Health Care Contacts in the Year Before Suicide Death
Suicide prevention is a public health priority, but no data on the health care individuals receive prior to death are available from large representative United States population samples.
To investigate variation in the types and timing of health services received in the year prior to suicide, and determine whether a mental health condition was diagnosed.
Longitudinal study from 2000 to 2010 within eight Mental Health Research Network health care systems serving eight states.
In all, 5,894 individuals who died by suicide, and were health plan members in the year before death.
Health system contacts in the year before death. Medical record, insurance claim, and mortality records were linked via the Virtual Data Warehouse, a federated data system at each site.
Nearly all individuals received health care in the year prior to death (83 %), but half did not have a mental health diagnosis. Only 24 % had a mental health diagnosis in the 4-week period prior to death. Medical specialty and primary care visits without a mental health diagnosis were the most common visit types. The individuals more likely to make a visit in the year prior to death (p < 0.05) tended to be women, individuals of older age (65+ years), those where the neighborhood income was over $40,000 and 25 % were college graduates, and those who died by non-violent means.
This study indicates that opportunities for suicide prevention exist in primary care and medical settings, where most individuals receive services prior to death. Efforts may target improved identification of mental illness and suicidal ideation, as a large proportion may remain undiagnosed at death.
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- Health Care Contacts in the Year Before Suicide Death
Journal of General Internal Medicine
Volume 29, Issue 6 , pp 870-877
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- health services research
- mental health
- primary care
- Industry Sectors
- Brian K. Ahmedani PhD (1)
- Gregory E. Simon MD (2)
- Christine Stewart PhD (2)
- Arne Beck PhD (3)
- Beth E. Waitzfelder PhD (4)
- Rebecca Rossom MD (5)
- Frances Lynch PhD (6)
- Ashli Owen-Smith PhD (7)
- Enid M. Hunkeler MA (8)
- Ursula Whiteside PhD (2)
- Belinda H. Operskalski MPH (2)
- M. Justin Coffey MD (9)
- Leif I. Solberg MD (5)
- Author Affiliations
- 1. Center for Health Policy and Health Services Research, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA
- 2. Group Health Cooperative, Group Health Research Institute, Seattle, WA, USA
- 3. Kaiser Permanente Colorado, Institute for Health Research, Denver, CO, USA
- 4. Kaiser Permanente Hawaii, Center for Health Research, Honolulu, HI, USA
- 5. HealthPartners, Institute for Education and Research, Minneapolis, MN, USA
- 6. Kaiser Permanente Northwest, Center for Health Research, Portland, OR, USA
- 7. Kaiser Permanente Georgia, Center for Health Research, Atlanta, GA, USA
- 8. Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA
- 9. Department of Psychiatry, Henry Ford Health System, Detroit, MI, USA