The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.
Suicide within 12 months of contact with mental health services: national clinical survey
Open accessAbstract
OBJECTIVE: To describe the clinical circumstances in which psychiatric patients commit suicide. DESIGN: National clinical survey. SETTING: England and Wales. SUBJECTS: A two year sample of people who had committed suicide, in particular those who had been in contact with mental health services in the 12 months before death. MAIN OUTCOME MEASURES: Proportion of suicides in people who had had recent contact with mental health services; proportion of suicides in inpatients; proportion of people committing suicide and timing of suicide within three months of hospital discharge; proportion receiving high priority under the care programme approach; proportion who were recently non-compliant and not attending. RESULTS: 10 040 suicides were notified to the study between April 1996 and March 1998, of whom 2370 (24%; 95% confidence interval 23% to 24%) had had contact with mental health services in the year before death. Data were obtained on 2177, a response rate of 92%. In general these subjects had broad social and clinical needs. Alcohol and drug misuse were common. 358 (16%; 15% to 18%) were psychiatric inpatients at the time of death, 21% (17% to 25%) of whom were under special observation. Difficulties in observing patients because of ward design and nursing shortages were both reported in around a quarter of inpatient suicides. 519 (24%; 22% to 26%) suicides occurred within three months of hospital discharge, the highest number occurring in the first week after discharge. 914 (43%; 40% to 44%) were in the highest priority category for community care. 488 (26% excluding people whose compliance was unknown; 24% to 28%) were non-compliant with drug treatment while 486 (28%; 26% to 30%) community patients had lost contact with services. Most people who committed suicide were thought to have been at no or low immediate risk at the final service contact. Mental health teams believed suicide could have been prevented in 423 (22%; 20% to 24%) cases. CONCLUSIONS: Several suicide prevention measures in mental health services are implied by these findings, including measures to improve compliance and prevent loss of contact with services. Inpatient facilities should remove structural difficulties in observing patients and fixtures that can be used in hanging. Prevention of suicide after discharge may require earlier follow up in the community. Better suicide prevention in psychiatric patients is likely to need measures to improve the safety of mental health services as a whole, rather than specific measures for people known to be at high risk.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“the suicide risk is particularly high when the patients were discharged from psychiatric hospitals where the average LOS is between 5 to 7 days (Appleby et al., 1999; Goldacre et al., 1993).”
From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Appleby et al., 1999
Experimental — accuracy not yet measuredIn the citing paper
“Patients who are psychiatrically hospitalized for a suicide attempt or suicidal ideation (SI) are at very high risk for suicide following discharge [1 -3], with rates of suicide shortly postdischarge more than 100 times greater than the rate in the general population [4].”
From Feasibility and utility of positive psychology exercises for suicidal inpatients (2014) · cites this paper as [2]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Suicide as an outcome for mental disorders: A meta-analysis
Harris, E. C., & Barraclough, B. (1997) · British Journal of Psychiatry · doi:10.1192/bjp.170.3.205 · Cited by 2,589
Mental disorders and comorbidity in suicide
(1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.6.935 · Cited by 861
Compliance therapy in psychotic patients: randomised controlled trial
Kemp, R., Hayward, P., Applewhaite, G., Everitt, B. J., & David, A. S. (1996) · BMJ · doi:10.1136/bmj.312.7027.345 · Cited by 633
Assertive community treatment: an update of randomized trials
Burns, B. J., & Santos, A. B. (1995) · Psychiatric Services · doi:10.1176/ps.46.7.669 · Cited by 396
Suicide after discharge from psychiatric inpatient care
Goldacre, M., Seagroatt, V, & Hawton, K. (1993) · The Lancet · doi:10.1016/0140-6736(93)91822-4 · Cited by 380
(1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00033-0 · Cited by 324
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness
Appleby, L., Shaw, J. J., & Amos, T. (1997) · The British Journal of Psychiatry · doi:10.1192/bjp.170.2.101 · Cited by 301
Risk Factors for Suicide in Psychiatric Patients
Roy, A. (1982) · Archives of General Psychiatry · doi:10.1001/archpsyc.1982.04290090071014 · Cited by 292
Appleby, L., Shaw, J. J., Sherratt, J., Amos, T., Robinson, J. J., & McDonnell, R. (1999) · Research Explorer (The University of Manchester) · Cited by 239
The Limitations of Official Suicide Statistics
O’Donnell, I., & Farmer, R. D. T. (1995) · The British Journal of Psychiatry · doi:10.1192/bjp.166.4.458 · Cited by 131
Research works printed but not linked: 3
- Harris EC, Barraclough B. Suicide as an outcome for mental disorders. Br J Psychiatry 1997;170:205-28.
