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Suicide and recency of health care contacts

A systematic review

Published online by Cambridge University Press:  03 January 2018

Jane Pirkis*
Affiliation:
Centre for Health Program Evaluation, Department of General Practice and Public Health, The University of Melbourne
Philip Burgess
Affiliation:
Mental Health Research Institute and Department of Psychological Medicine, Monash University, Australia
*
Jane Pirkis, Senior Research Fellow, Program Evaluation Unit, Centre for Health Program Evaluation. PO Box 477, West Heidelberg, Victoria 3081, Australia. Tel: +61 3 9496 4431; Fax: +61 3 9496 4424; e-mail: j.pirkis@gpph.unimelb.edu.au

Abstract

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.

Type
Review Article
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

Appleby, L. (1992) Suicide in psychiatrie patients: risk and prevention, british Journal of Psychiatry, 161, 749758.Google Scholar
Barraclough, B., Bunch, J., Nelson, B., et al (1974) A hundred cases of suicide: clinical aspects. british Journal of Psychiatry, 125, 355373.Google Scholar
Black, D. W., Warrack, G. & Winokur, G. (1985) The Iowa record-linkage study: suicides and accidental deaths among psychiatric patients. Archives of General Psychiatry, 42, 7175.Google Scholar
Cantor, C. H., Burnett, P. C., Quinn, J., et al (1992) Suicide and community psychiatric care: a preliminary report. Acta Psychiatrica Scandinavica, 85, 229233.Google Scholar
Cheng, A. T. A. (1995) Mental illness and suicide: a case-control study in East Taiwan. Archives of General Psychiatry, 52, 594603.CrossRefGoogle ScholarPubMed
Commonwealth Department of Human Services and Health (1993) better Health Outcomes for Australians: National Goals, Targets and Strategies for Better Health Outcomes into the Next Century. Canberra: Commonwealth of Australia.Google Scholar
Davis, A. T. & Schrueder, C. (1990) The prediction of suicide. Medical Journal of Australia, 153, 552554.CrossRefGoogle ScholarPubMed
Department of Health (1992) The Health of the Nation: A Strategy for Health in England. London: HMSO.Google Scholar
Diekstra, R. F. W. & van Egmond, M. (1989) Suicide and attempted suicide in general practice, 1979–1986. Acta Psychiatrica Scandinavica. 79, 268275.CrossRefGoogle ScholarPubMed
Evans, J. (1994) The health service contacts of 87 suicides. Psychiatric Bulletin, 18, 548550.CrossRefGoogle Scholar
Hughes, D. H. (1995) Can the clinician predict suicide? Psychiatric Services, 46, 449451.CrossRefGoogle ScholarPubMed
Hyden, L. C. (1996) Care utilization and the incidence of suicide: suicide cases' contacts with primary health care and psychiatry in six psychiatric districts in the County of Stockholm from 1979 to 1990. Acta Psychiatrica Scandinavica, 93, 442446.CrossRefGoogle Scholar
bometsä, E. T., Heikkinen, M. E., Marttunen, M. J., et al (1995) The last appointment before suicide: is suicide intent communicated? American Journal of Psychiatry, 152, 919922.Google Scholar
King, E. (1994) Suicide in the mentally ill. An epidemiological sample and implications for clinicians. british Journal of Psychiatry, 165, 658663.Google Scholar
King, E. & Barraclough, B. (1990) Violent death and mental illness. A study of a single catchment area over eight years, british Journal of Psychiatry, 156, 714720.Google ScholarPubMed
Lewis, G., Hawton, K. & Jones, P. (1997) Strategies for preventing suicide, british Journal of Psychiatry, 171, 351354.Google Scholar
Macdonald, A. (1992) 'Suicide prevention by GPs? (letter), British Journal of Psychiatry, 161, 574.Google Scholar
Macdonald, A. (1993) The myth of suicide prevention by general practitioners (letter). British Journal of Psychiatry, 163, 260.Google Scholar
Matthews, K., Milne, S. & Ashcroft, G. W. (1994) Role of doctors in the prevention of suicide: the final consultation. British Journal of General Practice, 44, 345348.Google ScholarPubMed
Mock, C. N., Grossman, D. C., Mulder, D., et al (1996) Health care utilization as a marker for suicidal behaviour on an American Indian Reservation. Journal of General Internal Medicine, II, 519524.Google Scholar
Myers, D. H. & Neal, C. D. (1978) Suicide in psychiatric patients. British Journal of Psychiatry, 133, 3844.CrossRefGoogle ScholarPubMed
Nuttall, E. A., Evenson, R. C. & Won Cho, D. (1980) Patients of a public state mental health system who commit suicide. Journal of Nervous and Mental Disease, 168, 424427.CrossRefGoogle ScholarPubMed
Obafunwa, J. O. & Busuttil, A. (1994) Clinical contact preceding suicide. Postgraduate Medical Journal, 70, 428432.Google Scholar
Perris, C., Beskow, J. & Jacobsson, L. (1980) Some remarks on the incidence of successful suicide in psychiatric care. Social Psychiatry, 15, 161166.Google Scholar
Pokorny, A. D. (1960) Characteristics of 44 patients who subsequently committed suicide. Archives of General Psychiatry 2, 314323.CrossRefGoogle Scholar
Power, K., Davies, C., Swanson, V., et al (1997) Case – control study of GP attendance rates by suicide cases with or without a psychiatric history. British Journal of General Practice, 47, 211215.Google Scholar
Pyke, J. & Steers, M. J. (1992) Suicide in a community based case management service. Community Mental Health Journal. 28 484489.Google Scholar
Robins, E., Murphy, G. E., Wilkinson, R. H., et al (1959) Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides. American Journal of Public Health. 49, 888899.Google Scholar
Roy, A. (1982) Risk factors for suicide in psychiatric patients. Archives of General Psychiatry. 39, 10891095.CrossRefGoogle ScholarPubMed
Seager, C. P. & Flood, R. A. (1965) Suicide in Bristol. British Journal of Psychiatry, III, 919932.Google Scholar
Squires, T. J. & Busuttil, A. (1991) Elderly suicides in the Lothian and Borders Region of Scotland. 1983–1988. Mediane, Science and the Law, 31, 137146.Google Scholar
Sundqvist-Stensman, U. B. (1987) Suicides in dose connection with psychiatric care: an analysis of 57 cases in a Swedish county. Acta Psychiatrica Scandinavica, 76, 1520.CrossRefGoogle Scholar
US Department of Health and Human Services (1991) Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Hyattsville, MD: Department of Health and Human Services.Google Scholar
van Casteren, V., van der Velen, J., Taffoeau, J. & van Oyen, H. (1993) Suicide and attempted suicide reported by general practitioners in Belgium, 1990–1991. Acta Psychiatrica Scandinavica. 87, 451455.CrossRefGoogle ScholarPubMed
Vassilas, C. A. & Morgan, H. G. (1993) General practitioners' contact with victims of suicide, british Medical Journal. 307, 300301.Google Scholar
Westreich, L. (1991) Assessing an adult patients suicide risk. What primary care physicians need to know. Postgraduate Medicine. 90, 5962.Google Scholar
Wilkinson, G. (1994) Can suicide be prevented? Better treatment of mental illness is more appropriate aim. British Medical Journal. 309, 860861.CrossRefGoogle ScholarPubMed
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