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Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria
OBJECTIVE: The 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 con...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772269/ https://www.ncbi.nlm.nih.gov/pubmed/36569615 http://dx.doi.org/10.3389/fpsyt.2022.1047894 |
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author | Fernando, Tharanga Clapperton, Angela Spittal, Matthew Berecki-Gisolf, Janneke |
author_facet | Fernando, Tharanga Clapperton, Angela Spittal, Matthew Berecki-Gisolf, Janneke |
author_sort | Fernando, Tharanga |
collection | PubMed |
description | OBJECTIVE: The 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. METHODS: A 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. RESULTS: During 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). CONCLUSION: Suicide 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. |
format | Online Article Text |
id | pubmed-9772269 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97722692022-12-23 Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria Fernando, Tharanga Clapperton, Angela Spittal, Matthew Berecki-Gisolf, Janneke Front Psychiatry Psychiatry OBJECTIVE: The 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. METHODS: A 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. RESULTS: During 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). CONCLUSION: Suicide 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. Frontiers Media S.A. 2022-12-08 /pmc/articles/PMC9772269/ /pubmed/36569615 http://dx.doi.org/10.3389/fpsyt.2022.1047894 Text en Copyright © 2022 Fernando, Clapperton, Spittal and Berecki-Gisolf. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychiatry Fernando, Tharanga Clapperton, Angela Spittal, Matthew Berecki-Gisolf, Janneke Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria |
title | Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria |
title_full | Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria |
title_fullStr | Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria |
title_full_unstemmed | Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria |
title_short | Suicide among those who use mental health services: Suicide risk factors as evidenced from contact-based characteristics in Victoria |
title_sort | suicide among those who use mental health services: suicide risk factors as evidenced from contact-based characteristics in victoria |
topic | Psychiatry |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772269/ https://www.ncbi.nlm.nih.gov/pubmed/36569615 http://dx.doi.org/10.3389/fpsyt.2022.1047894 |
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