Suicide-related service presentations following residential treatment for substance use disorders: a data linkage study

Background: Individuals seeking alcohol and other drug (AOD) treatment consistently experience higher rates of suicidal behaviours and death by suicide when compared to the general population. By linking residential AOD treatment data to administrative healthcare and death datasets, we aimed to examine suicide-related behaviours and identify risk and protective factors for these events following discharge from residential treatment.

Methods: Participants included 1056 individuals aged 18-69 (M=32.06, SD=9.55, male=696,65.9%) admitted to three residential treatment facilities in Queensland, Australia from January 1 2014 to December 31 2016. Treatment data was linked to administrative hospital, emergency department (ED), mental health service, and Registry of Deaths data 2-years post-discharge. ICD-10 codes were used to identify suicide-related events. The Anderson-Gill cox regression model with time to event was used to analyse recurrent events of suicidal behaviour.

Results: Within 2-years post-discharge, 175 (16.6%) individuals had a suicide-related event (n=298 episodes). The highest proportion of episodes (11.1%) occurred within 1-month of discharge. Higher risk of a recurrent suicide-related event was associated with receiving a Disability Support Pension (aHR=1.69 (95%CI:1.10,2.59), two or more previous episodes of residential AOD treatment (aHR=1.49 (95%CI:1.30,2.15). Completing residential treatment was associated with a lower risk of suicide-related events (aHR=0.54 (95%CI:0.35,0.83).

Conclusions: Suicide-related events among this population were common after leaving treatment, consistent with previous research. Understanding suicidal behaviours and critical risk periods following discharge from residential treatment is crucial for improving continuing care, developing effective suicide prevention, and implementing targeted interventions among this high-risk population.