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To investigate cases of suicide in which there was no healthcare contact, by looking at history of help-seeking and evidence of previous mental health vulnerability. To identify any life events associated with suicide for which individuals did not seek help.
Previous research has suggested that non-consultation is the main barrier to suicide prevention among men. Estimates suggest approximately 22% of men who die by suicide have not consulted their GP in the year before their death. Little is known about the lifetime pattern of engagement with services among these individuals and whether or not this may influence their help-seeking behaviour before death.
Coroner records of suicide deaths in Northern Ireland over 2 years were linked to general practice (GP) records. This identified 63 individuals who had not attended health services in the 12 months before death. Coroner’s data were used to categorise life events associated with the male deaths. Lifetime mental health help-seeking at the GP was assessed.
The vast majority of individuals who did not seek help were males (n=60, 15% of all suicide deaths). Lack of consultation in the year before suicide was consistent with behaviour over the lifespan; over two-thirds had no previous consultations for mental health. In Coroner’s records, suicides with no prior consultation were primarily linked to relationship breakdown and job loss. These findings highlight the limitations of primary care in suicide prevention as most had never attended GP for mental health issues and there was a high rate of supported consultation among those who had previously sought help. Public health campaigns that promote service use among vulnerable groups at times of crisis might usefully be targeted at those likely to be experiencing financial and relationship issues.
Although substance misuse is a key risk factor in suicide, relatively
little is known about the relationship between lifetime misuse and misuse
at the time of suicide.
To examine the relationship between substance misuse and subsequent
Linkage of coroners' reports to primary care records for 403 suicides
occurring over 2 years.
With alcohol misuse, 67% of the cohort had previously sought help for
alcohol problems and 39% were intoxicated at the time of suicide.
Regarding misuse of other substances, 54% of the cohort was tested.
Almost one in four (38%) tested positive, defined as an excess of drugs
over the prescribed therapeutic dosage and/or detection of illicit
substances. Those tested were more likely to be young and have a history
of drug misuse.
A deeper understanding of the relationship between substance misuse and
suicide could contribute to prevention initiatives. Furthermore,
standardised toxicology screening processes would avoid diminishing the
importance of psychosocial factors involved in suicide as a ‘cause of
The aims of this study were to improve responses to students in distress and who are feeling suicidal, to help practitioners to increase their responsiveness to those at high risk of suicide and to develop effective responses to those affected by their deaths. The study sought to build a detailed picture of students’ patterns of service use.
National suicide prevention strategies emphasise that suicide prevention requires the collaboration of a wide range of organisations. Among these, primary care services play a key role in relation to suicide prevention for young people in crisis.
This study, undertaken between 2004 and 2007, focused on 20 case studies of student suicide that took place in the United Kingdom between May 2000 and June 2005. It adopted a psychological autopsy approach to learn from a wide range of informants, including parents, friends, university staff and the records of coroners or procurator fiscals. Twenty families gave permission for their son’s or daughter’s death to be included in the study and agreed to participate in the study. Informants were interviewed in person and the data were analysed thematically. Analysis of the case study data suggested that in a number of cases students had failed to engage with services sufficiently early or in sufficient depth. Primary care practitioners need to be proactive in communicating concerns about vulnerable students to student support services. At local levels, collaboration between student support and National Health Service practitioners varied considerably and channels of communication need to be developed.
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