Characteristics of deaths by suicide in Northern Ireland from 2005 to 2011 and use of health services prior to death

Background
Service presentation may offer an opportunity for intervention prior to suicide. The study aimed to examine the characteristics, disorders and service use profiles of those who had died by suicide in Northern Ireland (NI) from 2005 to 2011.

Methods
An analysis of a database of deaths by suicide and undetermined intent based on data in the NI Coronial files from 2005 to 2011 (N=1667).

Results
Males are three times as likely to die by suicide as females and suicide rates similar among those aged 20–60 years. Females have increased service use prior to suicide; males tend to disengage with services prior to death. Females are more likely to have recorded prior attempts, service use, diagnosis and referral. The most common health service used was primary care.

Limitations
Despite the inclusion of undetermined deaths (probable suicides) a proportion of deaths by suicide remain unrecorded as such. Data on marital status and mental and physical disorders were based on information recorded by police officers from relatives, other informants and medical records. The reliability of this data may therefore be questioned.

Conclusions
Primary care has an important role in suicide prevention. Gendered patterns in service use prior to death should be considered in suicide prevention programmes. It is important to strengthen clinicians׳ knowledge of the manifestations of suicidal ideation in males and ways of encouraging service use in males. The NI population who were exposed to the height of the violence of the conflict appear to be at increased risk of suicide as they age.