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Immediate time after hospital discharge poses high suicide risk (England)

April 18, 2013

A recent study published in Psychiatric Services found that people with psychiatric illnesses are at extremely high risk for suicide in the immediate weeks post-discharge from hospital. In fact, a retrospective study conducted by researchers from the Centre for Mental Health and Risk at the University of Manchester found that fifty-five per cent of completed suicides happened within the first week after discharge.

Investigators analyzed data from the National Confidential Inquiry Into Suicide by People With Mental Illness survey on 100 adults in England between the ages of 18 and 65 years, who had died by suicide within two weeks of discharge. They compared this group with a control group of 100 psychiatric patients discharged at the same time who did not complete suicide, to determine risk factors.

The findings indicate that the risk factors for higher suicide post-discharge (defined as a period of up to two weeks after release as a psychiatric inpatient) predicted the rate and timing of suicides. A short hospital stay of less than a week, no follow up care by a mental health professional, adverse life effects, illness onset in the previous year, a history of self-harm, and being over the age of 40 were all found to be significant suicide predictors.

Unlike the review group, the control group had follow-up care within two weeks of discharge. Many of these subjects received enhanced levels of community based mental health services and were supervised by a care coordinator such as a psychiatric nurse or social worker. This finding suggests that quality aftercare is an important intervention that could reduce the risk of suicide after hospital discharge, particularly for those individuals with predictive risk factors.

If you have a free subscription to Medscape online, you can read the article, “Early Postdischarge Period Linked to Very High Suicide Risk” by going to the Medscape Today site.

The Psychiatric Services online abstract, “Suicide Within Two Weeks of Discharge from Psychiatric Inpatient Care: A Case-Control Study” is available on the PsychiatryOnline website.

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