The mental and physical health profile of people who died by suicide: findings from the Suicide Support and Information
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ORIGINAL PAPER
The mental and physical health profile of people who died by suicide: findings from the Suicide Support and Information System Daniel Leahy1 · Celine Larkin2 · Dorothy Leahy3,4 · Carmel McAuliffe5 · Paul Corcoran3,4 · Eileen Williamson4 · Ella Arensman3,4 Received: 24 May 2019 / Accepted: 30 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose There is limited research on the associations between factors relating to mental and physical health in people who died by suicide. Methods Consecutive suicide cases were included in a psychological autopsy study as part of the Suicide Support and Information System in southern Ireland. Chi-square tests and logistic regression analysis were used to examine factors associated with recorded presence or absence of mental and physical health problems. Results The total sample comprised 307 suicide cases, the majority being male (80.1%). Sixty-five percent had a history of self-harm and 34.6% of these cases had not been seen or treated following previous self-harm, although most (80.3%) had a history of recent GP attendance. Mental health diagnoses were present in 84.8% of cases where this variable was documented, and among these, 60.7% had a history of substance misuse and 30.6% had physical health problems. Variables associated with mental illness included gender, older age, previous self-harm episode(s), and presence of drugs in toxicology at time of death. Variables associated with physical illness included older age, death by means other than hanging, and previous self-harm episode(s). Conclusions Different factors associated with suicide were identified among people with mental and physical illness and those with and without a diagnosis, and need to be taken into account in suicide prevention. The identified factors highlight the importance of integrated care for dual-diagnosis presentations, restricting access to means, and early recognition and intervention for people with high-risk self-harm. Keywords Suicide · Self-harm · Psychological autopsy · Mental health · Physical health
Introduction
* Ella Arensman [email protected] 1
Department of Child and Adolescent Psychiatry, North Lee North, Unit 9, St Stephen’s Hospital, Glanmire, Cork, Ireland
2
Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
3
School of Public Health, College of Medicine and Health, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
4
National Suicide Research Foundation, University College Cork, Cork, Ireland
5
St. Patrick’s Mental Health Services, Cork, Ireland
Suicide is a major public health problem worldwide, and is responsible for approximately 800,000 deaths every year [1]. The importance of suicide prevention is highlighted by the United Nations Sustainable Development Goals for 2030, which includes a target of reducing by one-third premature mortality from non-communicable diseases, with suicide mortality rate identified as an indicat
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