CoChat
Sign Up
Cited by 212Suicide and Self-Harm StudiesPsychiatric care and mental health servicesHomicide, Infanticide, and Child Abuse

Suicide in recently discharged psychiatric patients: a case-control study

Hunt, I. M., Kapur, N., Webb, R., Robinson, J., Burns, J., Shaw, J., Appleby, L.·2009·Psychological Medicine
DOI 10.1017/s0033291708003644
Open this paper in CoChat — free account

Abstract

BACKGROUND: Few controlled studies have specifically investigated aspects of mental health care in relation to suicide risk among recently discharged psychiatric patients. We aimed to identify risk factors, including variation in healthcare received, for suicide within 3 months of discharge. METHOD: We conducted a national population-based case-control study of 238 psychiatric patients dying by suicide within 3 months of hospital discharge, matched on date of discharge to 238 living controls. RESULTS: Forty-three per cent of suicides occurred within a month of discharge, 47% of whom died before their first follow-up appointment. The first week and the first day after discharge were particular high-risk periods. Risk factors for suicide included a history of self-harm, a primary diagnosis of affective disorder, recent last contact with services and expressing clinical symptoms at last contact with staff. Suicide cases were more likely to have initiated their own discharge and to have missed their last appointment with services. Patients who were detained for compulsory treatment at last admission, or who were subject to enhanced levels of aftercare, were less likely to die by suicide. CONCLUSIONS: The weeks after discharge from psychiatric care represent a critical period for suicide risk. Measures that could reduce risk include intensive and early community follow-up. Assessment of risk should include established risk factors as well as current mental state and there should be clear follow-up procedures for those who have self-discharged. Recent detention under the Mental Health Act and current use of enhanced levels of aftercare may be protective.

Integrity signals

Registry

Crossref · 10.1017/s0033291708003644

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Another study found an increased risk of presentations to emergency departments with suicidal behaviour after involuntary treatment orders were rescinded by independent review.

    “Although the prevention of suicide is a common reason for involuntary treatment (92), only one of the included studies found that involuntary admission decreased the risk of suicide compared to voluntary admission (93), while another found an increased risk of presentations to emergency departments with suicidal behaviour after involuntary treatment orders were rescinded by independent review (94”

    From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [94]

  • Poor physical health has been found to affect suicide ideation and may increase isolation, leading to greater thwarted belonging and perceived burdensomeness.

    “In addition to mental health characteristics, poor physical health has also been found to affect suicide ideation, (for a review see Hunt et al., 2009) and may increase isolation, leading to an increases feeling of not belonging (T.B.) as well as greater sense of being a burden (P.B.).”

    From Thwarted Belonging and Perceived Burdensomeness During Middle and Older Adulthood: The Role of Generativity (2024) · cites this paper as Hunt et al., 2009

  • The period following discharge from a psychiatric hospitalization is a time of increased risk for suicidal behavior including deaths by suicide.

    “The period following discharge from a psychiatric hospitalization is a time of increased risk for suicidal behavior [6–8] including deaths by suicide [9].”

    From Skills to Enhance Positivity in adolescents at risk for suicide: Protocol for a randomized controlled trial (2023) · cites this paper as [9]

  • There is a very high suicide rate in the year after psychiatric hospital discharge.

    “There is a very high suicide rate in the year after psychiatric hospital discharge.”

    From Using Administrative Data to Predict Suicide After Psychiatric Hospitalization in the Veterans Health Administration System (2020) · cites this paper as [5]

  • Recent UK research found that quality of care indicators, such as staff turnover and short average duration of stay, are significant predictors of postdischarge suicides.

    “Recent research in the UK has found that quality of care indicators, such as extent of staff turnover and short average duration of stay, are significant predictors of postdischarge suicides (5, 14).”

    From Using Administrative Data to Predict Suicide After Psychiatric Hospitalization in the Veterans Health Administration System (2020) · cites this paper as [5]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Hunt, I. M., Kapur, N., Webb, R., Robinson, J., Burns, J., Shaw, J., & Appleby, L.
Affiliations
University of Manchester (GB)
Corresponding author
Hunt, I. M.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2008-05-28
Volume
39
Issue
3
Pages
443-449
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291708003644
OpenAlex
W2159925517
Cited by
212
References
26
Citations by year
2026: 6 · 2025: 7 · 2024: 18 · 2023: 8 · 2022: 8 · 2021: 12 · 2020: 22 · 2019: 21 · 2018: 18 · 2017: 14 · 2016: 15 · 2015: 12 · 2014: 10 · 2013: 14 · 2012: 12
FWCI
5.21
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
suicide, psychiatric hospital discharge, suicide risk factors, self-harm, mood disorders, community follow-up, self-discharge, compulsory detention, Mental Health Act, post-discharge care, missed appointments
MeSH terms
Adolescent, Adult, Aftercare, Aged, Appointments and Schedules, Mental Disorders, Cause of Death, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Patient Discharge, Surveys and Questionnaires, Risk Factors, Suicide, Time Factors, Case-Control Studies, Risk Assessment, Mood Disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review