Differences in Health Care Utilization in the Year Before Suicide Death: A Population-Based Case-Control Study

Chock, Megan M.; Lin, Jane C.; Athyal, Vidush P; Bostwick, John

doi:10.1016/j.mayocp.2019.04.037

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…These are indicative of cases having more intense interaction with the acute-care health system closer to the suicide date. This finding corroborates conclusions drawn from previous studies (14,15,(18)(19)(20)27), that closer to the death date, suicide decedents showed an increase in service utilisation. Community contacts were negatively associated with suicide (possibly related to healthy user bias); however, these also showed an increased uptake closer to the index date.…”

Section: Change In Service Use Intensity Over the 12-month Period For...supporting

confidence: 92%

“…Our findings that 37% of suicide decedents had accessed mental health services in the preceding twelve months suggest a higher uptake of mental health services in those who died by suicide, when compared with the general population. Consistent with the study findings, other studies have also concluded that cases (i.e., those who died by suicide) were more likely to have had more recent contacts with inpatient and community services (14,15,(18)(19)(20).…”

Section: Contact Profile Of Cases and Controlssupporting

confidence: 87%

“…Two studies ( 18 , 19 ) in the US found that overall, suicide decedents had more health care visits and mental health related visits than controls. This is contrary to what the current study found; out of the four specific mental health services that were included in the study, the number of contacts among cases was not significantly higher than the number among controls.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple US studies have found that suicide decedents had more inpatient admissions and emergency department (ED) presentations compared to controls, for both mental health and non-mental health related conditions (18)(19)(20). They also found that closer to the death date, the suicide decedents showed an increase in health care utilisation and that compared to controls, suicide decedents had more healthcare visits, including psychiatric-related contacts, in the last 12 months prior to suicide.…”

Section: Introductionmentioning

confidence: 99%

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Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria

et al. 2022

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ObjectiveThe majority of suicide decedents have had contact with health services in the months before their death. Contacts for mental health services present potential suicide prevention opportunities. This study aims to compare contact-based characteristics among suicide decedents and living controls in the year subsequent to clinical mental health contact with the public health system in Victoria, Australia.MethodsA population-based nested case-control study of those who had mental health-related hospital and community contacts with the public health system was conducted. Cases (suicide decedents) were age and gender-matched to living controls (suicide non-decedents). These records were linked to records of suicides that occurred in the 12 months following the health service contact, between January 1, 2011, and December 31, 2016. Victorian residents aged 10 years and above were selected at the time of contact (483,933 clients). In the study population, conditional logistic regression models were used to assess the relationship between contact-based characteristics and suicide. Socio-demographics and mental health-related hospital and community contact data was retrieved from the Victorian Admitted Episodes Dataset, the Victorian Emergency Minimum Dataset and the Public Clinical Mental Health database and suicide data from the Victorian Suicide Register.ResultsDuring a six-year period, 1,091 suicide decedents had at least one mental health contact with the public health system in the 12 months preceding the suicide. Overall, controls used more mental health services than cases; however, cases used more mental health services near the event. The relationship between the type of service and suicide differed by service type: hospital admissions and emergency department presentations had a significant positive association with suicide with an OR of 2.09 (95% CI 1.82–2.40) and OR of 1.13 (95% CI 1.05–1.22), and the effect size increased as the event approached, whereas community contacts had a significant negative association with an OR of 0.93 (95% CI 0.92–0.94), this negative association diminished in magnitude as the event approached (OR∼1).ConclusionSuicide decedents had less contact with mental health services than non-decedents; however, evidence suggests suicide decedents reach out to mental health services proximal to suicide. An increase in mental health service contact by an individual could be an indication of suicide risk and therefore an opportunity for intervention. Further, community level contact should be further explored as a possible prevention mechanism considering the majority of suicide decedents do not access the public clinical mental health services.

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Section: Change In Service Use Intensity Over the 12-month Period For...supporting

confidence: 92%

Section: Contact Profile Of Cases and Controlssupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria

et al. 2022

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“…However, in some studies individuals with lower socioeconomic status, e.g. uninsured are not included [ 4 , 8 , 26 ] and other studies only cover specific health care settings, e.g. primary care [ 22 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Health care utilization among individuals who die by suicide as compared to the general population: a population-based register study in Sweden

et al. 2022

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Background Globally, 700 000 people die every year by suicide. Health care consultation patterns the period before suicide could be one potential way to identify people at risk for suicide. Therefore, this study examines health care patterns up to one year prior to the suicide by age, sex and prior diagnoses and specifically investigates if and how this differs from the general population of Skåne, Sweden. Methods This cohort study includes all individuals, aged 15 and older, that died by suicide in Region Skåne, Sweden from 2004 to 2015 (n = 1653). The individuals were identified through the Cause of death register and then linked to the Skåne healthcare register. Health care data was analyzed as proportions consulting different types of health care the month and year preceding the suicide, we also investigated the impact of age, sex and the occurrence of prior psychiatric and pain diagnoses. Additionally, we compared the proportion of consulting care among the suicide victims and the general population of Skåne. Results In the month before their death, 53% of the suicide victims had any health care consultation, compared with 20% in the general population of Skåne, a given month (p < 0.0001). The corresponding figures for the year prior to suicide was 86% among those who died by suicide, compared to 69% in the general population of Skåne, a given year (p < 0.0001). Women, and those having a documented history of psychiatric diagnosis were more likely to have health care consultations in the month and year preceding suicide (p < 0.001), compared to men and suicide victims without a history of psychiatric disease. Older adults that died by suicide, were less likely to consult psychiatric care compared to the younger suicide victims (p < 0.001). Conclusion A majority of the suicide victims consulted health care in the near time before death and the proportion of seeking health care was significantly higher than in the general population of Skåne and higher among female suicide victims as compared to males. Alternative preventive screening measures should be considered for individuals consulting health care, especially for older people and individuals outside the psychiatric care.

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Nursing students' experience of approaching risk for suicide behaviour through simulated environments: A content analysis study

Quemada-González,

Flores Becerra-Martos,

Blenkarn

et al. 2024

Archives of Psychiatric Nursing

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Differences in Health Care Utilization in the Year Before Suicide Death: A Population-Based Case-Control Study

Cited by 8 publications

References 27 publications

Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria

Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria

Health care utilization among individuals who die by suicide as compared to the general population: a population-based register study in Sweden

Nursing students' experience of approaching risk for suicide behaviour through simulated environments: A content analysis study

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