Hostname: page-component-7c8c6479df-r7xzm Total loading time: 0 Render date: 2024-03-27T18:57:47.100Z Has data issue: false hasContentIssue false

Suicide in mental health in-patients and within 3 months of discharge

National clinical survey

Published online by Cambridge University Press:  02 January 2018

Janet Meehan
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Navneet Kapur
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Isabelle M. Hunt
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Pauline Turnbull
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Jo Robinson
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Harriet Bickley
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Rebecca Parsons
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Sandra Flynn
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
James Burns
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Tim Amos
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Jenny Shaw
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
Louis Appleby*
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
*
Professor Louis Appleby, Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. E-mail: Louis.appleby@manchester.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
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.

Type
Papers
Copyright
Copyright © 2006 The Royal College of Psychiatrists 

Footnotes

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

Declaration of Interest

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

References

Appleby, L., Dennehy, J. A., Thomas, C. S., et al (1999a) Aftercare and clinical characteristics of people with mental illness who commit suicide: a case–control study. Lancet, 353, 13971400.CrossRefGoogle ScholarPubMed
Appleby, L., Shaw, J., Amos, T., et al (1999b) Suicide within 12 months of contact with mental health services: national clinical survey. BMJ, 318, 12351239.CrossRefGoogle ScholarPubMed
Appleby, L., Shaw, J., Meehan, J., et al (2001) Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. London: Department of Health.Google Scholar
Department of Health (2002) National Suicide Prevention Strategy for England. London: Stationery Office.Google Scholar
Geddes, J. R. & Juszczak, E. (1995) Period trends in rate of suicide in first 28 days after discharge from psychiatric hospital in Scotland, 1968–92. BMJ, 311, 357360.CrossRefGoogle ScholarPubMed
Goldacre, M., Seagroatt, V. & Hawton, K. (1993) Suicide after discharge from psychiatric in-patient care. Lancet, 342, 283286.Google Scholar
King, E. A., Baldwin, D. S., Sinclair, J. M. A., et al (2001a) The Wessex Recent In-Patient Suicide Study, I. Case-control study of 234 recently discharged psychiatric patient suicides. British Journal of Psychiatry, 178, 531536.CrossRefGoogle Scholar
King, E. A., Baldwin, D. S., Sinclair, J. M. A., et al (2000b) The Wessex Recent In-Patient Suicide Study, 2. Case-control study of 59 in-patient suicides. British Journal of Psychiatry, 78, 537542.Google Scholar
Lönnqvist, J. (1988) National suicide prevention project in Finland: a research phase of the project. Psychiatrica Fennica, 9, 125132.Google Scholar
Neeleman, J. & Wessely, S. (1997) Changes in classification of suicide in England and Wales; time trends and associations with coroners’ professional background. Psychological Medicine, 27, 467472.Google Scholar
O'Donnell, I. & Farmer, R. (1995) The limitations of official suicide statistics. British Journal of Psychiatry, 166, 458461.Google Scholar
Powell, J., Geddes, J., Hawton, K., et al (2000) Suicide in psychiatric hospital in-patients. Risk factors and their predictive power. British Journal of Psychiatry, 176, 266272.CrossRefGoogle ScholarPubMed
Steblaj, A., Tavcar, R. & Dernovsek, M. Z. (1999) Predictors of suicide in psychiatric hospital. Acta Psychiatrica Scandinavica, 100, 383388.CrossRefGoogle ScholarPubMed
Watts, D. & Morgan, G. (1994) Malignant alienation. Dangers for patients who are hard to ike. British Journal of Psychiatry, 164, 1115.CrossRefGoogle Scholar
Yim, P. H. W., Yip, S. F., Li, R. H. Y., et al (2004) Suicide after discharge from psychiatric inpatient care: a case-control study in Hong Kong. Australian and New Zealand Journal of Psychiatry, 38, 6572.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.