Suicide within 12 months of mental health service contact in different age and diagnostic groups: National clinical survey.
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.
Hunt
Isabelle M
IM
Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. Louis.appleby@manchester.ac.uk.
Kapur
Navneet
N
Robinson
Jo
J
Shaw
Jenny
J
Flynn
Sandra
S
Bailey
Hayley
H
Meehan
Janet
J
Bickley
Harriet
H
Burns
James
J
Appleby
Louis
L
Parsons
Rebecca
R
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