Does Compulsory Admission Prevent Inpatient Suicide Among Patients with Schizophrenia? A Nationwide Cohort Study in Taiwan
Abstract
Objective: The aim of this study was to analyze the risk of inpatient suicide in patients with schizophrenia during 2007–2013 and to determine putative risk factors. Methods: We conducted a national population‐based cohort study of 2,038 psychiatric inpatients in their first compulsory admission, matched with 8,152 controls who were voluntary inpatients. Only patients with schizophrenia were included in the study. We used data derived from the Taiwanese National Health Insurance Database 2005, comprising 1 million beneficiaries randomly selected from the entire population of Taiwan. Results: During the follow‐up period, 23 and 75 inpatient suicides were observed in the compulsory and control groups, respectively. Kaplan–Meier curves showed that the cumulative incidence rate of inpatient suicide was not significantly different between compulsory and voluntary admissions (log‐rank test, p = .206). Conclusions: Our results suggest that compulsory admission has no protective effects on risk reduction of inpatient suicide for patients with schizophrenia who are compulsorily admitted compared with voluntarily admitted controls. Clinicians should be more alert for the prevention of inpatient suicide among patients with schizophrenia and consider the close monitoring of inpatient suicide risk in the first week of admission.
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Five studies found an increased risk of suicide for people admitted involuntarily.
“However, five studies found an increased risk of suicide for people admitted involuntarily (98–102), and one study found that involuntary admission was associated with a greater risk of all-cause mortality (with no deaths attributable to suicide in either group) (103).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [98]
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Jordan, J. T., & McNiel, D. E. (2020) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12560 · Cited by 66 · see citing works
The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review
Corderoy, A., Kisely, S., Zirnsak, T., & Ryan, C. J. (2025) · Psychiatry, Psychology and Law · doi:10.1080/13218719.2024.2346734 · Cited by 19 · see citing works
“However, five studies found an increased risk of suicide for people admitted involuntar-ily (98 – 102), and one study found that invol-untary admission was associated with a greater risk of all-cause mortality (with no deaths attributable to suicide in either group) (103).”
- Authors
- Lin, C., Chung, C., Chen, L., & Chien, W.
- Affiliations
- Tzu Chi University (TW)
- Tri-Service General Hospital (TW)
- Corresponding author
- Chien, Wu‐Chien
- Venue
- Suicide and Life-Threatening Behavior
- Publisher
- Wiley
- Published
- 2018-08-06
- Volume
- 49
- Issue
- 4
- Pages
- 966-979
- ISSN
- 0363-0234 (ISSN-L)
- 1943-278X
- OpenAlex
- W2885284425
- Cited by
- 7
- References
- 43
- Citations by year
- 2024: 2 · 2021: 1 · 2020: 1 · 2019: 3
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Suicide and Life-Threatening Behavior (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan (TCRD-TPE-107-03)
- Tri-Service General Hospital (TSGH-C107-004)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- inpatient suicide, schizophrenia, involuntary admission, involuntary psychiatric admission, voluntary admission, suicide risk factors, suicide prevention, psychiatric inpatients, Taiwan
- MeSH terms
- Involuntary Treatment, Suicide Prevention, Adult, Female, Humans, Inpatients, Male, Middle Aged, Patient Admission, Risk Factors, Schizophrenia, Schizophrenic Psychology, Suicide, Taiwan, Cohort Studies, Kaplan-Meier Estimate
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