title: Suicide within 12 months of mental health service contact in different age and diagnostic groups: National clinical survey.
abstract: BACKGROUND
  Suicide prevention is a health service priority but the most effective approaches to prevention may differ between different patient groups.
  
  
  OBJECTIVE
  To describe social and clinical characteristics in cases of suicide from different age and diagnostic groups.
  
  
  METHODS
  A national clinical survey of a 4-year (1996-2000) sample of cases of suicide in England and Wales where there had been recent (<1 year) contact with mental health services (n=4859).
  
  
  RESULTS
  Deaths of young patients were characterised by jumping from a height or in front of a vehicle, schizophrenia, personality disorder, unemployment and substance misuse. In older patients, drowning, depression, living alone, physical illness, recent bereavement and suicide pacts were more common. People with schizophrenia were often in-patients and died by violent means. About a third of people with depressive disorder died within a year of illness onset. Those with substance dependence or personality disorder had high rates of disengagement from services.
  
  
  CONCLUSIONS
  Prevention measures likely to benefit young people include targeting schizophrenia, dual diagnosis and loss of service contact; those aimed at depression, isolation and physical ill-health should have more effect on elderly people.
authors.affiliation: Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. Louis.appleby@manchester.ac.uk.
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Hunt
authors.forename: Navneet
authors.initials: N
authors.lastname: Kapur
authors.forename: Jo
authors.initials: J
authors.lastname: Robinson
authors.forename: Jenny
authors.initials: J
authors.lastname: Shaw
authors.forename: Sandra
authors.initials: S
authors.lastname: Flynn
authors.forename: Hayley
authors.initials: H
authors.lastname: Bailey
authors.forename: Janet
authors.initials: J
authors.lastname: Meehan
authors.forename: Harriet
authors.initials: H
authors.lastname: Bickley
authors.forename: James
authors.initials: J
authors.lastname: Burns
authors.forename: Louis
authors.initials: L
authors.lastname: Appleby
authors.forename: Rebecca
authors.initials: R
authors.lastname: Parsons
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003866:Depressive Disorder / Q000523:psychology; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D008605:Mental Health Services; D008875:Middle Aged; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology; D011159:Population Surveillance / Q000379:methods; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology / Q000628:therapy; D012565:Schizophrenic Psychology; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000523:psychology; D013405:Suicide / Q000706:statistics & numerical data; D013997:Time Factors; D014852:Wales / Q000453:epidemiology; D000092864:Suicide Prevention