title: Contact with mental health and primary care providers before suicide: a review of the evidence.
abstract: OBJECTIVE
  This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide.
  
  
  METHODS
  The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects.
  
  
  RESULTS
  Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults.
  
  
  CONCLUSIONS
  While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men.
authors.affiliation: Division of Services and Intervention Research, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Jason B
authors.initials: JB
authors.lastname: Luoma
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Martin
authors.forename: Jane L
authors.initials: JL
authors.lastname: Pearson
mesh_terms: D000328:Adult; D000367:Age Factors; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D012737:Sex Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data* / Q000639:trends