Death by suicide among aged care recipients in Australia 2008-2017

Objective:To characterize the features of aged care users who died by suicide and examine the use of mental health services and psychopharmacotherapy in the year before death. Design:Population-based, retrospective exploratory study Setting and participants:Individuals who died while accessing or waiting for permanent residential aged care (PRAC) or home care packages in Australia between 2008 and 2017. Measurements:Linked datasets describing aged care use, date and cause of death, health care use, medication use, and state-based hospital data collections. Results:Of 532,507 people who died, 354 (0.07%) died by suicide, including 81 receiving a home care package (0.17% of all home care package deaths), 129 in PRAC (0.03% of all deaths in PRAC), and 144 approved for but awaiting care (0.23% of all deaths while awaiting care). Factors associated with death by suicide compared to death by another cause were male sex, having a mental health condition, not having dementia, less frailty, and a hospitalization for self-injury in the year before death. Among those who were awaiting care, being born outside Australia, living alone, and not having a carer were associated with death by suicide. Those who died by suicide more often accessed Government-subsidized mental health services in the year before their death than those who died by another cause. Conclusions:Older men, those with diagnosed mental health conditions, those living alone and without an informal carer, and those hospitalized for self-injury are key targets for suicide prevention efforts.