Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
BMJ Open. 2024 Oct 4;14(10):e086487. doi: 10.1136/bmjopen-2024-086487.
The objectives of this study are as follows: (1) to estimate the prevalence of suicide risk among individuals seeking mental health and addiction (MHA) services in Nova Scotia; (2) to examine the relationship between substance use and suicide risk among this population.
MHA intake programme, a province-wide centralised intake process established in 2019 by the Department of Health and Wellness of Nova Scotia.
We included 22 500 MHA intake clients aged 19-64 years old who contacted MHA intake from 2020 to 2021.
During the intake assessment, clients were assessed for suicide risk (past suicide attempt, suicidal ideation during the interview or 2 weeks before the interview).
The lifetime prevalence of suicide attempt was 25.25% in the MHA clients. The prevalence of mild and moderate/high suicide risk was 34.14% and 4.08%, respectively. Clients who used hallucinogens had the highest prevalence of mild and moderate/high suicide risk (61.3% and 12.9%, respectively), followed by amphetamine/methamphetamine (47.6% and 13.3%, respectively) and sedative/hypnotics (47.2% and 8.9%, respectively) users. Stimulant (aOR=1.84, 95% CI 1.23 to 2.75) and hallucinogen (aOR=3.54, 95% CI 1.96 to 6.43) use were associated with increased odds of moderate/high suicide risk compared with denying current use. Additionally, alcohol (aOR=1.17, 95% CI 1.06 to 1.30) and tobacco (aOR=1.20, 95% CI 1.10 to 1.30) use were associated with increased odds of mild suicide risk.
Suicide behaviours were prevalent among clients seeking MHA services. Substance use is an important factor associated with suicide risk in this population. This result underscored the importance of considering substance use patterns when assessing suicide risk and highlighted the need for targeted interventions and preventive measures for individuals engaging in substance use. Future interventional studies are needed to identify and evaluate effective strategies for reducing substance use and suicide risk among clients of MHA central intake.
本研究的目的如下：(1) 估计在新斯科舍省寻求心理健康和成瘾治疗（MHA）服务的个体中自杀风险的流行情况；(2) 研究该人群中物质使用与自杀风险之间的关系。
MHA 摄入量计划，这是一个由新斯科舍省卫生和福利部于 2019 年设立的全省集中摄入程序。
我们纳入了 22500 名年龄在 19-64 岁之间的 MHA 摄入量客户，他们在 2020 年至 2021 年期间通过 MHA 摄入量联系。
在摄入评估期间，对客户进行自杀风险评估（过去自杀企图、访谈期间或访谈前两周的自杀意念）。
MHA 客户的终生自杀企图发生率为 25.25%。轻度和中度/高度自杀风险的发生率分别为 34.14%和 4.08%。使用致幻剂的客户具有最高的轻度和中度/高度自杀风险发生率（分别为 61.3%和 12.9%），其次是安非他命/甲基苯丙胺（分别为 47.6%和 13.3%）和镇静/催眠药（分别为 47.2%和 8.9%）使用者。与否认当前使用相比，兴奋剂（aOR=1.84，95%CI 1.23-2.75）和致幻剂（aOR=3.54，95%CI 1.96-6.43）的使用与中度/高度自杀风险的几率增加有关。此外，酒精（aOR=1.17，95%CI 1.06-1.30）和烟草（aOR=1.20，95%CI 1.10-1.30）的使用与轻度自杀风险几率增加有关。
自杀行为在寻求 MHA 服务的客户中很常见。物质使用是该人群自杀风险的一个重要因素。这一结果强调了在评估自杀风险时考虑物质使用模式的重要性，并突出了针对参与物质使用的个体进行有针对性的干预和预防措施的必要性。需要进行未来的干预研究，以确定和评估减少 MHA 集中摄入客户物质使用和自杀风险的有效策略。
