Suicide within 12 months of mental health service contact in different age and diagnostic groups: National clinical survey

Abstract

Background: Suicide prevention is a health service priority but the most effective approaches to prevention may differ between different patient groups.

Aims: To describe social and clinical characteristics in cases of suicide from different age and diagnostic groups.

Method: A national clinical survey of a 4-year (1996-2000) sample of cases of suicide in England and Wales where there had been recent (<1 year) contact with mental health services (n=4859).

Results: Deaths of young patients were characterised by jumping from a height or in front of a vehicle, schizophrenia, personality disorder, unemployment and substance misuse. In older patients, drowning, depression, living alone, physical illness, recent bereavement and suicide pacts were more common. People with schizophrenia were often in-patients and died by violent means. About a third of people with depressive disorder died within a year of illness onset. Those with substance dependence or personality disorder had high rates of disengagement from services.

Conclusions: Prevention measures likely to benefit young people include targeting schizophrenia, dual diagnosis and loss of service contact; those aimed at depression, isolation and physical ill-health should have more effect on elderly people.