- Goldacre M, Seagroatt V, Hawton K. Suicide after discharge from psychi- atric in-patient care. Lancet 1993;342:283-6.
- Hawton K, Appleby L, Platt S, Foster T, Cooper J, Malmberg A, et al. The psychological autopsy approach to studying suicide: a review of method- ological issues. J Affect Disord 1998;50:269-76.
Cited by
Sorted by citations
Items 401–470 of 470
Mulligan, L. D., Bojanić, L., Hunt, I. M., Baird, A., Turnbull, P., Kapur, N., Appleby, L., & Shaw, J. J. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2024.03.048 · Cited by 1
Body Image and Other Psychological Issues in Breast Augmentation
Sarwer, D. B., & Infield, A. L. (2008) · Springer eBooks · doi:10.1007/978-3-540-78948-2_14 · Cited by 1
The Strengthening Families Programme (SFP) 10-14 and Substance Misuse
Coombes, L., Allen, D., Marsh, M., & FOXCROFT, D. R. (2009) · Cited by 1
Peer Mentors in the Emergency Department
Mullinax, S., & Wilson, M. P. (2021) · Springer eBooks · doi:10.1007/978-3-030-52520-0_22
Support for community mental health teams post-suicide
McGuire, E., & Murthy, S. (2019) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2018.54 · Cited by 1
Dual diagnosis in a Dublin tertiary addiction centre - A cross-sectional study
Iro, C., & O’Connor, J. (2009) · Irish Journal of Psychological Medicine · doi:10.1017/s0790966700000690 · Cited by 1
Treatment of suicide attempters prior to hospital admission
Orha, F. A., ZULLINO, D. F., & Baumann, P. (2005) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2005.04.015 · Cited by 1
Co-morbidity and cannabis use in a mental health trust in South East England
Trathen, B., OʼGara, C., Sarkhel, A., Sessay, M., Rao, H., & Luty, J. S. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2007.02.015 · Cited by 1
Management of Suicidal Risk in Emergency Departments
Hatcher, S. (2016) · doi:10.1002/9781118903223.ch22 · Cited by 1
Cosmetic surgical and minimally invasive treatments
Sarwer, D. B., & Spitzer, J. C. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-91497-0.00024-2 · Cited by 1
Mullen, P. E. (2000) · Current Opinion in Psychiatry · doi:10.1097/00001504-200011000-00018 · Cited by 1
Predictors of Suicide Risk: Capability, Reasons, and Identification
Kene, P., & Hovey, J. D. (2012) · PsycEXTRA Dataset · doi:10.1037/e640802012-001 · Cited by 1
The Social Context of Suicide in England and Wales: a multilevel analysis
Turnbull, P. (2014) · Research Explorer (The University of Manchester) · Cited by 1
Chapitre 22 – Comportements suicidaires
Par, C., & Bourgeois, M. (2012) · Elsevier eBooks · doi:10.1016/b978-2-294-71157-2.00022-4
Psychological Issues and the Male
Peate, I. (2007) · doi:10.1002/9780470697801.ch13
Users of hospital emergency department who are discharged home
Gunnarsdottir, O. S. (2012) · Hirsla (Landspítali University Hospital)
Mental disorders and attempted suicide in Vietnam
Nguyên, V. T. (2010) · Figshare
So That Others Might Also Live
Eisenberg, L. (1999) · Science · doi:10.1126/science.286.5449.2455
Minimizing Discontinuity of Care Through a Follow-up Call Program
Dziopa, F., McArthur, L., & John, D. (2008) · Australasian Psychiatry · doi:10.1080/10398560801975774
Prevalence of substance misuse comorbidity in an Irish university training hospital
Dixit, A., & Payne, A. (2011) · Irish Journal of Psychological Medicine · doi:10.1017/s0790966700011654
