Vast majority who died by suicide had contacted GP in the preceding year, research shows

Those who had died by suicide were more likely to have had a psychological reason for their last consultation with a GP, the study found.

New research shows the vast majority of people who died by suicide had contacted a GP in the previous year, with almost a quarter visiting a doctor at least 10 times, while half had a history of self-harm.

The findings are contained in a new study which analyses coroner's records in 132 suicide cases in Cork city and county between June 2014 and September 2017.

A team led by Elaine McMahon of the National Suicide Research Foundation and the School of Public Health, University College Cork, examined the 132 consecutive cases of suicide drawn from coronial files, while interviews were carried out with 35 family informants, and GPs completed questionnaires for 60 suicide cases. 

Information was then gathered and compared with a control group on a range of adverse life events, substance use, and stressors.

According to the research data: "The age range of the suicide cases was 15 to 83, with a mean age of 43 years. Of the suicide cases, 110 (83.3%) were male and 117 (88.6%) were of Irish nationality. Over half (53.8%) were single, while 28.8% were married or cohabiting. 

"The most common living arrangements among the suicide decedents were living alone (26.5%), followed by living with partner/spouse and children (14.4%). Of the suicide cases, 31.8% were in paid employment and 29.5% were unemployed."

The comparisons between the two groups showed that those who had died by suicide were significantly more likely to have a history of violent behaviour (45.7%) than the control group (22.6%) and were also significantly more likely to have experienced legal trouble (31.4% versus 11.3%).

It said:

Among suicide cases, a history of physical, sexual, or emotional abuse was reported for 40% of suicide cases, compared with 34% of controls. 

"Major financial difficulties were reported for 28.6% of suicide cases and 24.5% of controls. Of the suicide cases, 31.4% had a history of alcohol misuse, compared with 17.0% of control participants, while drug misuse was reported in 22.9% of suicide decedents and 9.4% of controls."

It said this highlighted a lack of documentation of alcohol problems and a need to reinforce positive attitudes among GPs regarding preventive work.

The study also found that 83.3% of those who had died by suicide had contacted a GP in the year prior to death, while 23.3% had 10 or more consultations during the year prior to death. Half of suicide decedents had a history of self-harm. Those visiting a GP were more likely to have had a psychological reason for their last consultation.

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There was also a higher incidence of psychiatric diagnosis and depressive illness among those who had died by suicide, with more than one-quarter having been treated as a psychiatric inpatient.

The research team concluded that those who had died by suicide were predominantly male and were more likely than the control group to be single, living alone, and unemployed. 

"Half of suicide decedents in our study had a history of self-harm of which their GP was aware, highlighting opportunities for timely intervention and highlighting the importance of the therapeutic alliance between GP and patient. People who present very frequently to primary care are a target for multidisciplinary intervention."

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