Contact patterns in health care before and after first registered suicide attempt or self-harm: A nationwide register...

This study aimed to identify possible missed opportunities for suicide prevention by investigating health care utilization two years before and after the first recorded suicide attempt or self-harm (SA/SH). The SA/SH group was identified in 2010-2021 and was matched 1:10 with a reference group using risk set sampling on sex, birth year, and time of SA/SH diagnosis. Incidence rates for contacts to general practitioner, somatic hospital, or psychiatric hospital were estimated within quarters (i.e. three-month intervals). Negative binomial regression was used to determine incidence rate ratios for contact patterns in the SA/SH group compared to the two years prior to their first event. Underlying causes for health care contacts were also examined. The SA/SH group included 29,439 individuals. Contact to health care facilities changed markedly in the three months before SA/SH. The underlying causes for these encounters were often related to poisoning, injuries, abnormal or unspecific causes influencing health status, or neurotic, stress-related and somatoform disorders. This study provides health care professionals with useful insight into changing health care contact patterns among individuals with SA/SH.