Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-27T15:44:03.119Z Has data issue: false hasContentIssue false

Suicide among psychiatric in-patients in a changing clinical scene

Suicidal ideation as a paramount index of short-term risk

Published online by Cambridge University Press:  02 January 2018

H. G. Morgan*
Affiliation:
Department of Mental Health, University of Bristol
Ruth Stanton
Affiliation:
Department of Mental Health, University of Bristol
*
Emeritus Professor H. G. Morgan, FRCPsych, Department of Mental Health, University of Bristol, 41 St Michael's Hill, Bristol BS2 8DZ

Abstract

Background

Rapid changes in styles of clinical practice mean that we should carefully monitor the way suicides occur among psychiatric patients both in hospital and in the wider community.

Method

Patients who had died through suicide either while receiving in-patient care or within 2 months of discharge from hospital were compared with a similar series reported 10 years previously. Clinicians' perceptions of patients' behaviour were compared with concurrent controls.

Results

Patients in the more recent study were younger, more often male, and a greater proportion had been discharged from in-patient status. Hazards which complicated risk assessment included short-lasting misleading clinical improvements, variability in degree of distress, and a reluctance to discuss suicidal ideas. Over a range of perceived behaviours it was not possible to distinguish suicides from controls.

Conclusions

In assessing suicide risk paramount importance should be attached to monitoring suicidal ideation and addressing the several hazards which might complicate this procedure.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bannerjee, S., Bingley, W. & Murphy, E. (1995) Deaths of Detained Patients: A Review of Reports to the Mental Health Act Commission. London: Mental Health Foundation.Google Scholar
Dennehey, J. A., Appleby, L., Thomas, C. S., et al (1996) Case control study of suicide by discharged psychiatric patients. British Medical Journal, 312, 1580.CrossRefGoogle Scholar
Morgan, H. G. (1979) Death Wishes? The Assessment and Management of Deliberate Self-Harm. Chichester: Wiley.Google Scholar
Morgan, H. G. & Priest, P. (1991) Suicide and other unexpected deaths amongst psychiatric inpatients. The Bristol Confidential Inquiry. British Journal of Psychiatry, 158, 368374.CrossRefGoogle Scholar
Nordentoft, M., Breum, L. & Munck, L. K. (1993) High mortality by natural and unnatural causes: A 10 year follow-up of patients admitted to a poisoning treatment centre after suicide attempts. British Medical Journal, 306, 16371641.CrossRefGoogle ScholarPubMed
Pokorny, A. D. (1982) Prediction of suicide in psychiatric patients. Archives of General Psychiatry, 30, 10891095.Google Scholar
Steering Committee of the Confidential Inquiry into Homicides and Suicides by Mentally III People (1996) Report of the Confidential Inquiry into Homicides and Suicides by Mentally III People. London: Royal College of Psychiatrists.Google Scholar
Watts, D. & Morgan, H. C. (1994) Malignant alienation. British Journal of Psychiatry, 164, 1115.Google ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.