Long-Term Outcomes After Preadolescent STBs

Healthcare service utilization declined during the HBPC period compared with the pre-HBPC period. Children who made an attempt at the index visit had significantly higher subsequent ED visits and psychiatric hospitalizations than those presenting with ideation only. The near-equivalent subsequent attempt rates across ideation-only and attempter groups argue that suicidal ideation should be treated with the same clinical urgency as an actual attempt. The survivor improvements cannot be interpreted as causal effects of HBPC without adjustment for differential attrition. Apparent health improvements among survivors should be interpreted cautiously because attrition was non-random. At 12 months, 204 of 332 baseline participants remained, yielding 61.5% retention. Despite receiving more intensive acute mental health treatment, attempters' subsequent attempt rate remained only modestly higher than the ideation-only group, suggesting current treatment approaches may be insufficient. 31% of the full cohort had at least one subsequent suicide attempt during the approximately 7-year follow-up. Three deaths occurred in the cohort over follow-up; none were explicitly attributed to suicide. Fe…