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The British Journal of Psychiatry 173: 462-474 (1998)
© 1998 The Royal College of Psychiatrists

Suicide and recency of health care contacts. A systematic review

J Pirkis and P Burgess
Department of General Practice and Public Health, University of Melbourne, Australia. j.pirkis@gpph.unimelb.edu.au

BACKGROUND: Many countries have set targets for suicide reduction, and suggested that mental health care providers and general practitioners have a key role to play. METHOD: A systematic review of the literature. RESULTS: Among those in the general population who commit suicide, up to 41% may have contact with psychiatric inpatient care in the year prior to death and up to 9% may commit suicide within one day of discharge. The corresponding figures are 11 and 4% for community-based psychiatric care and 83 and 20% for general practitioners. CONCLUSIONS: Among those who die by suicide, contact with health services is common before death. This is a necessary but not sufficient condition for clinicians to intervene. More work is needed to determine whether these people show characteristic patterns of care and/or particular risk factors which would enable a targeted approach to be developed to assist clinicians in detecting and managing high-risk patients.


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