Gambling Disorder and Suicide: The Final Healthcare Contact Before Death

Abstract Background Gambling disorder (ICD-10: F63.0) is a behavioural addiction associated with significant psychiatric comorbidity and an elevated risk of suicide. Despite its serious public health consequences, it is often underdiagnosed and underrecognized in clinical settings. This study investigates the final healthcare contacts of individuals with gambling disorder who died by suicide in Finland, aiming to identify critical points for intervention and improve suicide prevention strategies. Methods This retrospective cohort study used national healthcare register data from Finland (1996-2023) to identify all deceased individuals aged ≥15 with a documented gambling disorder diagnosis. The temporal proximity of their last primary or specialized healthcare visit to their death by suicide was analysed, with attention to comorbid mental health conditions and healthcare service use patterns. Results Among individuals with a gambling disorder diagnosis who died, 16% died by suicide. All had at least one additional psychiatric diagnosis, with 34% diagnosed in four or more F-code categories-most commonly mood disorders. Intentional self-harm was documented in 57% of cases. Within this group, 66% had a healthcare visit in the last 30 days before death, 48% within the last week, and 20% on the day of death. In 68% of cases, the final visit occurred in specialized healthcare, primarily for mental health-related concerns. Conclusions Suicide among individuals with gambling disorder is closely linked with multiple psychiatric comorbidities and frequent healthcare contact shortly before death. These findings underscore missed opportunities for intervention and highlight the urgent need to enhance the identification and treatment of gambling disorder within health services. Targeted suicide prevention efforts during recent healthcare encounters could be crucial, given the high proportion of individuals who were seen by professionals in the days leading up to their death. Key messages • Most individuals with gambling disorder who died by suicide had recent contact with healthcare services. • Improved recognition of gambling disorder in mental health care could offer critical suicide prevention opportunities.