More than 80 per cent of youth who die by suicide had some form of contact with the health care system in the year before their death, according to a new study from St. Michael's Hospital.
"This suggests there are a lot of opportunities for prevention," said Dr. Anne Rhodes, a research scientist at the hospital's Suicide Studies Research Unit. "Most of these youth were seen by an outpatient physician or went to an emergency department where they could have potentially benefited from an intervention."
Among those seen by an outpatient physician, half of young men and 67.5 per cent of young women were there for mental health-related reasons.
"Since not all were seen for mental health reasons, the potential benefits of screening and preventative interventions in these settings are underrated," the authors wrote.
The study looked at data from 724 youth aged 10 to 25 years living in Ontario who died by suicide between April 2003 and December 2007. Dr. Rhodes and colleagues looked at who among these youth had an outpatient physician visit, emergency department visit or inpatient stay in the year prior to their death and how the results differ by sex.
The paper appeared in the Canadian Journal of Psychiatry today.
The study found that young women had more outpatient physician and emergency department contact than young men, and visits were closer to their time of death.
"We suspect that, in general, female youth are more likely than male youth to have their mental health problems detected and acted on when they present to the emergency department," Dr. Rhodes said. "This pattern was suggested in our sample of youth."
She noted that the emergency department may be an underused site for suicide prevention, given that high-risk groups may be more prevalent and therefore can be more efficiently detected than in other settings.
"The role of the health care system in caring for these vulnerable youth is especially important because given their age, many may no longer be in school and therefore, would not benefit from school-led interventions."
She said it will be important in future studies to confirm whether a higher risk of suicide in boys, compared to girls, is mediated by the use of effective interventions.
Data from the Institute for Clinical Evaluative Sciences was used.