Suicide within two weeks of discharge from psychiatric inpatient care: a case-control study
Abstract
OBJECTIVE: Suicide risk after discharge from psychiatric inpatient care is high, particularly in the first few weeks. The aim of the study was to identify risk factors and protective factors (that is, factors associated with a reduced risk of suicide), including variation in health care received, for suicide among patients in the two-week postdischarge period. METHODS: This was a national population-based retrospective case-control study of 100 psychiatric patients in England (2004-2006), age 18-65, who died by suicide within two weeks of hospital discharge. These patients were matched on discharge date with 100 living control group patients. RESULTS: Fifty-five percent of suicides occurred within a week of discharge, 49% of whom died before their first follow-up appointment. Conditional logistic regression analyses indicated that recent adverse life events and a short (less than one week) final admission were independently associated with postdischarge suicide, as were older age and comorbid psychiatric disorders. Receiving enhanced aftercare (under the Care Programme Approach) was protective of suicide. CONCLUSIONS: Discharged patients viewed as being at high risk of suicide require immediate community follow-up. Mental health services should be mindful of discharging patients after a short admission. The potential role of detrimental life experiences indicates that mental health clinicians need to be aware of the circumstances into which patients are being discharged. Use of enhanced levels of care, such as that offered by the Care Programme Approach, may play a strong role in preventing suicide within two weeks of discharge.
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Studies published after the Troister et al. review found similar predictors.
“Studies published after the Troister et al. review found similar predictors (20, 26–28).”
From Using Administrative Data to Predict Suicide After Psychiatric Hospitalization in the Veterans Health Administration System (2020) · cites this paper as [27]
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- Authors
- Bickley, H., Hunt, I. M., Windfuhr, K., Shaw, J., Appleby, L., & Kapur, N.
- Affiliations
- University of Manchester (GB)
- Venue
- Psychiatric Services
- Published
- 2013-07
- Volume
- 64
- Issue
- 7
- Pages
- 653-659
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2139460385
- Cited by
- 129
- References
- 33
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 14 · 2023: 10 · 2022: 10 · 2021: 11 · 2020: 15 · 2019: 7 · 2018: 14 · 2017: 9 · 2016: 12 · 2015: 4 · 2014: 10 · 2013: 1
- FWCI
- 10.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- 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, protective factors, life events, Care Programme Approach, follow-up care, community follow-up, psychiatric comorbidity, old age
- MeSH terms
- Suicide Prevention, Adolescent, Adult, Aftercare, Age Factors, Aged, Mental Disorders, England, Epidemiologic Methods, Female, Hospitals, Psychiatric, Humans, Length of Stay, Life Change Events, Male, Middle Aged, Patient Care Planning, Patient Discharge, Suicide, Comorbidity, Young Adult
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