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Cited by 34Suicide and Self-Harm StudiesPsychiatric care and mental health servicesHealthcare Decision-Making and Restraints

Patient characteristics and behaviours associated with self‐harm and attempted suicide in acute psychiatric wards

Stewart, Duncan, Ross, Jamie, Watson, Charlotte, James, Karen, Bowers, Len·2012·Journal of Clinical Nursing
DOI 10.1111/j.1365-2702.2011.03832.x
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Abstract

Aims and objectives. The study examined events before and after incidents of self‐harm and attempted suicide and the characteristics of patients who engage in these behaviours. Background. Psychiatric inpatient populations have an elevated risk of self‐harm and suicide, but relatively little is known about the circumstances of these events during an admission. Design. Retrospective case note analysis. Method. Data were collected on conflict (aggression, rule breaking, etc.) and containment (coerced medication, restraint, etc.) during the first two weeks of admission for a sample of 522 acute psychiatric inpatients. Results. One in 10 patients self‐harmed, and 4% attempted suicide. Aggression, attempting to leave the ward without permission and medication refusal were frequent precursors to incidents. Pro re nata medication and de‐escalation were the most frequent interventions to follow an incident. Self‐harm and attempted suicides during the current admission were significantly associated with younger age and a history of self‐harm. Conclusions. A minority of the sample were involved in these behaviours, but incidents occurred soon after admission and sometimes repeatedly during the course of a day. Assessment of risk should be completed as early as possible. Relevance to clinical practice. At‐risk patients should be monitored for signs of withdrawal from ward activity, wanting to leave the ward without permission or non‐compliance with medication to enable early intervention.

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Crossref · 10.1111/j.1365-2702.2011.03832.x

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  • Five studies found no difference in the risk of suicide or all-cause mortality among involuntarily and voluntarily admitted patients.

    “Five studies found no difference in the risk of suicide or all-cause mortality among involuntarily and voluntarily admitted patients (71,96,97,100).”

    From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [97]

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Authors
Stewart, D., Ross, J., Watson, C., James, K., & Bowers, L.
Affiliations
King's College London (GB)
Corresponding author
Stewart, Duncan
ORCID
Venue
Journal of Clinical Nursing
Publisher
Wiley
Published
2011-10
Volume
21
Issue
7-8
Pages
1004-1013
ISSN
  • 0962-1067 (ISSN-L)
  • 1365-2702
DOI
10.1111/j.1365-2702.2011.03832.x
OpenAlex
W1855572959
Cited by
34
References
30
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 1
FWCI
1.03
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Clinical Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Research Repository (Kingston University London) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • National Institute for Health and Care Research
  • Programme Grants for Applied Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
Keywords
self-harm, suicide attempts, acute psychiatric inpatients, aggression, medication non-adherence, coercion, physical restraint, de-escalation, pro re nata medication, risk assessment, patient dropout, self-harm history, hospitalization
MeSH terms
Adolescent, Adult, Aged, Aggression, Conflict, Psychological, Female, Follow-Up Studies, United Kingdom, Humans, Inpatients, Male, Middle Aged, Professional-Patient Relations, Psychiatric Department, Hospital, Retrospective Studies, Risk-Taking, Suicide, Attempted, Cohort Studies, Survival Rate, Confidence Intervals, Chi-Square Distribution, Logistic Models, Treatment Refusal, Self-Injurious Behavior, Age Distribution, Sex Distribution, Risk Assessment, Young Adult, Early Medical Intervention

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