The Prevalence of Attempted Suicides in Proportion of Referrals to Emergency Departments in Karaj, Iran

Introduction: The World Health Organization (WHO) has recognized suicidal behaviors as a serious public health problem in developed and developing countries. To increase the knowledge about suicidal behaviors, WHO has carried out the Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS) across eight countries. This paper presents data from the site in Karaj, Islamic Republic of Iran. Method: Karaj, with an urban population of 941,000, was selected as a catchment area. For the duration of the study all emergency departments (EDs) in the city were covered for 24 hours to identify suicide attempters who were presented the SUPRE-MISS questionnaire, consisting of comprehensive personal, family, social, somatic, and psychiatric variables. Results: During 10 months, 945 suicide attempters (the mean of referrals per month was 98) were referred to EDs (0.12 percent of the urban population in one year). Age, education, marriage, employment and occupational status, and the method of the suicide attempt had a significant correlation with the gender of the attempters (p < .001). Overall, 0.2 percent of the particpants died due to the suicide attempt. At the time of discharge, only 5.5 percent of the particpants were referred to psychiatric or consultation services. Conclusions: The comparison of the rate of suicidal behaviors generated from community and EDs studies gives an indication of the mental health services needed for particpants at risk of suicide.