Suicidality, depression, and mental health service use in Canada.
OBJECTIVE
To determine the magnitude of depression and suicidal populations, the overlap between these populations, and the associated patterns of mental health service use.


METHODS
We examined depression, suicidality (ideation and nonfatal behaviours), and the mental health service use of participants in the Canadian Community Health Survey Cycle 1.2: Mental Health and Well-Being. The sample comprised 36 984 household members aged 15 years or over.


RESULTS
Approximately 4% to 5% of the population suffered from a major depression or suicidality. About 2 of 3 of those who were suicidal did not suffer from depression, and over 70% of those with depression did not report suicidality. Persons with depression and suicidality or depression (but no suicidality) were the 2 groups most likely to report ambulatory mental health contacts, and the provider groups contacted most often included physicians. The use of provider groups was considerably lower for those who were suicidal (but had no depression). Whereas the latter were more likely to report contacts than not, suicidality, in and of itself, did not exert a strong effect on contact with any particular provider group. For those who were suicidal (but who had no depression), less than 1 in 3 reported any mental health service contact, including an inpatient mental health stay.


CONCLUSIONS
The lack of contact by those who are suicidal (but who have no depression) is provocative, given that almost 2 of 3 of the suicidal subjects had no depression. Detrimental outcomes such as depression may develop without effective early interventions and uptake by a sufficient supply of appropriately trained and financially accessible personnel.
Suicide Studies Unit, St Michael's Hospital, Toronto, Ontario. rhodesa@smh.toronto.on.ca
Anne E
AE
Rhodes
Jennifer
J
Bethell
Susan J
SJ
Bondy
D002170:Canada; D003430:Cross-Sectional Studies; D003625:Data Collection; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010552:Personality Assessment; D011320:Primary Health Care / Q000706:statistics & numerical data; D011570:Psychiatry / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D018570:Risk Assessment; D013223:Statistics as Topic; D013406:Suicide, Attempted / Q000706:statistics & numerical data*