Skip to main content
×
×
Home

Suicide in mental health in-patients and within 3 months of discharge: National clinical survey

  • Janet Meehan (a1), Navneet Kapur (a1), Isabelle M. Hunt (a1), Pauline Turnbull (a1), Jo Robinson (a1), Harriet Bickley (a1), Rebecca Parsons (a1), Sandra Flynn (a1), James Burns (a1), Tim Amos (a1), Jenny Shaw (a1) and Louis Appleby (a1)...
Abstract
Background

Suicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge.

Aims

To describe the social and clinical characteristics of a comprehensive sample of in-patient and post-discharge cases of suicide.

Method

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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Suicide in mental health in-patients and within 3 months of discharge
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Suicide in mental health in-patients and within 3 months of discharge
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Suicide in mental health in-patients and within 3 months of discharge
      Available formats
      ×
Copyright
Corresponding author
Professor Louis Appleby, Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. E-mail: Louis.appleby@manchester.ac.uk
Footnotes
Hide All

See pp. 135–142 and 143–147, this issue.

Declaration of Interest

L.A. is the National Director of Mental Health for England. Funding detailed in Acknowledgements.

Footnotes
References
Hide All
Appleby, L., Dennehy, J. A., Thomas, C. S., et al (1999a) Aftercare and clinical characteristics of people with mental illness who commit suicide: a case–control study. Lancet, 353, 13971400.
Appleby, L., Shaw, J., Amos, T., et al (1999b) Suicide within 12 months of contact with mental health services: national clinical survey. BMJ, 318, 12351239.
Appleby, L., Shaw, J., Meehan, J., et al (2001) Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. London: Department of Health.
Department of Health (2002) National Suicide Prevention Strategy for England. London: Stationery Office.
Geddes, J. R. & Juszczak, E. (1995) Period trends in rate of suicide in first 28 days after discharge from psychiatric hospital in Scotland, 1968–92. BMJ, 311, 357360.
Goldacre, M., Seagroatt, V. & Hawton, K. (1993) Suicide after discharge from psychiatric in-patient care. Lancet, 342, 283286.
King, E. A., Baldwin, D. S., Sinclair, J. M. A., et al (2001a) The Wessex Recent In-Patient Suicide Study, I. Case-control study of 234 recently discharged psychiatric patient suicides. British Journal of Psychiatry, 178, 531536.
King, E. A., Baldwin, D. S., Sinclair, J. M. A., et al (2000b) The Wessex Recent In-Patient Suicide Study, 2. Case-control study of 59 in-patient suicides. British Journal of Psychiatry, 78, 537542.
Lönnqvist, J. (1988) National suicide prevention project in Finland: a research phase of the project. Psychiatrica Fennica, 9, 125132.
Neeleman, J. & Wessely, S. (1997) Changes in classification of suicide in England and Wales; time trends and associations with coroners’ professional background. Psychological Medicine, 27, 467472.
O'Donnell, I. & Farmer, R. (1995) The limitations of official suicide statistics. British Journal of Psychiatry, 166, 458461.
Powell, J., Geddes, J., Hawton, K., et al (2000) Suicide in psychiatric hospital in-patients. Risk factors and their predictive power. British Journal of Psychiatry, 176, 266272.
Steblaj, A., Tavcar, R. & Dernovsek, M. Z. (1999) Predictors of suicide in psychiatric hospital. Acta Psychiatrica Scandinavica, 100, 383388.
Watts, D. & Morgan, G. (1994) Malignant alienation. Dangers for patients who are hard to ike. British Journal of Psychiatry, 164, 1115.
Yim, P. H. W., Yip, S. F., Li, R. H. Y., et al (2004) Suicide after discharge from psychiatric inpatient care: a case-control study in Hong Kong. Australian and New Zealand Journal of Psychiatry, 38, 6572.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 70 *
Loading metrics...

Abstract views

Total abstract views: 249 *
Loading metrics...

* Views captured on Cambridge Core between 3rd January 2018 - 26th May 2018. This data will be updated every 24 hours.

Suicide in mental health in-patients and within 3 months of discharge: National clinical survey

  • Janet Meehan (a1), Navneet Kapur (a1), Isabelle M. Hunt (a1), Pauline Turnbull (a1), Jo Robinson (a1), Harriet Bickley (a1), Rebecca Parsons (a1), Sandra Flynn (a1), James Burns (a1), Tim Amos (a1), Jenny Shaw (a1) and Louis Appleby (a1)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *