3.23 A SILENT EPIDEMIC: SUICIDE IN THE COLLEGE STUDENT POPULATION

Objectives: Humans face several transitional phases during life. The transition to early adulthood is particularly vulnerable. According to the SAMHSA 2013 National Survey on Drug Use and Health, noncollegiate adults (aged 18-22 years) and full-time college students were found to have similar percentages of suicidal thoughts (8.0 and 8.7 percent, respectively) and suicidal ideation (SI) with plans (2.4 and 3.1 percent, respectively). College students were less likely to attempt suicide than adults aged 18-22 years (0.9 vs. 1.9 percent). The aim of the study was to characterize the prevalence and characteristics of SI and suicide attempts (SA) among the college students who visited the emergency department (ED) from 2009 to 2015. Methods: The University of Virginia has established a database of students who are seen in the ED. Visits indicating different classes of psychiatric diagnoses were identified through specific clinical diagnosis codes based on the ICD-9. The prevalence of SI and SA was determined by the proportion of ED visits resulting from SI or SA. Data were reviewed by two physicians for clinical presentation characteristics. The data were subsequently analyzed using SAS version 9.4. Results: Data showed that 56 percent were female. Students were identified as white (62 percent), Asian (26 percent), African American (7.4 percent), and other (11 percent). Students (26 percent) were intoxicated upon admission. Discharge diagnoses included MDD (51 percent), substance use (10 percent), bipolar disorder (4 percent), and personality disorders (4 percent). Characterizations of suicidality included SI with a plan (37 percent), SI without a plan (25 percent), SA (19 percent), and suicidal gestures (11 percent). The most common method was overdose (28 percent), followed by cutting (19 percent) and jumping (10 percent). Most patients were admitted for inpatient psychiatric hospitalization (54 percent), followed by outpatient follow-up (41 percent). The most common stressors were dysphoria (82 percent), academic stress (51 percent), and poor self-esteem (45 percent). Regarding access to firearms, 3 percent had access, 30 percent were denied access, and 67 percent had no documentation of firearms access. Conclusions: The most prominent risk factors were dysphoria, academic stress, poor self-esteem, and relationship strife. Given that significant risk factors were not documented uniformly by all ED providers further standardization of suicide risk assessment