The British Journal of Psychiatry (2006) 188: 129-134. doi: 10.1192/bjp.188.2.129
© 2006 The Royal College of Psychiatrists
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Suicide in mental health in-patients and within 3 months of discharge

National clinical survey{dagger}

JANET MEEHAN, MBChB, MRCPsych, NAVNEET KAPUR, MBChB, MMedSc, MRCPsych, MD, ISABELLE M. HUNT, BSc, PAULINE TURNBULL, BA, JO ROBINSON, MSc, HARRIET BICKLEY, BA, REBECCA PARSONS, BA, SANDRA FLYNN, BA, JAMES BURNS, BA, TIM AMOS, MA, MSc, MBBS, MRCPsych, DPMSA, JENNY SHAW, MBBS, MRCPsych, PhD and LOUIS APPLEBY, MD, FRCP, FRCPsych

Centre for Suicide Prevention, University of Manchester, Manchester, UK

Correspondence: Professor Louis Appleby, Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. E-mail: Louis.appleby{at}manchester.ac.uk

Declaration of interest L.A. is the National Director of Mental Health for England. Funding detailed in Acknowledgements.

{dagger} See pp. 135–142 and 143–147, this issue.

Background Suicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge.

Aims To describe the social and clinical characteristics of a comprehensive sample of in-patient and post-discharge cases of suicide.

Method A national clinical survey based on a 4-year (1996–2000) sample of cases of suicide in England and Wales who had been in recent contact with mental health services (n=4859).

Results There were 754 (16%) current in-patients and a further 1100 (23%) had been discharged from psychiatric in-patient care less than 3 months before death. Nearly a quarter of the in-patient deaths occurred within the first 7 days of admission; 236 (31%) occurred on the ward, the majority by hanging. Post-discharge suicide was most frequent in the first 2 weeks after leaving hospital; the highest number occurred on the first day.

Conclusions Suicide might be prevented among in-patients by improving ward design and removing fixtures that can be used in hanging. Prevention of suicide after discharge requires early community follow-up and closer supervision of high-risk patients.


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