title: Suicide in mental health in-patients and within 3 months of discharge. National clinical survey.
abstract: BACKGROUND
  Suicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge.
  
  
  OBJECTIVE
  To describe the social and clinical characteristics of a comprehensive sample of in-patient and post-discharge cases of suicide.
  
  
  METHODS
  A national clinical survey based on a 4-year (1996-2000) sample of cases of suicide in England and Wales who had been in recent contact with mental health services (n=4859).
  
  
  RESULTS
  There were 754 (16%) current in-patients and a further 1100 (23%) had been discharged from psychiatric in-patient care less than 3 months before death. Nearly a quarter of the in-patient deaths occurred within the first 7 days of admission; 236 (31%) occurred on the ward, the majority by hanging. Post-discharge suicide was most frequent in the first 2 weeks after leaving hospital; the highest number occurred on the first day.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Meehan
authors.forename: Navneet
authors.initials: N
authors.lastname: Kapur
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Hunt
authors.forename: Pauline
authors.initials: P
authors.lastname: Turnbull
authors.forename: Jo
authors.initials: J
authors.lastname: Robinson
authors.forename: Harriet
authors.initials: H
authors.lastname: Bickley
authors.forename: Rebecca
authors.initials: R
authors.lastname: Parsons
authors.forename: Sandra
authors.initials: S
authors.lastname: Flynn
authors.forename: James
authors.initials: J
authors.lastname: Burns
authors.forename: Tim
authors.initials: T
authors.lastname: Amos
authors.forename: Jenny
authors.initials: J
authors.lastname: Shaw
authors.forename: Louis
authors.initials: L
authors.lastname: Appleby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008605:Mental Health Services; D008875:Middle Aged; D010351:Patient Discharge; D011159:Population Surveillance / Q000379:methods; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data; D013997:Time Factors; D014852:Wales / Q000453:epidemiology; D000092864:Suicide Prevention