Can health services help detect suicide risk?

A significant number of people who die by suicide attended primary care and mental health services in the last year before making the attempt

Bearing in mind that a high percentage of people who died by suicide attended primary care or mental health centers during the last year, healthcare system is presented as an essential tool in intervention and prevention of suicidal behavior. Thus, it represents a favorable environment for detecting risk factors and protection of people at risk, as well as for the implementation of specific strategies.

A cross-sectional study carried out with suicide data in Extremadura during 2019, 2020 and 2021 has shown that approximately half of the people who committed suicide during this period went to primary care or mental health services. In this regard, the study highlights that people who had a mental disorder were the ones who most requested these consultations (97.9%). In contrast, only 2.1% of people without a diagnosis had visited primary care or mental health services in the last year.

Regarding the sample with a mental disorder diagnosis who sought care, 67.3% did it in primary care and the rest in mental health. Differences were also observed regarding  sex, with a higher proportion of women (54.2%) attending specialized services than men (32.8%), who requested more assistance in primary care services. People aged between 40-69 attended mental health services more frequently.

It is also important to highlight the result found by the authors regarding the time elapsed between the suicide and the last visit. Thus, 60% of people who sought care in a mental health center did so in the last three months, unlike those who sought care in primary care services, who did so in the last year.

It is remarkable the difference observed in the three years of the study 2019, 2020 and 2021. The results of this study show that, during 2020, people who committed suicide made greater use of mental health services compared to previous years. The authors highlight that this result could be related to the increase in mental health problems observed after the period of confinement.

This research confirms that, in the study area, Extremadura, there are many people with no psychiatric history who die by suicide each year and who, in addition, make very little use of health services during the previous year or months. These results show the existence of an at-risk group of suicide who are difficult to identify and, consequently, quite difficult to prevent from the health field. Likewise, specific characteristics (diagnosis, age group and when was the last visit) associated with people attending specialized mental health services are determined.

This highlights the need for trained health professionals in the detection and intervention of suicidal behavior as an effective preventive strategy. In addition, there is a need for an additional review of guidelines such as consultation time, (6 minutes per patient), which is insufficient time for a good approach in these cases, being necessary a continuous risk assessment, a direct intervention and a long term follow-up.

Original paper: Puig-Amores, I., Cuadrado-Gordillo, I., & Martín-Mora-Parra, G. (2023). Health Service Protection vis-à-vis the Detection of Psychosocial Risks of Suicide during the Years 2019-2021. Healthcare (Basel, Switzerland), 11(10), 1505. https://doi.org/10.3390/healthcare11101505