Suicide Among Psychiatric In-Patients With Schizophrenia in an Australian Mental Hospital

62 suicides, occurring over a 21 year period, in inpatients with schizophrenia in a large psychiatric hospital in Melbourne were examined. The suicide victims were compared with a comparison group of 22 inpatients with schizophrenia. Suicide was associated with previous deliberate self-harm, a greater number of episodes of previous self-harm, pre-admission & intra-admission suicidal thoughts, intra-admission suicide attempts, fluctuating suicidal ideation, longer length of stay, a greater number of ward transfers, & prescription of a greater number of neuroleptics & antidepressants. Over 40% of the suicides occurred after absconding from the hospital & a similar number during approved leaves. Violent methods were most frequently used. It is concluded that psychiatric units should be developed away from readily available methods of suicide. Inpatients at high risk should be observed carefully. Suicide risk should be examined carefully in patients prior to approving leave, particularly if they have fluctuating suicidal ideation. (48 refs.)