Suicidal people are being failed by doctors and are not getting the care they need, according to a survey.

About 1,600 callers to SANELINE, a helpline run by mental health charity SANE, had been in touch with health professionals in the month before ringing, but were still expressing suicidal thoughts.

Many also had a history of attempted suicide.

A follow-up study of 21 suicides found that as many as a third had received little or no follow-up following contact with a health worker, despite the fact that two out of three had a history of attempted suicide.

The SANE survey, covering the period January 1996 and June 1998, found that half of 10,359 people who contacted the helpline reporting a history of mental illness and suicidal ideas had actually attempted suicide in the past.

Almost one fifth said they were planning suicide at the time of the call.

More than three quarters of suicidal callers had been in contact with a health professional in the preceding month.

Almost three-fifths were under 35 years old. Most were suffering from depression and about a third were severely mentally ill.

Failure

Marjorie Wallace, chief executive of SANE, said: "Our research reveals the failure of services to respond to the needs of people at risk of suicide, particularly those with mental health problems."

She added that lack of time and stretched resources was "no excuse".

"We believe that much more could be done to identify the people most at risk, and treat what is often undiagnosed illness such as depression before people become so desperate that any incident in their lives can bring them to flashpoint."

She said that if health workers did not have more time to treat suicidal people and better training in risk assessment the government would not be able to meet its target of reducing suicide by one fifth by the year 2010.

Self-harm

Doctors have also been calling for improvements in risk assessment.

The UK's first psychological study of suicides among the under-35s, published in the British Journal of Psychiatry last month, found the majority had been to see their GP in the three months before taking their lives.

The researchers, from the School of Psychiatry and Behavioural Sciences at Withington Hospital in Manchester, identified a variety of risk factors linked to suicide, including a history of self harm or mental illness, unemployment and drug and alcohol problems.

They called for a broad-based prevention strategy which could deal with both social and health issues.

And they said they wanted to see more awareness among GPs of the risk factors, as well as targeting of support at groups most likely to be at risk, such as the unemployed, and better services for people with drug and alcohol problems.

Another study published this week found almost half of 174 young people who committed suicide had a recent history of self-harm, but only a fifth were in the care of psychiatric services.

The researchers, from Warneford Hospital in Oxford, stressed the need for high quality referral services for young people and for doctors to take the expression of suicidal thoughts more seriously.