title: Contacts with health professionals before suicide: missed opportunities for prevention?
abstract: OBJECTIVE
  This study aims to examine contacts with different health professionals in the three months prior to death in suicide cases compared to sudden death controls; and, to analyse contacts with health professionals among people who died by suicide having a diagnosable mental health disorder at the time of suicide compared to those who did not have such a diagnosis within four major groups of conditions.
  
  
  METHODS
  The psychological autopsy method was utilised to investigate suicides of individuals over the age of 35years. A case-control study design was applied using sudden death cases as controls. Odds ratios with a 95% confidence interval were calculated.
  
  
  RESULTS
  In total, 261 suicides and 182 sudden deaths were involved. In terms of contacts during the last three months prior to death, 76.9% of suicides and 81.9% of sudden deaths visited a general practitioner (GP). Persons who died by suicide had significantly more frequently contacts with mental health professionals than sudden death controls did. People with a diagnosable mental health disorder at the time of suicide attended GP surgeries with approximately the same frequency of people without a diagnosis at GP level.
  
  
  CONCLUSIONS
  Similarly, approximately 90% of people who die by suicide and by sudden death seek for help from health care system, mainly from GPs in three months prior to their death. With reference to health care contacts, people who had or did not have a diagnosable psychiatric disorder are not distinguishable at the GP surgery level.
authors.affiliation: Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane. Electronic address: D.DeLeo@griffith.edu.au.
authors.forename: Diego
authors.initials: D
authors.lastname: De Leo
authors.forename: Brian M
authors.initials: BM
authors.lastname: Draper
authors.forename: John
authors.initials: J
authors.lastname: Snowdon
authors.forename: Kairi
authors.initials: K
authors.lastname: Kõlves
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention