Preventable suicides involving medicines: A systematic case series of coroners’ reports in England and Wales

Background In England and Wales coroners have a duty to write a report, called a Prevention of Future Deaths report or PFD, when they believe that actions should be taken to prevent future deaths. Coroners send PFDs to individuals and organisations who are required to respond within 56 days. Despite the increase in mental health […]

The co-production of an intervention facilitating informal caregivers to support adults at risk of suicide and serious self-harm: A brief report

The recovery model in mental healthcare increasingly recognises suicidal behaviour as an interpersonal issue, with caregivers seen as essential in prevention.  In the UK, as in other parts of the world, there is growing consensus in policies, guidelines and academic research towards carer involvement in a person’s mental healthcare, yet inconsistency in practice remain commonplace. […]

Six major steps to make investigations of suicide valuable for learning and prevention

Objective The decline in suicide rates has leveled off in many countries during the last decade, suggesting that new interventions are needed in the work with suicide prevention. Learnings from investigations of suicide should contribute to the development of these new interventions. However, reviews of investigations have indicated that few new lessons have been learned. […]

Effects of community-based caring contact in reducing thwarted belongingness among postdischarge young adults with self-harm: Randomized controlled trial

Background: For patients with self-harm behaviors, the urge to hurt themselves persists after hospital discharge, leading to costly readmissions and even death. Hence, postdischarge intervention programs that reduce self-harm behavior among patients should be part of a cogent community mental health care policy. Objective: We aimed to determine whether a combination of a self-help mobile […]

Safer services: Suicide by people with mental illness

Effect of an emergency department process improvement package on suicide prevention: The ED-SAFE 2 cluster randomized clinical trial

Importance: Suicide is a leading cause of deaths in the US. Although the emergency department (ED) is an opportune setting, ED-initiated interventions remain underdeveloped and understudied. Objective: To determine if an ED process improvement package, with a subfocus on improving the implementation of collaborative safety planning, reduces subsequent suicide-related behaviors. Design, setting, and participants: The Emergency Department Safety […]

Analysis of reported suicide safety events among veterans who received treatment through Department of Veterans Affairs–contracted community care

Introduction Veteran patients have access to a broad range of health care services in the Veterans’ Health Administration (VHA). There are concerns, however, that all Veteran patients may not have access to timely care. The Maintaining Internal Systems and Strengthening Integrated Outside Networks Act was passed in 2018 to ensure that eligible Veterans can receive […]

Ethical issues to consider in designing suicide prevention studies: An expert consensus study

Aim: Research is imperative to advance our understanding of suicidal behavior and its prevention. Suicide prevention research involves various ethical issues, many of which are not straightforward to address. Hence, suicide prevention researchers sometimes face particular issues when designing their research studies. This expert consensus study aimed to identify the most important ethical issues to consider […]

Facing a patient who seeks help after a suicide attempt: The difficulties of health professionals

Background: Although intervention with suicidal patients is one of the hardest tasks in clinical practice, little is known about health professionals’ perceptions about the difficulties of working with suicidal patients. Aims: The aims of this study were to: (1) describe the difficulties of professionals facing a suicidal patient; (2) analyze the differences in difficulties according to the […]

Family involvement, patient safety and suicide prevention in mental healthcare: Ethnographic study

Background: Family involvement has been identified as a key aspect of clinical practice that may help to prevent suicide. Aims: To investigate how families can be effectively involved in supporting a patient accessing crisis mental health services. Method: A multi-site ethnographic investigation was undertaken with two crisis resolution home treatment teams in England. Data included […]

Prediction of suicide attempts using clinician assessment, patient self-report, and electronic health records

Objective  To predict suicide attempts within 1 and 6 months of presentation at an emergency department (ED) for psychiatric problems. Design, Setting, and Participants  This prognostic study assessed the 1-month and 6-month risk of suicide attempts among 1818 patients presenting to an ED between February 4, 2015, and March 13, 2017, with psychiatric problems. Data analysis was […]

Patient-related factors associated with an increased risk of being a reported case of preventable harm in first-line health care: A case-control study

Background: Patient safety issues in primary health care and in emergency departments have not been as thoroughly explored as patient safety issues in the hospital setting. Knowledge is particularly sparse regarding which patients have a higher risk of harm in these settings. The objective was to evaluate which patient-related factors were associated with risk of harm […]

Consensus statement on ethical & safety practices for conducting digital monitoring studies with people at risk of suicide and related behaviors

Objective Digital monitoring technologies (e.g., smartphones and wearable devices) provide unprecedented opportunities to study potentially harmful behaviors such as suicide, violence, and alcohol/substance use in real‐time. The use of these new technologies has the potential to significantly advance the understanding, prediction, and prevention of these behaviors. However, such technologies also introduce myriad ethical and safety […]

The perspectives of adults with suicidal ideation and behaviour regarding their interactions with nurses in mental health and emergency services: A systematic review

Background In contemporary healthcare, both community and inpatient mental health and emergency services are important help-seeking avenues for persons with suicidal ideation and behaviour. Regarding nursing practice in these services, there is a strong focus on assessing and managing suicide risk. Within this clinical context, the perspectives of persons with suicidal ideation and behaviour are […]

The Veterans Affairs patient safety center of inquiry – suicide prevention collaborative: Creating novel approaches to suicide prevention among veterans receiving community services

Background: While the US Department of Veterans Affairs has made significant strides to prevent veteran suicide, efforts have largely targeted veterans actively engaged in and eligible for Veterans Health Administration (VHA) care, which is consistent with the VHA mission. The majority of veterans are not enrolled in VHA care, and many are ineligible for services. Veterans […]

Learning from clinicians’ views of good quality practice in mental healthcare services in the context of suicide prevention: A qualitative study

Background Suicide and non-fatal self-harm represent key patient safety events in mental healthcare services. However, additional important learning can also be derived by highlighting examples of optimal practice that help to keep patients safe. In this study, we aimed to explore clinicians’ views of what constitutes good practice in mental healthcare services in the context […]

Assessing psychiatric safety in suicidal emergency department patients

We provide a review of the assessment of suicidal emergency department patients and includes a legal and ethical perspective. Screening tools and psychiatric consultation are important adjuncts to the ED evaluation of potentially suicidal patients. Suicide risk should be assessed, and if positive, an appropriate and safe disposition should be arranged. The aim of this […]

Patient suicide and self-harm prevention strategies in hospitals

Inpatient suicide and self-harm attempts are two sentinel events hospitals seek to avoid. Nonetheless, each year, patients are able to commit suicide or self-harm within hospitals. While several national entities have provided guidance to reduce the risk of self-harm among inpatients, no global standard exists to address these preventable events. The objectives of this paper […]

How health care systems let our patients down: A systematic review into suicide deaths

Purpose To synthesize the literature in relation to findings of system errors through reviews of suicide deaths in the public mental health system. Data sources A systematic narrative meta-synthesis using the PRISMA methodology was conducted. Study selection All English language articles published between 2000 and 2017 that reported on system errors identified through reviews of […]