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

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.