title: Suicide after absconding from inpatient care in England: an exploration of mental health professionals' experiences.
abstract: BACKGROUND
  Absconding from inpatient care is associated with suicide risk in psychiatric populations. However, little is known about the real world context of suicide after absconding from a psychiatric ward or the experiences of clinical staff caring for these patients.
  
  
  OBJECTIVE
  To identify the characteristics of inpatients who died by suicide after absconding and to explore these and further key issues related to suicide risk from the perspective of clinical staff.
  
  
  METHODS
  A mixed-methods study using quantitative data of all patient suicides in England between 1997 and 2011 and a thematic analysis of semi-structured interviews with 21 clinical staff.
  
  
  RESULTS
  Four themes were identified as areas of concern for clinicians: problems with ward design, staffing problems, difficulties in assessing risk, and patient specific factors.
  
  
  CONCLUSIONS
  Results suggest that inpatients who died by suicide after absconding may have more complex and severe illness along with difficult life events, such as homelessness. Closer monitoring of inpatients and access points, and improved risk assessments are important to reduce suicide in this patient group.
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Hunt
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Clements
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Pooja
authors.initials: P
authors.lastname: Saini
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Mohammad Shaiyan
authors.initials: MS
authors.lastname: Rahman
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Shaw
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Louis
authors.initials: L
authors.lastname: Appleby
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Nav
authors.initials: N
authors.lastname: Kapur
authors.affiliation: a National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, University of Manchester , Manchester , UK.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Windfuhr
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004739:England; D005260:Female; D006749:Hospital Design and Construction; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000401:mortality; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D000092864:Suicide Prevention
keywords: Absconding; inpatient; mental health; mixed methods; patient safety; qualitative analysis; suicide; suicide prevention