Suicide preceded by health services contact - A whole-of-population study in New Zealand 2013-2015

PLoS One. 2021 Dec 20;16(12):e0261163. doi: 10.1371/journal.pone.0261163. eCollection 2021.

Abstract

New Zealand's rate of suicide persistently exceeds the global average. The burden of suicide in New Zealand is disproportionately borne by youth, males and Māori (NZ indigenous people). While the demographic characteristics of suicide decedents are established, there is a need to identify potential points of contact with health services where preventative action could take place. This paper aims to determine if suicide deaths in New Zealand were likely to be preceded by contact with health services, and the type and time frame in which these contacts took place. This study utilised a whole-of-population-cohort of all individuals age 15 years and over, who were alive on March 5th 2013, followed up to December 2015. Associations between the odds of suicide, demographic factors, area-based deprivation, and the timing of last contact with primary, secondary, and tertiary services were analysed using univariate and multivariate logistic regression. Contact with a health service in the 6 Months prior to death was associated with the highest odds of suicide. Over half of the suicide decedent population (59.4%) had contacted primary health services during this period. Large proportions of the suicide decedent population contacted secondary and tertiary services in the 6 Months prior to death, 46.5% and 30.4% respectively. Contact with primary, secondary and tertiary services in the prior 6 Months, were associated with an increased odds of suicide of 2.51 times [95% CI 2.19-2.88], 4.45 times [95% CI 3.69-4.66] and 6.57 times [95% CI 5.84-7.38], respectively, compared to those who had no health services contact.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • New Zealand
  • Patient Acceptance of Health Care*
  • Suicide / statistics & numerical data*
  • Suicide / trends*
  • Time Factors
  • Young Adult

Grants and funding

This work was supported by the Health Research Council of New Zealand. Grant Number:13/428 – Exeter: Delivering a new measure of neighbourhood disadvantage for New Zealand. Funder: Health Research Council of New Zealand. https://www.hrc.govt.nz/ The funder did not play any role in the study design, data collection, analysis, decision to publish or preparation of the manuscript. AC was supported by The Kate Edger Educational Charitable Trust Masters Degree Award. Funder: The Kate Edger Educational Charitable Trust. https://www.kateedgertrust-suffrage125.nz/ The funder did not play any role in the study design, data collection, analysis, decision to publish or preparation of the manuscript. Though if the original wording is required PLOS One publication standards, then we would be happy for this to remain the unchanged.