Suicide risk after psychiatric discharge: study protocol of a naturalistic, long-term, prospective observational study

Abstract

Background Suicide risk of psychiatric patients has proven to be strongly increased in the months after discharge from a psychiatric hospital. Despite this high risk, there is a lack of systematic research on the causes of this elevated suicide risk as well as a lack of treatment and intervention for patients at high risk after discharge. The main objective of this pilot study is, firstly, to examine the factors contributing to the elevated suicide risk and, secondly, to investigate whether an additional setting of care starting at discharge may reduce suicidality. Methods In this multi-centre pilot study, treatment as usual is complemented by an additional 18-month post-discharge setting of care for psychiatric patients at high risk for suicide. Two groups of patients differing in the amount of post-discharge personal contacts will be compared. One group of patients will be offered continuous personal contacts after discharge (months 1–6: monthly contacts; months 6–18: every 2 months) while another group of patients will receive contacts only at months 6, 12, and 18 after discharge. Data on suicidality, as well as associated with other symptoms, treatment, and significant events, will be collected. In the case of health-related severe events, the setting of care allows the patient to have the opportunity to connect with the doctor or therapist treating the patient. Discussion The results of this study will contribute to identifying critical factors raising suicide risk after discharge and will demonstrate the potential influence on suicide prevention of a setting of care with regular personal contact after discharge. Trial registration ZMVI1-2517FSB135 – funded by the German Federal Ministry of Health.

Suizidalität

“…Hierzu wird bereits während der stationären Behandlung Kontakt mit den Patienten aufgenommen und über den Zeitraum von 18 Monaten ein kontinuierlicher Kontakt (ohne Eingreifen in die üblichen Behandlungssettings) zu einer Person (Studienpersonal) eingerichtet. In diesen Kontakten werden das Auftreten suizidaler Gedanken, Krisen sowie weitere Faktoren erfragt 26 . Erste Eindrücke der Studie zeigen, dass die Mehrheit der Patienten genau von diesem konkreten Ansprechen profitiert und v. a. die Möglichkeit der Vermittlung (zwischen Station/Behandler/anderen Angeboten und/oder vorher bestimmten Vertrauenspersonen) als unterstützend empfindet.…”