Recent GP consultation before death by suicide in middle-aged men: a national consecutive case series study

Background: Reducing suicide risk in middle-aged men (40-54) is a national priority. People have often presented to their GP within three months before suicide thus highlighting an opportunity for early intervention. Aim: To describe the sociodemographic characteristics and identify antecedents in middle-aged men who recently consulted a GP before dying by suicide. Methods: This study was a descriptive examination of suicide in a national consecutive sample of middle-aged men in 2017 in England, Scotland, and Wales. We obtained general population mortality data from the Office for National Statistics and National Records for Scotland. We collected information about antecedents considered relevant to suicide from data sources. Logistic regression examined associations with final recent GP consultation. We consulted men with lived experience during the study. Results: In 2017, a quarter (n=1516) of all suicide deaths were in middle-aged men. Data were attained on 242 men: 43% had their last GP consultation within three months of suicide; and a third of these men were unemployed and nearly half were living alone. Men who saw a GP recently before suicide were more likely to have had recent self-harm and work-related problems then men who hadn’t. Having a current major physical illness, recent self-harm, presenting with a mental health problem, and recent work-related issues was associated with having a last GP consultation close to suicide. Conclusion: We identified clinical factors that GPs should be alert to when assessing middle-aged men. Personalised holistic management may have a role in preventing suicide in these individuals.