Currently, there is limited data comparing demographic and clinical characteristics of individuals who died by probable suicide who did and did not previously attend mental health services. This study compared demographic and clinical factors for both groups, in a Western region of Ireland over a 13- 18 year period. Post-mortem reports between January 1st, 2006, and March 31st, 2019 were reviewed 19 for 400 individuals who died by probable suicide. Relevant socio-demographic and clinical data were 20 extracted from individuals’ lifetime case notes. One hundred and fifty nine individuals (40%) had 21 attended mental health services at some stage (“attendee”). Hanging was the most common method of suicide (61%), followed by drowning (18%) for both attendees and non-attendees of mental health services, with more violent methods utilised overall by non-attendees (p = 0.028). Sixty-eight percent of individuals who previously attempted hanging, subsequently died utilising this method. A higher proportion of attendees were female compared to non-attendees of mental health services (28.9% v. 14.5%, p = 0.001). Recurrent depressive disorder (55%) was the most common diagnosed mental health disorder. For individuals with a diagnosis of schizophrenia, 39% had antipsychotic medications detectable in their toxicology reports. In conclusion, the majority of people who died by probable suicide had never had contact with mental health services and non attendees overall were more likely to utilise violent methods of suicide. Non-concordance with psychotropic medications in psychotic patients and previous hanging attempt were highlighted as potential risk factors for death by probable suicide.