title: Factors associated with not seeking professional help or disclosing intent prior to suicide: a study of medical examiners' records in Nova Scotia.
abstract: OBJECTIVE
  Individual-level data from clinical settings lack information on people who did not seek professional help prior to suicide. We used records of the Nova Scotia Medical Examiner Service (NSMES) to compare people who had contact with a health professional prior to suicide with those who did not.
  
  
  METHODS
  We linked data from the NSMES to routine administrative data of the province.
  
  
  RESULTS
  The NSMES recorded 108 suicides in Nova Scotia from January 1, 2006, to December 31, 2006; there were 90 male and 18 female suicide deaths. Mean and median age at death were 44.73 (SD 13.33) and 44 years, respectively. Patients aged 40 to 49 years made up one-third of the cases (n = 35) and this was the decade of life with the highest number of suicides. This was also the group least likely to have suicidal intent recorded in the NSMES files (χ(2) = 3.86, df = 1, P = 0.05). Otherwise, there were no significant differences between people who sought help, or disclosed intent, prior to suicide and people who did not. The samples in all cases were predominately male and single.
  
  
  CONCLUSIONS
  People aged 40 to 49 years were the age group with the highest absolute number of suicides, but were the least likely to have suicidal intent recorded in the NSMES files. This finding merits further investigation. Medical examiner or coroner data may provide additional information not obtained elsewhere for the surveillance of suicide.
authors.affiliation: Queensland Centre for Health Data Services, University of Queensland, Brisbane, Australia. s.kisely@uq.edu.au
authors.forename: Stephen
authors.initials: S
authors.lastname: Kisely
authors.forename: Leslie Anne
authors.initials: LA
authors.lastname: Campbell
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cartwright
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Bowes
authors.forename: Lois
authors.initials: L
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000368:Aged; D015982:Bias; D003334:Coroners and Medical Examiners / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009674:Nova Scotia; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*