title: Contact of mental and nonmental health care providers prior to suicide in Taiwan: a population-based study.
abstract: OBJECTIVE
  Higher rates of health care service use prior to suicide were previously reported in Western countries; however, these studies have tended to suffer from small sample sizes. This nationwide, population-based study examines the distribution and patterns of health care service use among suicide victims in Taiwan.
  
  
  METHODS
  A retrospective cohort study was conducted using linked population-based data to determine the proportion of health care service use among suicide victims aged 15 years and older within the 1-year and 1-month period prior to their deaths. After adjusting for demographic, socioeconomic and health care indices, the differences in health care service use patterns were assessed for age and sex.
  
  
  RESULTS
  Among the 19 426 suicide victims in the sample, 83.1% had used nonmental health care services within the 1-year period prior to their death, while only 22.2% had used mental health care services. Men, and suicide victims aged 55 years and older, were less likely to have had any contact with mental health care professionals prior to their deaths (P < 0.001).
  
  
  CONCLUSIONS
  In line with prior studies, similarly high rates and distinct patterns of health care service use were found in Taiwan prior to suicide. These findings will be of practical interest and should support designing appropriate methods of suicide intervention and effective preventive strategies.
authors.affiliation: Department of Psychiatry and Sleep Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.forename: Tsai-Ching
authors.initials: TC
authors.lastname: Liu
authors.forename: Shiyng-Yu
authors.initials: SY
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health; D015331:Cohort Studies; D003142:Communication; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D011369:Professional-Patient Relations; D012189:Retrospective Studies; D012944:Social Support; D013405:Suicide / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology