Homeless shelter contacts and suicide risk: a critical window for intervention

Abstract

Homelessness has long been associated with an elevated risk of suicide and self-harm, but previous studies have largely been restricted to selected patient groups, such as those presenting to hospital following self-harm. A new nationwide, population-based study by Sandra F Nilsson and colleagues¹ contributes substantially to the existing body of knowledge on the association between homelessness and suicidal behaviour. Applying a strong registry-based, cohort study design, the authors show markedly elevated risks of both suicide and self-harm among people experiencing homelessness in Denmark compared with the general population. The authors find that 1·3% of male individuals experiencing homelessness and 0·9% of female individuals experiencing homelessness died by suicide within 10 years, with suicide mortality rates 8 times higher for males and 15 times higher for females than in the general population. Nearly 10% of people experiencing homelessness had self-harmed, reflecting a 6-fold increased risk over the same period compared with the general population. In addition, the study shows that the risk of suicide and self-harm was especially high shortly after shelter contact and among individuals with frequent shelter use.