Patterns of treatment utilization before suicide among male veterans with substance use disorders

We sought to describe the extent and nature of contact with the health care system before suicide among veterans with substance use disorders (SUDs). We examined all male Veterans Health Administration patients who died by suicide between October 1, 1999, and September 30, 2007, and who had a documented SUD diagnosis during the 2 years before death (n = 3132). Over half (55.5%; n = 1740) of the male patients were seen during the month before suicide, and 25.4% (n = 796) were seen during the week before suicide. In examining those with a medical visit in the year before suicide (n = 2964), most of the last visits before suicide (56.6%; n = 1679) were in a general medical setting, 32.8% (n = 973) were in a specialty mental health setting, and 10.5% (n = 312) were in SUD treatment. Men with SUDs who died from suicide were frequently seen in the month before their death. Most were last seen in general medical settings, although a substantial minority of those with SUDs was seen in specialty mental health settings.