Suicide prevention: service contacts and coordination between primary and secondary care
Vassilas, C. A., & Morgan, H. G. (2001) · The British Journal of Psychiatry · doi:10.1192/bjp.179.3.271-a
Lorenzo, R. D. (2013) · International Neuropsychiatric Disease Journal · doi:10.9734/indj/2013/4825
The Fort Campbell High Interest Program
Waits, W. M., & Wise, J. E. (2011) · Military Medicine · doi:10.7205/milmed-d-10-00253
Prevalence of Suicide and Suicide Ideation in Western Australia Using Linked Data Sources
Wood, N. A. (2013) · eSpace (Curtin University)
Weaver, T. D., Madden, P. A. F., Charles, V., Stimson, G. V., Renton, A. M., Yrer, P. T., Barnes, T. R. E., Bench, C. J., Middleton, H., Wright, N., et al. (2003)
SuicideWithinTwoWeeks ofDischargeFromPsychiatric InpatientCare:ACase-ControlStudy
Bickley, H., Hunt, I. M., Appleby, L., & Kapur, N. (2013)
ADDITIONAL COUNSEL FOR PLAINTIFFS
Gonzalez, A. J., Moser, H. A., Sprenkel, S. M., Taira, P. J., Llp, F., & Janicki, B. D. (2007)
Reducing suicide through improved quality of care
Spittal, M. J., & Bismark, M. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30023-2
[The use of the Norcolut preparation in gynecologic; practice].
Bozhinova, S. (1996) · PubMed
Martelli, C., & Hardy, P. M. (2010)
Pablo, J., Cárdenas, B. D. C., Santelices, H. D., Fredes, B. A., & Florenzano, U. R. (2012)
Ohlander, J. (2010)
Suicide risk assessment in the ER
Dawe, I. C. (2008)
Varselsignaler for selvmord i akuttpsykiatri
Strand, M. (2008)
Cognitive Functioning and Quality of Life in Patients with Dual Diagnosis
Fusté, I. B. (2013) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Inquiry into Suicide in Australia
Dudgeon, P., Kelly, K., & Barnett, L. M. (2009) · UWA Profiles and Research Repository (University of Western Australia)
Nagaratnam, N., Nagaratnam, K., & Cheuk, G. (2017) · Springer eBooks · doi:10.1007/978-3-319-32700-6_75-1
Best Practice Following Hospital Presentation for Self-Harm: A Rapid Literature Review
Robinson, S. S., Donaldson, A., Witt, K., & Bailey, E. (2016) · Monash University Research Portal (Monash University)
Ammendola, E. (2019) · Springer eBooks · doi:10.1007/978-3-030-02723-0_3
A mixed methods study of the increased risk of suicide following discharge: a long road ahead
Cutcliffe, J. R., Santos, J. C., Links, P. S., Zaheer, J., Harder, H. G., Campbell, F., McCormick, R., Harder, K., Bergmans, Y., & Eynan, R. (2013) · Routledge eBooks · doi:10.4324/9780203795583-17
Omgaan met suïcidaliteit bij de antisociale persoonlijkheidsstoornis
van den Bosch, L. M. C. (2019) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2295-4_8
Noorani, N., Najarzadegan, M. R., Bahramian, A., Alavi, K., Salimi, S., & Nadoushan, A. H. J. (2019) · Journal of Iranian Medical Council
Notfallpsychiatrisch relevante Syndrome und Störungen
Pajonk, F., Messer, T., & Berzewski, H. (2020) · Springer eBooks · doi:10.1007/978-3-662-61174-6_3
Ishida, T., Kuwahara, Y., Shibahashi, K., Okura, Y., Sugiyama, K., Hamabe, Y., Mimura, M., Suzuki, T., & Uchida, H. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113456
Khairi, K. F., Laili, N. H., & Kamarubahrin, A. F. (2021) · Jurnal Intelek · doi:10.24191/ji.v16i1.366
Anxiety in late-life depression
