Introduction Suicide rate has increased dramatically in Japan since 1998. It is important to reveal the characteristics of attempted suicide patients at emergency rooms (ERs) to prevent future suicides.

Methods Questionnaires were sent to all 74 secondary and tertiary ERs in Tochigi prefecture. Data were collected for attempted suicide patients who presented in September 2009.

Results All ERs responded to the survey. Only nine ERs had psychiatric departments. There were 81 attempted suicides (36 men, 45 women). 43% were in their 20s or 30s. Approximately half (47%) were unemployed. The majority (85%) resided with other family members. The average number of patients presenting to ERs were 3.2 for workdays and 1.6 for weekends/holidays. The most common method of suicide attempt was drug overdose (57%) followed by stabbing (18%), hanging (8%), and jumping from height (8%). Half (49%) used prescription drugs to commit suicide. The majority (59%) had presented to psychiatric departments, 38% had a history of depressive disorders in the past, and a quarter had previous suicide attempt. About half (47%) were admitted to medical or surgery departments, 33% were discharged home, and 9% died. After excluding those who died, 46% were not referred to a psychiatrist, and 39% were confirmed to have seen a psychiatrist.

Conclusion Although attempted suicide patients should be referred for psychiatric assessment, many of them were not. It is important to strengthen the chain of care as well as to educate health providers and family members to prevent repeated suicide attempts.