Services Analysis Platform

From a public health perspective, there are 4 determinants of health problems: genetics, environment, behaviors/lifestyles and services. Are current Québec polices on health services appropriate to intervene in mood and substance disorders and suicidal behaviour? Our Réseau is tackling this question by developing a comprehensive database on health service utilization comprising two sections: one focusing on suicide completers and the other one on attempters. 

 Instead of painstakingly collecting service utilization from consecutive suicide cases, administrative databases may be exploited. Therefore, for the section of the Health Services Platform focusing on suicide, our Réseau has established a collaboration with Québec’s chronic diseases, trauma and determinants unit of the INSPQ to gain access to data going back to 1996, which is updated yearly and for all chronic diseases, including mental and substance disorders, mortality and utilization of services. In collaboration with the Québec Coroner’s Office, the feasibility of developing a registry of previous years’ services utilization of all suicide cases in one year has been successfully tested by the INSPQ with the Réseau’s expertise. The production of a registry available to researchers is under development.

 As addiction services databases are not currently linked with the INSPQ’s databases, we have now partnered with Centre Dollard-Cormier – Institut universitaire sur les dépendances (CD-IUD) and with the Réseau Recherche et intervention sur les substances psychoactives – Québec (RISQ) to eventually link their databases with the Services Analysis Platform database we are developing. A preliminary database from Dollard-Cormier’s 1-year 8000 clients has been linked to Québec’s health administrative databases during collaboration with A Lesage. Dr. Fleury and RISQ researchers have also engaged separately with the INSPQ to examine addiction disorders in health administrative databases.

 The other section of this Platform focuses on suicide attempters. Currently, data on attempted suicide are very limited by sample size and/or quality. Our Réseau is constructing a cohort of suicide attempters seen in hospital settings, including demographic characteristics, type of attempt, treatment received, risk of one and two-year mortality and rate of health services use pre- and post-attempt. Such information on the epidemiology of attempted suicide is currently very scarce. We have assembled data on 600 attempters to date from three hospitals in Montréal and are planning to expand it to include community hospitals serving urban and rural areas. Our Suicide Attempt Cohort is the first large cohort to provide detailed information on suicide attempts and will be of tremendous importance to inform strategies aimed at decreasing the risk of suicide and its burden on the patient, families, health care system and society.