Service Use in the Month and Year Prior to Suicide Among Adults Enrolled in Ohio Medicaid

Objectives:The purpose of this study was to inform suicide prevention efforts by estimating the incidence of suicide among adult Medicaid enrollees and describing clinical profiles and service utilization patterns among decedents.Methods:Death certificate data for adults (N=1,338) ages 19 to 65 who died by suicide between January 1, 2008, and December 31, 2013, were linked with Ohio Medicaid data.Results:The suicide rate was 18.9 deaths per 100,000 Ohio Medicaid enrollees. Most decedents (83%) made a general medical or mental health visit within one year of suicide, with 50% doing so within 30 days and 27% within one week before death. In the year before suicide, the median number of visits was 16, indicating a subgroup with intensive service utilization. Decedents whose visits were proximal to suicide (within 30 days) rather than distal (31–365 days) were more likely to have individual and co-occurring behavioral and general medical conditions and to be Medicaid eligible through disability. In the year b...