Recent Police Contact Signals Need for Suicide Assessment

Having contact with police, either as a victim or perpetrator of a crime, may be one of the risk factors for suicide, according to new findings from a study of suicides in northern England.

Almost as many suicide victims had police contact in the three months prior to their deaths as those who had contact with a psychiatrist or mental health professional in the year before their deaths, according to a study in the February British Journal of Psychiatry.

As part of the study, Neil Johnson, M.Sc., one of the study authors, identified residents of Durham and Darlington counties in northern England who had died of suicide between January 1999 and December 2001 by checking the mortality register and local coroner's office.

Johnson and colleagues then cross-referenced each of these cases with local police records, concentrating on those who had had police contact in the three months before their deaths.

The researchers found 205 probable suicide cases in the three-year period. Of those, 133 were definite suicides and 43 had open verdicts, meaning the deaths resulted from undetermined causes but likely could have been suicides (one man, for example, overdosed on antidepressants and alcohol).

Also included in the 205 probable suicides were 29 deaths ruled accidental by the coroner but that the researchers believe may have been suicides.

Of the 205 individuals who were believed to have committed suicide, in the three months prior to their deaths, 24 (12 percent) had contact with police as victims of crime and another 24 had been arrested for allegedly perpetrating a crime. Seven of those who committed suicide had been both a victim of crime and an alleged perpetrator of a crime in this three-month period. Because of that overlap, the total number of people who had been in contact with police before their deaths was 41.

The crimes that brought these people into police contact ranged from minor and nonviolent offenses such as trespassing to violent offenses such as assault.

Most of the suicides were by hanging or drug overdose, first author and psychiatrist Keith Linsley, M.B.B.S., told Psychiatric News. Among the 41 people who had had police contact within three months of their deaths, 17 had seen a general practitioner in the same period, and four of those patients had received an antidepressant or benzodiazepine. Three subjects had come to a local emergency room after harming themselves. In addition, 13 of the 41 received mental health treatment in the year prior to their suicides.

Linsley said that while the findings need to be replicated, they“ herald an important component for suicide prevention in a vulnerable group of people.”

He also suggested that while researchers could benefit by further understanding the link between police contact and suicide, psychiatrists and mental health professionals might consider working with police to develop a screening instrument for those who instigate or are victims of crime.

“Depending on the level of risk and mental distress of the individual,” Linsley said, “there would be tiered levels of response” on the part of psychiatrists or mental health professionals.

An abstract of “Police Contact Within Three Months of Suicide and Associated Health Service Contact” is posted at<http://bjp.rcpsych.org/cgi/content/abstract/190/2/170>.▪