Example 9: Young suicide attempters need follow-up care after emergency-room treatment. The rate of suicide attempts is rising in today’s struggling economy, and the majority of attempters survive, raising the question of what will happen to them. Service delivery studies reveal that most attempters receive no further care after emergency-room treatment of their injury. Our Dunedin cohort came of age in a deep economic recession in New Zealand in the 1990s, giving us the opportunity to ask what happened to suicide attempters when followed up 15–20 years later, to midlife. We compared them to controls matched on psychiatric history, to highlight whether their suicide attempt signalled more prognosis than clinicians could glean from their initial psychiatric diagnoses. The life outcomes of attempters were very poor across the board, including poor physical health and financial dependency. Particularly concerning was that they were harming others, with high rates of violent crime, intimate partner violence, and having their children go into care for child protection [73].
