title: Increasing rates of suicide in Western Australian psychiatric patients: a record linkage study.
abstract: OBJECTIVE
  To investigate the risk of suicide following contact with mental health services and whether it has changed over time.
  
  
  METHODS
  Record linkage was used to obtain the records of previous hospital admissions and mental health service contacts for deaths due to suicide in the period 1980-98. Standardized incidence rates were calculated for the general population and for users of mental health services. Proportional hazards regression was used to assess risk factors within the cohort of people with mental health service contact.
  
  
  RESULTS
  Suicide risk was significantly increased in users of mental health services (rate ratio 6.66 in males and 7.52 in females). Suicide risk was highest in the first 7 days after discharge from in-patient care, and decreased exponentially with time since discharge. Suicide risk in users of mental health services has increased over the study period.
  
  
  CONCLUSIONS
  These results highlight the importance of adequate follow-up of patients discharged from in-patient services, and the need for adequate resources for community-based services.
authors.affiliation: Centre for Health Services Research, Department of Public Health, The University of Western Australia, Nedlands, WA, 6907, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Lawrence
authors.forename: C D
authors.initials: CD
authors.lastname: Holman
authors.forename: A V
authors.initials: AV
authors.lastname: Jablensky
authors.forename: S A
authors.initials: SA
authors.lastname: Fuller
authors.forename: A J
authors.initials: AJ
authors.lastname: Stoney
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D001523:Mental Disorders / Q000523:psychology*; D008605:Mental Health Services; D008875:Middle Aged; D010361:Patients / Q000523:psychology / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013405:Suicide / Q000706:statistics & numerical data*; D013997:Time Factors