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Health Care Service Utilization Before Suicide Among Young Black Individuals: A National Case-Control Study
Cynthia A Fontanella1,2, Xueting Xia1, Danielle L Steelesmith1,2
1Center for Suicide Prevention and Research at Nationwide Children's Hospital, Columbus, OH.
Psychiatric Services (Washington, D.C.)
|May 20, 2026
Summary
Black youth suicide is rising. Those who died by suicide used more mental health and general medical services compared to peers. Healthcare settings are key for suicide prevention in this group.
Area of Science:
- Public Health
- Epidemiology
- Mental Health Services Research
Background:
- Suicide is a significant public health concern, particularly among Black youth, who have experienced a rapid increase in rates.
- Understanding healthcare utilization patterns among Black youth who die by suicide is crucial for developing effective prevention strategies.
Purpose of the Study:
- To compare general medical and mental health service utilization between Black youth suicide decedents and matched nondecedents.
- To identify patterns of healthcare engagement preceding suicide in a vulnerable population.
Main Methods:
- A population-based case-control study utilizing national Medicaid data from 2010-2019.
- Analysis of healthcare service use at 1, 6, and 12 months prior to death for 875 Black youth suicide decedents and 8,750 matched nondecedents with a lifetime behavioral diagnosis.
Main Results:
- Suicide decedents had higher rates of mental health and general medical service utilization across all analyzed time points compared to nondecedents.
- Inpatient and emergency mental health visits within one year of death showed the strongest association with suicide risk.
- Decedents were more likely to have had multiple mental health visits, with outpatient mental health being the most common final contact.
Conclusions:
- Black youth who died by suicide were more likely to have accessed both mental health and acute general medical care.
- Healthcare settings play a vital role in identifying suicide risk and implementing preventive interventions for Black youth.
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