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

Abstract

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.

What is the Lived Experience of Being Discharged From a Psychiatric Inpatient Stay?

“…Following discharge, patients are at high risk of self-harm and suicide, with many incidents occurring in the first two weeks Morgan & Priest, 1991), most within three months (McKenzie & Wurr, 2001) and 40% occurring before the first community follow-up (Meehan et al, 2006).…”

In-patient suicide in psychiatry – an Indian experience

“…Past history of in-patient psychiatric care was found in only 15% of cases, whereas it was 68 and 76% in other studies (Dong et al 2005;Madsen et al 2012). Suicidal risk assessment was done in half of the people and this suggests that others were possibly considered to have low risk of suicidal behaviour, similar finding is noted in other studies also (Dong et al 2005;Meehan et al 2006).…”

“…Hanging was the method opted by majority of them, which is similar to many other studies, and the incident site being bathroom or toilet (Proulx et al 1997;Meehan et al 2006;Madsen et al 2012;Bose et al 2016). This could be due to comparatively easy accessibility to hanging in an inpatient setting.…”

“…This is important in the context of World Health Organization's observation of suicide being second most common cause of death in age group of 15-29 years. Findings are differing in some studies such as in one study median age was 39 years and in two studies the mean ages were 45 and 49 years (Deisenhammer et al 2000;Meehan et al 2006;Cheng et al 2009). In the current study, many patients were well educated (studied till graduation) similar to another study (Madsen et al 2012).…”

The collaborative assessment and management of suicide (CAMS): an important model for mental health services to consider

“…Managing suicidality within mental health care is challenging: risk assessment is an inexact science, suicidal behaviour is extremely difficult to predict, causes of suicidality are multifaceted, medications and hospitalisation are rarely effective or sufficient, and sometimes make things worse. Research has shown that suicide risk increases post discharge from inpatient psychiatric care (Bostwick & Pankratz, 2000;Qin & Nordentoft, 2005;Meehan et al 2006). As Shneidman, the father of modern suicidology noted, 'Suicide is chiefly a drama of the mind ' (1998).…”