Summary

A consecutive sample of 302 individuals who had made medically serious suicide attempts was followed for two and a half years after the index attempt, with personal interviews at six, 18, and 30 months. During the follow-up period, mortality and psychiatric morbidity were high and measures of psychosocial functioning indicated a range of long-term adverse outcomes. Within 30 months of the index suicide attempt, 19 (6.7%) people died, 51.7% made at least one further suicide attempt, and 44.4% were admitted at least once to a psychiatric hospital or residential drug treatment center. There was evidence of enduring psychiatric morbidity: 46.1% of the sample met DSM-III-R criteria for major depression at the time of at least one of the three follow-up interviews. In addition, 40.1% of the sample met DSM-III-R criteria for substance-use disorder during the follow-up period. Those who made serious suicide attempts experienced high and enduring levels of a range of difficulties during the 30 months after such attempts: 58.7% reported relationship problems; 29.5% faced legal charges; 8.9% had at least one term of imprisonment; and 72.8% were social welfare beneficiaries at the time of at least one of the three follow-up interviews. It is concluded that those who make medically serious suicide attempts are a group at high and enduring risk for a range of adverse outcomes. The needs for care for this group which are implied by these outcomes are examined.

Introduction

Suicidal behavior is a significant medical, public health and mental health problem in New Zealand, just as it is in many countries (Diekstra & Gulbinat, 1993; La Vecchia, Ludhina & Levi, 1994; New Zealand Health Information Service, 1997; World Health Organization, 1992).