Suicide within 12 months of contact with mental health services: national clinical survey

Abstract

Several suicide prevention measures in mental health services are implied by these findings, including measures to improve compliance and prevent loss of contact with services. Inpatient facilities should remove structural difficulties in observing patients and fixtures that can be used in hanging. Prevention of suicide after discharge may require earlier follow up in the community. Better suicide prevention in psychiatric patients is likely to need measures to improve the safety of mental health services as a whole, rather than specific measures for people known to be at high risk.

Warning signs for suicide within a week of healthcare contact in Veteran decedents

“…VHA programs to enhance the monitoring of psychotic symptoms and common precursors to suicide attempts (e.g., suicidal ideation) in Veterans with psychotic symptoms may help clinicians identify individuals at immediate risk and provide an opportunity for intervention. Although hospitalization provides one means of managing risk in Veterans with psychotic symptoms, it is costly and frequently ineffective (Appleby et al, 1999;Desai et al, 2005;Hunt et al, 2007;Yim et al, 2004). The American Psychiatric Association supports an integrative approach to treatment and recommends the use of both antipsychotics and anti-depressants for individual who may be at elevated suicide risk (Anonymous, 2003;Lehman et al, 2004).…”

Prediction of repeated parasuicide after 1–12 months

“…One treatment strategy, Dialectical Behaviour Therapy, has been found to significantly reduce the number of suicidal acts within one year in 18 -45 years old females with previous parasuicide incidents [38]. Since repetition often occurs soon after the attempt, i.e., within 4 weeks [11] or 12 weeks [37,39,40,41], risky behaviour such as early repetition ought to be considered. At a suicide attempt special attention should be put to those with several previous attempts to prevent further repetitive behaviour.…”

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

“…Substance use disorders have been associated with several adverse consequences among these patients, such as a more severe symptom burden, more frequent hospital admissions, poor treatment outcome and increased risk of violent and suicidal behaviour (53)(54)(55)(56)(57). It has also been suggested that even small amounts of drugs or alcohol may pose problems for patients with severe mental illness (58,59).…”