The association between suicide and the utilization of mental health services in South Tirol, Italy: a psychological autopsy study.
OBJECTIVE
The aim of the present study was to investigate potential differences between suicide decedents who had contact with a psychologist or psychiatrist before committing suicide and those individuals who had not had previous contact with a mental health professional prior to ending their lives.


METHODS
Psychological autopsy interviews (N = 396) were conducted for individuals who died by suicide between 1997 and 2007 in South Tirol, Italy.


RESULTS
The study found that suicide decedents known to mental health professionals were more frequently women and more frequently unemployed or with unstable employment. These decedents were significantly more likely than those unknown to mental health professionals to have a family history of mental illness, one or more past suicide attempts, and more frequent substance abuse, and likely to have frequent alcohol abuse. They more often had visited a physician in the last four weeks before dying and more frequently complained about psychological symptoms. In the prediction of group membership, individuals whom were known to mental health professionals prior to their suicidal act were 3 times more likely to have a family history of mental illness, 5.8 times more likely to have one past suicide attempt, 9.7 times more likely to have two or more past suicide attempts and 3.5 times more likely to have visited a physician in the four weeks prior to their death.


CONCLUSIONS
Our findings indicate that suicide decedents who had contact with mental health services can be distinguished from those who were not known to mental health professionals.
1Department of Psychiatry, Bolzano, Italy.
Giancarlo
G
Giupponi
Roger
R
Pycha
Marco
M
Innamorati
Dorian A
DA
Lamis
Evelyn
E
Schmidt
Andreas
A
Conca
Hans Peter
HP
Kapfhammer
David
D
Lester
Paolo
P
Girardi
Maurizio
M
Pompili
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007558:Italy; D016013:Likelihood Functions; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data; D000092864:Suicide Prevention