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Cited by 106Suicide and Self-Harm StudiesPsychiatric care and mental health servicesHomicide, Infanticide, and Child Abuse

Lessons From a Comprehensive Clinical Audit of Users of Psychiatric Services Who Committed Suicide

Burgess, Philip, Pirkis, Jane, Morton, Jane, Croke, Elizabeth·2000·Psychiatric Services
DOI 10.1176/appi.ps.51.12.1555
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Abstract

OBJECTIVE: Characteristics of patients who committed suicide were examined to provide a picture of the treatment they received before death and to determine whether and how the suicides could have been prevented by the service system. METHODS: The unnatural-deaths register was matched to the psychiatric case register in the state of Victoria in Australia to identify suicides by people with a history of public-sector psychiatric service use who committed suicide between July 1, 1989, and June 30, 1994. Data on patient and treatment characteristics were examined by three experienced clinicians, who made judgments about whether the suicide could have been prevented had the service system responded differently. Quantitative and qualitative data were descriptively analyzed. RESULTS: A total of 629 psychiatric patients who had committed suicide were identified. Seventy-two percent of the patients were male, 62 percent were under 40 years old, and 51 percent were unmarried. They had a range of disorders, with the most common being schizophrenia or schizoaffective disorder (36 percent). Sixty-seven percent had previously attempted suicide. A total of 311 patients (49 percent) received care within four weeks of death. Twenty percent of the suicides were considered preventable. Key factors associated with preventability were poor staff-patient relationships, incomplete assessments, poor assessment and treatment of depression and psychological problems, and poor continuity of care. CONCLUSIONS: Opportunities exist for the psychiatric service system to alter practices at several levels and thereby reduce patient suicides.

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Authors
Burgess, P., Pirkis, J., Morton, J., & Croke, E.
Affiliations
Monash University (AU)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2000-12
Volume
51
Issue
12
Pages
1555-1560
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/appi.ps.51.12.1555
OpenAlex
W2125922589
Cited by
106
References
11
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 9 · 2016: 3 · 2015: 4 · 2014: 7 · 2013: 1 · 2012: 6
FWCI
2.68
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (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, suicide prevention, mental health service utilization, psychiatric patients, schizophrenia, schizoaffective disorder, suicide attempts, staff-patient relationship, continuity of care, depression assessment, mental health system, clinical audit
MeSH terms
Adult, Australia, Catchment Area, Health, Major Depressive Disorder, Female, Humans, Male, Medical Audit, Mental Health Services, Professional-Patient Relations, Schizophrenia, Schizophrenic Psychology, Suicide, Suicide, Attempted

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