Health Care Prior to Suicide

The authors of a study of health care use by patients who died by suicide have provided additional evidence that medical settings offer important opportunities to identify mental illness and suicidal ideation and to prevent suicide. They recommend training medical providers to recognize and treat suicide risk and using electronic medical records systems to alert health care providers about suicide risk.

The study revealed that 83 percent of the patients who died by suicide had received health care services in the year prior to their death. Half had visited a health care provider in the four weeks before their suicide, and 22 percent in the week before. Only 24 percent of these patients had made a mental health care visit in the four weeks before their suicides.

Half of the patients who died by suicide received a mental health diagnosis in the year before their deaths. Only 24 percent had a mental health diagnosis in the four weeks preceding their suicides. Fewer than 14 percent had ever had a psychiatric hospitalization. The authors conclude that although a psychiatric hospitalization is an important indicator of suicide risk, the small proportion of patients who had been hospitalized demonstrates the importance of integrating suicide prevention into primary care and medical specialty care.

The authors also speculate that electronic medical records could present new possibilities for integrating suicide prevention into medical settings. Patients could complete an electronic suicide screening prior to seeing a health care provider, who would be alerted if the results indicated any suicide risk. Electronic medical record systems could also track whether patients were filling prescriptions for anti-depressants or following through with mental health referrals and treatment.

This summary based on: Ahmedani, B.K., Simon, G.E., Stewart, C., Beck, A., Waitzfelder, B.E., Rossom, R….& Solberg, L.I. (2014). Health care contacts in the year before suicide death. Journal of General Internal Medicine 29(6), 870-877.

SPRC Commentary

The study summarized this week involved eight major health care systems. The authors’ conclusions and recommendations on how these systems could better prevent suicide give added weight to the efforts of the National Action Alliance’s efforts to achieve Zero Suicide in Health and Behavioral Health Care.