Suicide attempts in Martinique and Reunion Island and appointments no-show

Abstract

Objectives: Studies on suicidal behaviors in the French overseas territories remain rare. Although mental health resources are limited, some patients identified as being at risk of suicide do not attend the specialist consultations scheduled after identification or screening. Thus, the objective of our study was, firstly to provide a descriptive profile of patients followed up for a suicide attempt in Martinique and Reunion Island, and secondly to explore the risk factors associated with appointments no-show during follow-up.

Methods: We conducted an ancillary retrospective cross-sectional study using data from the APSOM study. Data were collected on 255 patients aged at least 16, admitted to hospital emergency departments after a suicide attempt and followed up in ambulatory care, including 137 in Martinique and 118 in Reunion Island. The characteristics of the sample were described by means [min, max] and proportions [95% confidence intervals]. Differences according to the presence of appointments no-show or not were analyzed using comparison tests of means and percentages (Chi², Fisher and Wilcoxon). Factors associated with appointments no-show were analyzed using a bootstrapped multivariate logistic regression model.

Results: The mean age of patients was 35 years [16-84 years]. Women were predominant with a sex ratio of 2.4:1 (71% women). Unemployment affected 37% [28%, 46%] of patients in Martinique and 49% [40%, 59%] in Reunion Island. Psychoactive substances consumption at the time of the suicidal act was observed in 36% [27%, 45%] of patients in Martinique and 34% [26%, 44%] in Reunion Island. The average number of suicide attempts was two per patient [1-20]. Finally, we found no significant association with appointments no-show except for center. Patients from Reunion Island were associated with better compliance than patients from Martinique (OR: 0.20 [0.05-0.65], P<0.012).

Conclusion: Our study provides a description of suicide attempts admitted to hospital and followed up in ambulatory care in two French overseas territories and suggests interesting approaches for adapting prevention strategies to the socioeconomic context and cultural realities of these territories, particularly outreach interventions for the most vulnerable patients.

Keywords: Absence aux rendez-vous; Appointments no-show; La Martinique; La Réunion; Martinique; Prevention; Prévention; Reunion Island; Suicide attempts; Tentatives de suicide.