The association between suicidal ideation with future suicide attempts and service utilization: a population cohort study in Ontario, Canada
Bibliographic record
Abstract
Abstract Background Few studies examine suicidal ideation and its relationship with suicide attempts and health service use using a community sample. Objective To examine the association between suicidal ideation with (i) future mental health service use, and (ii) future suicide attempts, in a general population sample. Methods Using the 2002 and 2012 Canadian Community Health Surveys – Mental Health cycles linked with health administrative data, this study followed 14,708 Ontarians 15 years and older in a retrospective cohort study to examine patterns of mental health service use within 1 year, and suicide attempts within 5 years of self-reported suicidal ideation. Results A total of 2.1% (n=302) of all survey respondents reported suicidal ideation alone in the past year and another 0.5% (n=76) reported having ideation-with-action (i.e. ideation with planning or previous suicide attempt). Ideation-with-action was associated with a higher likelihood of future suicide attempts and future mental health service use, when compared to suicidal ideation alone. However, the majority of survey respondents who attempted suicide within the five-year follow-up period did not report a previous attempt or ideation at baseline. Conclusion While suicidal ideation is statistically significantly associated with greater likelihood of suicide attempt within five years, most attempters did not self-report ideation at baseline. Further study is needed to measure suicidal outcomes longitudinally to allow for dynamic expression of suicidal ideation as outcomes such as suicide attempts are measured. Those with ideation-with-action are more intense users of mental health services than those with ideation alone, indicating that care is reaching the more severe ideators.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".