van der Veen, D. C. (2021) · University of Groningen research database (University of Groningen / Centre for Information Technology) · doi:10.33612/diss.179793202
Berman, A. L. (2021) · Springer eBooks · doi:10.1007/978-3-030-41319-4_15-1
BA, R. J. H. (2008) · doi:10.1002/9780470774120.refs
Henden, J. (2017) · Wiley eBooks · doi:10.1002/9781119162926.refs
PRIDMORE, S. A., Ahmadi, J., & Evenhuis, M. (2006) · Australasian Psychiatry · doi:10.1111/j.1440-1665.2006.02304.x
(2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809289-7.00023-3
Berman, A. L. (2022) · Springer eBooks · doi:10.1007/978-3-030-42003-1_15
Borentain, S., McCormick, C. D., Joshi, K., O’Hara, M., Zhang, Q., Mulhern-Haughey, S., Richards, S., Anjo, J., Zante, D., Kewley, R. M., et al. (2022) · Research Square · doi:10.21203/rs.3.rs-2138354/v1
GALYNKER, I. I. (2023) · Oxford University Press eBooks · doi:10.1093/med/9780197582718.003.0001
Yahyavi, S. T., & Faraji, S. (2023) · Medical Journal of the Islamic Republic of Iran · doi:10.47176/mjiri.37.110
Aran, N., Ye, M., Chia, J., Card, K. G., Kooij, K. W., Trevorrow, R. M., Guillemi, S. A., Nicholson, V., & Hogg, R. S. (2025) · AIDS Care · doi:10.1080/09540121.2025.2468965
The Impact of Post-discharge Support on Suicidality
Shemin, A. E., Joseph, R. M., O’Connell, E., & Bongar, B. M. (2025) · Springer eBooks · doi:10.1007/978-981-96-1403-5_22
Temporal Relationship Between Psychiatric Consultations and Suicide: A Postmortem Study in OsakaPreprint
Murakami, R. (2025) · medRxiv · doi:10.1101/2025.06.23.25330125
Rothes, I. (2014) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · doi:10.34626/gnvk-wx77
Fu, T., Liu, H., Chen, C., Zhang, B., Chen, G., Bai, Y., Li, J., & Hou, F. (2024) · Figshare · doi:10.6084/m9.figshare.24934418
Woodward, D. W., Wilens, T. E., Glantz, M. D., Rao, V., Burke, C. W., & Yule, A. M. (2024) · Figshare · doi:10.6084/m9.figshare.26577869
Follow-up of recurrent suicide attempts of patients admitted to the emergency department
Sinanoğlu, G. K., & Doğan, V. (2026) · The Annals of Clinical and Analytical Medicine · doi:10.4328/acam.50155
Metadata
- Authors
- Appleby, L., Shaw, J., Amos, T., McDonnell, R., Harris, C., McCann, K., Kiernan, K., Davies, S., Bickley, H., & Parsons, R.
- Affiliations
- University of Manchester (GB)
- Corresponding author
- Appleby, L.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1999-05-08
- Volume
- 318
- Issue
- 7193
- Pages
- 1235-1239
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC27859
- OpenAlex
- W2168287347
- Cited by
- 469
- References
- 16
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 12 · 2023: 8 · 2022: 8 · 2021: 20 · 2020: 26 · 2019: 20 · 2018: 12 · 2017: 15 · 2016: 22 · 2015: 19 · 2014: 20 · 2013: 22 · 2012: 22
- FWCI
- 23.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (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
- Care Programme Approach, medication adherence, psychiatric inpatients, suicide prevention, post-discharge follow-up, alcohol and drug abuse, hanging
- MeSH terms
- Suicide Prevention, Adolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Deinstitutionalization, England, Female, Health Surveys, Hospitalization, Humans, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Suicide, Time Factors, Wales, Survival Rate, Treatment Refusal
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
