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To examine risk of future documented suicide attempts and emergency room (ER) returns among children and adolescents with first suicidal ER presentations.

A total of 548 consecutive ER presentations of suicidal 5-to 19-year-olds to a Canadian center over a 1-year period (1997–1998) were reviewed. Relative risk analyses were performed on 224 first-time patients (mean age 14.6 ± 2.1) to determine the strength of associations between predictors and outcomes (ER return and suicide attempts).

At 6-month follow-up, 32.6% (n = 73) had returned to the ER, 24.1% (n = 54) had a documented suicide attempt, and 14.3% (n = 32) required psychiatric hospitalization. Predictors for both ER return and future documented suicide attempts included 15-to 19-year age range, past foster/group home placement, past mental health care, a suicide plan, reported mood symptoms, sobriety at ER …