title: Service use and unmet needs in youth suicide: a study of trajectories.
abstract: OBJECTIVE
  While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims.
  
  
  METHODS
  We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects' psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received.
  
  
  RESULTS
  Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance.
  
  
  CONCLUSIONS
  Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people.
authors.affiliation: Child and Adolescent Psychiatrist and Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Medical Chief-Youth Section Outpatient Clinic of Depressive and Suicidal Disorders, Douglas Mental Health University Institute, Montreal, Quebec; Standard Life Senior Fellow, Standard Life Centre for Breakthroughs in Teen Depression and Suicide Prevention, Douglas Mental Health University Institute, McGill University, Montreal, Quebec; Researcher, McGill Group for Suicide Studies, McGill University, Montreal, Quebec.
authors.forename: Johanne
authors.initials: J
authors.lastname: Renaud
authors.affiliation: Psychologist, Université du Québec en Outaouais, Gatineau, Quebec; Professor, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Quebec; Researcher, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec.
authors.forename: Monique
authors.initials: M
authors.lastname: Séguin
authors.affiliation: Psychiatrist and Professor, Department of Psychiatry, Institut universitaire en santé mentale de Montréal, Université de Montréal, Montreal, Quebec.
authors.forename: Alain D
authors.initials: AD
authors.lastname: Lesage
authors.affiliation: Psychiatrist and Assistant Professor, Department of Psychiatry, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec.
authors.forename: Claude
authors.initials: C
authors.lastname: Marquette
authors.affiliation: Resident in Psychiatry, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec.
authors.forename: Bettina
authors.initials: B
authors.lastname: Choo
authors.affiliation: Psychiatrist and Professor, Departments of Psychiatry, Human Genetics, and Neurology and Neurosurgery, McGill University, Montreal, Quebec; Vice-Chair, Research and Academic Affairs, Department of Psychiatry, McGill University, Montreal, Quebec; Director, McGill Group for Suicide Studies, McGill University, Montreal, Quebec; Co-Director, Douglas-Bell Canada Brain Bank (Suicide Studies), Montreal, Quebec; Head, Depressive Disorders Program, Douglas Mental Health University Institute, McGill University, Montreal, Quebec; Director, Réseau québécois de recherche sur le suicide, Montreal, Quebec.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Turecki
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D020380:Needs Assessment; D011792:Quebec / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult