Preventing suicidal behaviour in a general hospital psychiatric service: priorities for programming.
OBJECTIVE
General hospital psychiatric services are able to provide leadership and coordinate the development of suicide prevention programs for individuals serviced in general hospital settings. We completed this literature review to suggest priorities for programming.


METHODS
Our procedure was to update the review by Gunnell and Frankel that guided priorities for Health of the Nation, the national suicide prevention strategy in the UK. We completed a search, using the terms suicide prevention and control, of all English-language research and clinical trials conducted between January 1, 1994, and May 1, 2004.


RESULTS
We identified 82 papers. Of these, 48 were excluded and the remaining 34 were grouped by secondary care setting categories. We found no articles on screening tools for predicting risk of suicide, 16 articles on interventions for individuals with suicidal behaviour, 14 articles on the treatment of major psychiatric disorders, 1 article and 1 published abstract on discharge from hospital, and 2 articles on reducing access to means.


CONCLUSIONS
Based on a review of each category, we make several program and policy recommendations, including regularly updating clinical assessment skills, using guidelines for assessment of patients following a suicide attempt, assessing the risk of suicide 24 to 48 hours before discharge from hospital, and incorporating education about reducing access to means into routine psychiatric care.
Links
Paul S
PS
Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario. paul.links@utoronto.ca
Hoffman
Brian
B
D006287:Health Planning Guidelines; D006292:Health Priorities; D006769:Hospitals, General; D006801:Humans; D008403:Mass Screening; D009864:Ontario; D010351:Patient Discharge; D010552:Personality Assessment; D011320:Primary Health Care; D011567:Psychiatric Department, Hospital; D012008:Recurrence; D018570:Risk Assessment; D012308:Risk Management; D013406:Suicide, Attempted / Q000517:prevention & control*; D000092864:Suicide Prevention