Following treatment in an intensive care unit (ICU), new research suggests individuals may be more likely to hurt themselves or commit suicide.
In findings published last week in the medical journal The BMJ, Canadian researchers indicate patients released from ICU stays had a 22% higher risk of suicide and a 15% higher risk of self-harm when compared to patients released from non ICU stays.
Researchers from the Ottawa Hospital and University of Ottawa reviewed health records from 2009 through 2017, involving 423,000 ICU patients discharged in the province of Ontario, and compared them to roughly 3 million patients who were hospitalized in non ICU settings. Admissions considered in the study had a median seven day stay at a hospital.
Of the ICU patients who survived and were released, 750 committed suicide compared to 2,427 suicides among other hospital survivors. When factoring the population of the study, researchers indicated ICU patients had a 0.2% rate of committing suicide after release compared, to a 0.1% rate of non ICU patients. Rates of self-harm were 1.3% among ICU survivors and 0.8% among others.
Researchers determined patients with the highest risk of suicide or self-harm following release fell into three categories; including 18 to 34 year old adults, patients with previous diagnosis of depression, anxiety or post-traumatic stress disorder (PTSD), or those who received invasive procedures in the ICU, such as kidney failure patients who underwent mechanical ventilation or blood filtration.
Additional factors which increased patient suicide and harm following ICU treatment were those discharged home independently, and not to a healthcare recovery facility; as well as those in lower income neighborhoods.
“These patients are often in hospital for weeks or months and need intense rehabilitation to get their strength back,” the researchers concluded. “Once they return home, they may not be able to work full time or at all. We know all of this impacts their mental health.”
While previous studies have found growing evidence of ICU patients developing psychiatric morbidity, the study offers a relatively small sample of data indicating the risk of suicide and self-harm was associated with younger age, previous mental health diagnoses, and receipt of life support interventions.
Researchers indicate ICU admission is an apparent risk factor of post-release suicide, suggesting mental health monitoring of at-risk patients is needed to identify and offer early suicide and self-harm interventions.