Mallon Sharon, Galway Karen, Rondon-Sulbaran Janeet, Hughes Lynette, Leavey Gerry
Faculty of Wellbeing, Education and Language Studies, Open University, Milton Keynes, Bucks, UK.
School of Nursing, Queen's University, Belfast, UK.
Prim Health Care Res Dev. 2019 Jun 11;20:e80. doi: 10.1017/S1463423619000057.
To investigate cases of suicide in which there was no healthcare contact, by looking at history of help-seeking and evidence of previous mental health vulnerability. To identify any life events associated with suicide for which individuals did not seek help.
Previous research has suggested that non-consultation is the main barrier to suicide prevention among men. Estimates suggest approximately 22% of men who die by suicide have not consulted their GP in the year before their death. Little is known about the lifetime pattern of engagement with services among these individuals and whether or not this may influence their help-seeking behaviour before death.
Coroner records of suicide deaths in Northern Ireland over 2 years were linked to general practice (GP) records. This identified 63 individuals who had not attended health services in the 12 months before death. Coroner's data were used to categorise life events associated with the male deaths. Lifetime mental health help-seeking at the GP was assessed.
The vast majority of individuals who did not seek help were males (n=60, 15% of all suicide deaths). Lack of consultation in the year before suicide was consistent with behaviour over the lifespan; over two-thirds had no previous consultations for mental health. In Coroner's records, suicides with no prior consultation were primarily linked to relationship breakdown and job loss. These findings highlight the limitations of primary care in suicide prevention as most had never attended GP for mental health issues and there was a high rate of supported consultation among those who had previously sought help. Public health campaigns that promote service use among vulnerable groups at times of crisis might usefully be targeted at those likely to be experiencing financial and relationship issues.
通过研究求助史和既往心理健康易损性证据，调查未与医疗保健机构接触的自杀案例。识别与自杀相关但个人未寻求帮助的任何生活事件。
先前的研究表明，不咨询是男性自杀预防的主要障碍。据估计，约22%自杀死亡的男性在死前一年未咨询过全科医生。对于这些人一生中与服务机构接触的模式以及这是否可能影响他们死前的求助行为，人们知之甚少。
将北爱尔兰两年内自杀死亡的验尸官记录与全科医疗（GP）记录相链接。这确定了63名在死前12个月未就诊于医疗服务机构的个体。验尸官的数据用于对与男性死亡相关的生活事件进行分类。评估了一生中在全科医生处寻求心理健康帮助的情况。
绝大多数未寻求帮助的个体为男性（n = 60，占所有自杀死亡人数的15%）。自杀前一年未咨询与一生的行为一致；超过三分之二的人以前从未因心理健康问题咨询过。在验尸官记录中，未事先咨询的自杀主要与关系破裂和失业有关。这些发现凸显了初级保健在自杀预防方面的局限性，因为大多数人从未因心理健康问题就诊于全科医生，而且在那些以前寻求过帮助的人中，得到支持的咨询率很高。在危机时刻促进弱势群体使用服务的公共卫生运动可能有效地针对那些可能正在经历财务和关系问题的人。
