Cited by 38Suicide and Self-Harm StudiesPsychiatric care and mental health servicesPersonality Disorders and Psychopathology

Inpatient suicide in psychiatric settings: Evaluation of current prevention measures

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Chammas, Francesca, Januel, Dominique, Bouaziz, Noomane·2022·Frontiers in Psychiatry

Abstract

The risk of suicide in psychiatric hospitals is 50 times higher than in the general population, despite patient safety being a priority for any hospital. However, to date, due to the complexity of assessing suicide risk, there has been no consensus on the suicide prevention measures that should be in place in hospitals. The aim of this work is: To provide an overview of the progress that has been made in the field of inpatient suicide prevention in recent years; discuss the problems that remain; and suggest potential future developments. As new clinical dimensions (notably anhedonia, psychological pain and hopelessness) develop, they should become new therapeutic targets. Team training (like the Gatekeeper Training Program) and the latest advances in suicide risk assessment (such as the Collaborative Assessment and Management of Suicidality) should be implemented in psychiatric wards. Suicide prevention plans (e.g., ASSIP, SAFE-T, etc.) represent easy-to-administer, low-cost interventions. The Mental Health Environment of Care Checklist has been proven effective to reduce suicide risk at hospitals. Furthermore, the types of psychotherapy recommended to reduce suicide risk are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). There are several pharmacological treatments for suicide risk, such as lithium and clozapine, which have been shown to be effective in the long term, as well as ketamine and esketamine, which are more effective in the short term. Following some encouraging recent results, buprenorphine may also be proposed to patients with a suicide risk. Triple chronotherapy rapidly improves depressive symptoms over 9 weeks. Regarding brain stimulation techniques, rTMS has proven to be effective in alleviating multiple dimensions of suicidality.

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Crossref · 10.3389/fpsyt.2022.997974

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  • Strengthening relational engagement and monitoring emotional pain in inpatient psychiatric settings was associated with improved safety outcomes.

    “Chammas et al. [47] evaluated suicide prevention measures in inpatient psychiatric settings and reported that strengthening relational engagement and monitoring emotional pain was associated with improved safety outcomes.”

    From Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol (2026) · cites this paper as [47]

    In Team training > Formal observation (page unavailable), the review reports that some inpatients felt safer and more hopeful when observers provided emotional support and interacted therapeutically. In Suicide risk assessment > Psychological pain (page unavailable), it recommends assessing psychological pain because its reported level predicted later suicidal events. Neither passage shows that strengthening engagement and monitoring pain together were associated with improved safety outcomes; the reported safety finding is patients’ perception of safety, not a measured outcome. (LLM, conf=0.86)

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  1. [214]Baldessarini RJ Tondo L Hennen J. Effects of lithium treatment and its discontinuation on suicidal behavior in bipolar manic-depressive disorders. J Clin Psychiatry. (1999) 60: 77– 84. 10073392

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Authors
Chammas, F., Januel, D., & Bouaziz, N.
Affiliations
Hôpital de Ville-Évrard (FR)
Corresponding author
Chammas, Francesca
Venue
Frontiers in Psychiatry
Published
2022-10-28
Volume
13
Pages
997974-997974
ISSN
1664-0640 (ISSN-L)
OpenAlex
W4307705064
Cited by
38
References
301
Citations by year
2026: 13 · 2025: 6 · 2024: 13 · 2023: 6
FWCI
1.04
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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 › Personality Disorders and Psychopathology
Keywords
inpatient suicide, suicide prevention, psychiatric hospitals, suicide risk assessment, Collaborative Assessment and Management of Suicidality, anhedonia, hopelessness, psychological suffering, cognitive behavioral therapy, dialectical behavior therapy, lithium, clozapine, ketamine, esketamine, buprenorphine, chronotherapy, repetitive transcranial magnetic stimulation

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