Suicide is a major health and social concern in New Zealand. A small group of people who present to emergency departments (ED) with intentional self-harm (ISH) also present for other causes ('Mixed Presenters'). These people experience significant psychological distress, poor physical health status and may have a suicide risk higher than the risk conferred by ISH alone. This research uses the unique opportunity presented by an existing project being carried out in 8 District Health Boards (DHBs) in which all ED presentations are being examined in detail. This data will be used to estimate the relative risk of suicide and serious ISH events between Mixed Presenters and the ISH Only Presenters; and to identify service gaps. Mixed Presenters will also be interviewed to explore how best to enhance their health outcomes when presenting to ED. Interventions for improvements will be guided by findings.