One in five of the 1,540 people who attended A&E in the three months prior to taking their own lives died within two days of leaving hospital, new figures show.
More than a quarter (30%) of the 5,826 people who died by suicide between 2011 and 2017 in Scotland went to A&E in the three months before their death.
Of these 1,540 people more than a third (36%) – 560 – died within a week of leaving A&E, according to the latest Scottish national statistics on suicide deaths.
Just under one in five people (19%) – 290 – died within two days of leaving A&E and 270 people (18%) died later that week.
The study suggested general health services are filling a gap between psychiatric need and supply but stressed the difficulty of accurately predicting suicide risk.
Nearly three-quarters (73%) of the people who died by suicide in the five-year period either attended hospital, had contact with drug services or were prescribed a mental health drug in the community in the year before their deaths.
Most had no contact with specialised mental health services in the 12 months before they died but 24% were offered a psychiatric outpatient appointment and 13% had been discharged from psychiatric inpatient care.
The report states: “These findings might raise concerns about a possible shortfall between the mental health needs of high risk individuals and the supply of services that meet those needs.
“It is therefore highly likely that some of the shortfall between psychiatric need and supply was filled by a wider range of more generic, non-specialist services.
“Nonetheless, there appears to be a sizeable minority of the ‘at risk’ population who are not in contact with healthcare services prior to death but who have unmet mental health (and other) needs.
“In responding to the finding of a high prevalence of contact with services… health service planners will want to consider possible improvements to the organisation, reach and delivery of services targeted at groups at high risk of suicide, while healthcare providers will want to consider improvements to the identification, engagement and effective treatment of individuals at high risk.
“However, it is important to be realistic about the challenges of assessing suicidality.”
People living in Scotland’s most deprived areas were around three times more likely to take their own lives than those in the most affluent.
The report said this shows the importance of addressing suicide as an “issue of equity, as well as of mental health” and the need for government intervention on inequality.
The need for action by employers was also highlighted, as two thirds (67%) of people were employed at the time of their death.
The majority (73%) of people across Scotland who took their own lives between 2011 and 2017 were men, and almost half of all people who died by suicide in this period were aged 35-54 at the time.
The suicide rate was of 14 people per 100,000.
Rose Fitzpatrick, chair of the Scottish Government’s National Suicide Prevention Leadership Group, said: “Every suicide is a tragedy, and suicide prevention is everybody’s business.
“I welcome this report, which will make a significant contribution to informing the actions we need to take to further prevent deaths by suicide.
“The Scottish suicide rate fell by 20% between 2002-06 and 2013-17, and we are committed to reducing this by another 20% over the next four years.”
She said her group will publish their delivery plan on the Scottish Government’s suicide prevention action plan later this month to “act to prevent suicides and save lives.”
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