundation Trust London UK
3. Innovation, Health, and Science RAND Europe Cambridge UK
4. Centre for Epidemiology and Biostatistics Melbourne School of Global and Population Health, The University of Melbourne Melbourne Victoria Australia
5. Department of Psychological Medicine and NIHR Maudsley Biomedical Research Centre King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
6. NIHR Maudsley Biomedical Research Centre (BRC) King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
Abstract
AbstractDespite 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 CRTs are not at increased risk of death‐or‐recontact within 1 year of treatment, suggesting that their inclusion can work, at least in a sample with predominantly hazardous or harmful alcohol use.
Funder
Institute of Psychiatry, Psychology and Neuroscience, King’s College London
National Institute for Health Research
Maudsley Charity
Subject
Pshychiatric Mental Health