Vol.:(0123456789) 1 3 Social Psychiatry and Psychiatric Epidemiology https://doi.org/10.1007/s00127-020-01911-y ORIGINAL PAPER The mental and physical health profle of people who died by suicide: fndings from the Suicide Support and Information System Daniel Leahy 1  · Celine Larkin 2  · Dorothy Leahy 3,4  · Carmel McAulife 5  · Paul Corcoran 3,4  · Eileen Williamson 4  · Ella Arensman 3,4 Received: 24 May 2019 / Accepted: 30 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Purpose There is limited research on the associations between factors relating to mental and physical health in people who died by suicide. Methods Consecutive suicide cases were included in a psychological autopsy study as part of the Suicide Support and Infor- mation System in southern Ireland. Chi-square tests and logistic regression analysis were used to examine factors associated with recorded presence or absence of mental and physical health problems. Results The total sample comprised 307 suicide cases, the majority being male (80.1%). Sixty-fve percent had a history of self-harm and 34.6% of these cases had not been seen or treated following previous self-harm, although most (80.3%) had a history of recent GP attendance. Mental health diagnoses were present in 84.8% of cases where this variable was documented, and among these, 60.7% had a history of substance misuse and 30.6% had physical health problems. Variables associated with mental illness included gender, older age, previous self-harm episode(s), and presence of drugs in toxicology at time of death. Variables associated with physical illness included older age, death by means other than hanging, and previous self-harm episode(s). Conclusions Diferent factors associated with suicide were identifed among people with mental and physical illness and those with and without a diagnosis, and need to be taken into account in suicide prevention. The identifed factors highlight the importance of integrated care for dual-diagnosis presentations, restricting access to means, and early recognition and intervention for people with high-risk self-harm. Keywords Suicide · Self-harm · Psychological autopsy · Mental health · Physical health Introduction Suicide is a major public health problem worldwide, and is responsible for approximately 800,000 deaths every year [1]. The importance of suicide prevention is highlighted by the United Nations Sustainable Development Goals for 2030, which includes a target of reducing by one-third premature mortality from non-communicable diseases, with suicide mortality rate identifed as an indicator for this target [2]. International research has identifed a number of factors that are strongly associated with suicide [3], in particular the presence of psychopathology. Psychological autopsy stud- ies have indicated that approximately 90% of people who die by suicide had an identifable mental health diagnosis [4]. Unipolar depression and bipolar afective disorder are especially common diagnoses: estimates of their prevalence in suicide cases range from 23 to 76% [3, 5, 6]. Often, more * Ella Arensman ella.arensman@ucc.ie 1 Department of Child and Adolescent Psychiatry, North Lee North, Unit 9, St Stephen’s Hospital, Glanmire, Cork, Ireland 2 Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA 3 School of Public Health, College of Medicine and Health, University College Cork, 4.28 Western Gateway Building, Cork, Ireland 4 National Suicide Research Foundation, University College Cork, Cork, Ireland 5 St. Patrick’s Mental Health Services, Cork, Ireland