Suicide in mental health in-patients and within 3 months of discharge. National clinical survey.
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.
Meehan
Janet
J
Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK.
Kapur
Navneet
N
Hunt
Isabelle M
IM
Turnbull
Pauline
P
Robinson
Jo
J
Bickley
Harriet
H
Parsons
Rebecca
R
Flynn
Sandra
S
Burns
James
J
Amos
Tim
T
Shaw
Jenny
J
Appleby
Louis
L
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