Suicide Prevention Pathways: linking risk and behaviour within the Maltese context

Abstract

Abstract Background People engage in suicidal behaviour as a result of several risk factors, such as acute stress, severe depression, violence, sexual abuse, etc. Beyond such evidence from literature, a mental public health approach to suicide prevention needs also to take into account specific country characteristics and to look beyond the demographic characteristics of deaths by suicide. Available clinical information can help identify and quantify risk, analyse patterns of behaviour, explore links between risk and behaviour and provide possible suicide prevention pathways. Methods In this study, the 128 deaths by suicide for the period 2015-2019 in Malta are analysed against available clinical information. Major sources of detailed clinical information include obligatory notifications to the Commissioner for Mental Health of all cases involuntarily admitted to acute psychiatric services and other medical records held within the Maltese public mental health system. Results 84% of 128 deaths by suicide for the period 2015-2019 were males, two-thirds of them between 25 and 54 years. The preliminary findings have confirmed that less than 50% of these deaths had previous contact with the public health system. The two main diagnostic criteria among deaths with recent psychiatric admission/s were acute stress reaction to personal life events and very severe mood disturbances, particularly depression. There seems to be increased risk among migrants and foreign workers residing and working in Malta. The frequency of prior admissions, age-related issues, the time-event relationships and relevance of elicited clinical findings are still being evaluated, and will be presented in more detail in the workshop. Conclusions Exploring risk factors within the history of cases of suicide and attempted suicide through available clinical information can contribute to the development of suicide prevention pathways, relevant to the specific context of local communities.