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Characteristics of suicides in recent contact with NHS Direct

  • Michael Bessant (a1), Elizabeth A. King and Robert Peveler (a2)
Abstract
Aims and Method

NHS Direct is increasingly used as a first source of health advice and information, receiving an average of 600 000 calls per month. We performed an audit of suicides in Hampshire and the Isle of Wight over a 2-year period to determine the characteristics of those who died by suicide and had been in recent contact with NHS Direct.

Results

Of 278 suicides resident in Hampshire and the Isle of Wight, 30 (10.8%) had contacted NHS Direct in the preceding year. Of the 30 callers within the preceding year, 12 (40%) made multiple calls, 7 (23%) called within 2 weeks of death, 9 (30%) callers reported mental health problems, 17 (57%) reported physical problems, and 4 (13%) just requested information. Eighteen (60%) calls resulted in urgent medical referral, 17 to a general practitioner and 1 to accident and emergency.

Clinical Implications

The high incidence of physical, often pain-related, problems merits further investigation.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Department of Health (2002) National Suicide Prevention Strategy for England. Department of Health.
Hansard (2005) House of Commons Hansard Written Answers for 5 Oct 2005 (http://www.publications.parliament.uk/pa/cm200506/cmhansrd/vo051005/index/51005-x.htm).
Isometsa, E., Heikkinen, M., Marttunen, M., et al (1995) The last appointment before suicide: is suicide intent communicated? American Journal of Psychiatry, 152, 919922.
Luoma, J., Martin, C. & Pearson, J. (2002) Contact with mental health and primary care providers before suicide: a review of the evidence. American Journal of Psychiatry, 159, 909916.
NHS Direct (2005) Executive Summary. Quarterly Performance Report (reference O6B.005) (http://www.nhsdirect.nhs.uk).
World Health Organization (1977) Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death (9th revision) (ICD–9). WHO.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Characteristics of suicides in recent contact with NHS Direct

  • Michael Bessant (a1), Elizabeth A. King and Robert Peveler (a2)
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eLetters

Characteristics of suicides in recent contact with NHS Direct

MEGAN T THEODOULOU, Consultant Old Age Psychiatrist
04 April 2008

We read with interest the article by Bessant et al (Psychiatric Bulletin March 2008, 32, 92-95) in which they reported that, of suicides who contacted NHS Direct in previous year, over half reported physical complaints. There appears to be a higher age subset of patients with painful physical problems who are at high risk of suicide. This is indeeda neglected field of research.

We carried out a retrospective case note study of all deliberate selfharm (DSH) patients with concurrent medical problems admitted to a generalhospital after presenting to Accident and Emergency. We found pain to be a contributory factor in 4% of the cases. At 46, we also found the mean age of these patients to be older.

Sixty percent of the patients had experienced pain for over six months and also had a relatively high prevalence of previous psychiatric disorder. They had a significantly higher suicidal intent associated withtheir acts of DSH than those with non-painful physical problems.

We recommended closer collaboration between general hospital servicesand local pain clinics for deliberate self harm patients with painful disorders. Furthermore, we would encourage all clinicians to assess suicidal ideation and risk of self harm when prescribing for this population. This is particularly important when considering prescribing analgesics or tricyclic antidepressants.

Theodoulou M, Harriss L, Hawton K, Bass C.Pain and deliberate self-harm: an important association.J Psychosom Res. 2005 Apr;58(4):317-20

Yours Faithfully

Megan Theodoulou

Consultant Old Age PsychiatristOxfordshire and Buckinghamshire Mental Health NHS Foundation Trust

Christopher Bass

Consultant PsychiatristOxfordshire and Buckinghamshire Mental Health NHS Foundation Trust

Declaration of Interest: None
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Conflict of interest: None Declared

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