Perfil clínico-forense y vinculación con salud mental en muertes por suicidio en Lleida (2019–2024)

Abstract

Introduction

Suicide is one of the leading causes of preventable mortality and represents a major public health priority.

Objective

To analyse the clinical–forensic profile of suicide and their engagement with mental healthcare.

Materials and methods

A retrospective observational study was conducted on suicide deaths registered in Lleida between 2019 and 2024. A total of 189 autopsy reports and corresponding medical records from the public healthcare system were reviewed. Sociodemographic, temporal and spatial variables, suicide methods, toxicological results, and mental healthcare-related variables and activation of the Suicide Risk Code (CRS) were analysed. Descriptive and bivariate analysis were performed using Fisher's exact test.

Results

Most decedents were male (73.5%), with a mean age of 54.1 years (SD 17.8). The most common method of suicide was hanging (47.1%), followed by jumping from height (22.2%). Most suicides occurred at home (71.9%). Although 67.2% of relatives reported a history of psychiatric disorders, only 36.5% were clinically documented. Only 18% were engaged with mental healthcare, and 10.6% had an activated CRS. Medical risk factors were present in 25.9% of cases. Significant differences were observed by sex in mental health engagement (p = 0.013) and by age in medical comorbidity (p = 0.024).

Conclusions

Clinical-forensic profile is characterised by middle-aged and older males with low engagement with mental healthcare, and a high prevalence of medical illness. These findings highlight deficits in early detection and continuity of care and support the need for integrated preventive strategies involving mental health services, primary care, and community-based resources.