5127.0: Wednesday, October 24, 2001 - 12:30 PM

Abstract #29756

Multiple injury and mortality among mentally ill adolescents and young adults

Linda Remy, MSW PhD, Geraldine Oliva, MD MPH, and Ted Clay, MS. Family Health Outcomes Project, University of California, San Francisco, 3333 California Street, Suite 365, San Francisco, CA 94118, 415-476-5283, lremy@itsa.ucsf.edu

Adolescents and young adults (AYA) are at high risk of self-inflicted injury, and risk increases among the mentally ill (MI) and substance abusers (SA). It is important to understand the epidemiologic, diagnostic, and clinical implications underlying the relationship between MI, the broader range of injury mechanisms, and mortality. OBJECTIVES: To evaluate the relationship between MI, SA, multiple injury, morbidity and mortality among AYA. METHODS: Confidential hospital discharge and Vital Statistics death files for 1995-1997 were searched to identify injured California residents age 13-24 who were hospitalized or died. Records were linked to create a "person-level" file. Individuals with any MI or SA diagnosis and/or multiple admissions were identified. RESULTS: We identified 104,340 AYA injured 1+ times, with 84,553 surviving to admission. A MI diagnosis was on 12% of cases; SA diagnosis, 10%, and MI/SA, 6%; or 30% of injured AYA. MI and/or SA were much more likely to have multiple discharges and to be multiply injured, with mechanisms ranging across the classification spectrum. Multiply injured MI had significantly elevated risk of death. Medicaid paid for at least one admission for 82% of the multiply admitted. Costs for multiply injured MI were hugely disproportionate. Many lives could have been saved had public funds spent on hospital care for multiply injured MI been directed to treatment programs. CONCLUSIONS: MI AYA who survive their first injury must be identified and targeted for intensive treatment. Injury prevention strategies and funding streams are needed. Mental health and injury prevention professionals must collaborate to develop these.

Learning Objectives: At the conclusion of the session, the participant will be able to: (1) quantify the impact of mental illness on injury morbidity for adolescents and young adults, (2) describe the role of mental illness in multiple injury and injury mortality among adolescents and young adults, and (3) quantify the social burden of multiple injuries among mentally ill adolescents and young adults.

Keywords: Adolescents, Epidemiology

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA