Patterns and predictors of help-seeking contacts with health services and general practitioner detection of suicidality prior to suicide: a cohort analysis of suicides occurring over a two-year period

Gerard Leavey,Karen Galway,Sharon Mallon,Lynette Hughes,Michael Rosato,Janeet Rondon

doi:10.1186/s12888-016-0824-7

Gerard Leavey, Karen Galway + Show 4 more

Open Access

https://doi.org/10.1186/s12888-016-0824-7

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Abstract

BackgroundContact with primary care and psychiatric services prior to suicide may be considerable, presenting opportunities for intervention. However, there is scant knowledge on the frequency, nature and determinants of contact.MethodRetrospective cohort study-an analysis of deaths recorded as suicide by the Northern Ireland Coroner’s Office linked with data from General Practice patient records over a 2 year periodResultsEighty-seven per cent of suicides were in contact with General Practice services in the 12 months before suicide. The frequency of contact with services was considerable, particularly among patients with a common mental disorder or substance misuse problems. A diagnosis of psychiatric problems was absent in 40 % of suicides. Excluding suicide attempts, the main predictors of a noted general practitioner concern for patient suicidality are male gender, frequency of consultations, diagnosis of mental illness and substance misuse.ConclusionsDespite widespread and frequent contact, a substantial proportion of suicidal people were undiagnosed and untreated for mental health problems. General Practitioner alertness to suicidality may be too narrowly focused.

Highlights

Contact with primary care and psychiatric services prior to suicide may be considerable, presenting opportunities for intervention
Of the 399 eligible cases of suicide recorded by the Coroner’s Office, general practitioner (GP) records were unobtainable for 38 individuals (9.5 % of all cases)
We found no significant differences in gender, age, locale, marital status, living alone or employment between available and unavailable GP records

Summary

Introduction

Contact with primary care and psychiatric services prior to suicide may be considerable, presenting opportunities for intervention. In Western societies the main factors associated with suicide include mental illness, gender, age, social class, unemployment, poor physical health and social isolation [1, 2]. These factors are related to help-seeking for mental health problems. Contact with primary care services prior to suicide is common, providing an opportunity for intervention for people recognised as vulnerable. Study aims To examine predictors of contact with health and social care services in the 12-month period prior to suicide and GP recognition of suicidality

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