What characterizes those who die by suicide without having received psychiatric care?

About half of all individuals who die by suicide have never been in contact with the psychiatric system. This study examines the characteristics of these individuals and compares them with two groups: (a) people with a psychiatric diagnosis and (b) the general population.

Register data from all Danes aged 15 and older during the period 2010–2021 were assessed. Among 7,119 people who died by suicide, 3,474 (48.8%) had not received hospital-based psychiatric treatment. Psychiatric care includes a registered contact with inpatient- or outpatient care, or attendance at a psychiatric emergency department.

Compared to the psychiatric control group, those without psychiatric contact were more likely to be men, older, recently retired, and grieving the loss of a partner or first-degree relative. Compared to the general population, those who had not sought psychiatric care before suicide were more likely to be men, living alone, unemployed, grieving the loss of a partner or first-degree relative, or recently divorced.

Nearly half of those who die by suicide have not had contact with psychiatric services. Men, older individuals, and those who recently experienced major life stressors (e.g., divorce or bereavement) are particularly vulnerable. The findings highlight the need for broader and more proactive suicide prevention efforts – including outside the psychiatric system.

Published in Journal of Affective Disorders.