Analysis of suicides reported as adverse events in psychiatry resulted in nine quality improvement intiatives

Background: The majority of persons who die by suicide have a mental disorder. Preventive strategies should include addressing social and psychological factors and the treatment of the mental disorder. Aim: We aimed to identify breaches in clinical care and identify areas for quality improvement initiatives. Method: An aggregate analysis of suicides reported as adverse events during 2012–2016 to Psychiatry, North […]

Healthcare utilization and comorbidity shortly before suicide mortality in patients with attention‑deficit/hyperactivity disorder: A nested case–control study

Few studies have analyzed healthcare utilization before suicide among individuals with attention-deficit/hyperactivity disorder (ADHD). This study examined the pattern of healthcare utilization and comorbidities shortly before death among patients with ADHD who died by suicide and compared these data with those of living controls. This study used Taiwan’s National Health Insurance Research Database to identify […]

Disturbing findings about the risk of suicide and psychiatric hospitals.

Comments on an article by C. R. Hjorthøj et al. (see record 2014-35908-002). The study, by Hjorthøj and associates, is a nested case– control study that compared Danish residents who died by suicide between 1996 and 2009 with living age-, sex- and year-matched controls. The authors describe the relationship between suicide and the extent of psychiatric […]

Deaths by suicide and their relationship with general and psychiatric hospital discharge: 30-year record linkage study.

BACKGROUND: Studies have rarely explored suicides completed following discharge from both general and psychiatric hospital settings. Such research might identify additional opportunities for intervention. AIMS: To identify and summarise Scottish psychiatric and general hospital records for individuals who have died by suicide. METHOD: A linked data study of deaths by suicide, aged ≥15 years from […]

Suicide risk after psychiatric hospital discharge.

Despite clinical and public health efforts aimed at preventing suicide, the suicide rate in the United States has steadily increased over the past decade.1 This disturbing trend stands in sharp contrast with 8 of the other 10 leading causes of death in the United States, the rates of which have substantially decreased in recent years.2 The national […]

Increase in US suicide rates and the critical decline in psychiatric beds.

The closure of most US public mental hospital beds and the reduction in acute general psychiatric beds over recent decades have led to a crisis, as overall inpatient capacity has not kept pace with the needs of patients with psychiatric disorders.1 Currently, state-funded psychiatric beds are almost entirely forensic (ie, allocated to people within the […]

Post-hospitalization course and predictive signs of suicidal behavior of suicidal patients admitted to a psychiatric hospital: a 2-year prospective follow-up study.

Background Suicidal patients admitted to a psychiatric hospital are considered to be at risk of suicidal behavior (SB) and suicide. The present study aimed to seek predictors of SB recurrence of the high-risk patients by examining their post-hospitalization course. Method The design was 2-year prospective follow-up study of patients consecutively admitted with SB to a […]

Psychiatric Disorders and Clinical Correlates of Suicidal Patients Admitted to a Psychiatric Hospital in Tokyo

This study examined features of a sample of newly admitted suicidal psychiatric patients in Tokyo. 155 patients consecutively admitted during a 20-month period were assessed. Associations of psychiatric diagnoses & suicidal behaviour-related characteristics with gender & age were examined. Features of the sample were the high prevalence of affective disorders, anxiety disorders, & borderline personality […]

Action to be Taken in the Event of a Suspected Suicide in an Inpatient Psychiatric Unit: Guidelines

These guidelines were developed to assist staff in managing the events surrounding the suicide of an inpatient. The roles & responsibilites of various health care professionals are outlined. Procedures for debriefing, the collection & return of the patient’s property, documentation, & support for the bereaved family are also included. Copies of the forms that have […]

A Socio-Demographic, Psychiatric and Medical Profile of Inpatient Suicide Attempters in a Psychiatric Hospital of Puerto Rico

This study describes the sociodemographic, medical, & psychiatric profile of psychiatric patients who had attempted suicide. Inpatient suicide attempts occurring in a state psychiatric hospital in Puerto Rico, during March 2005-March 2007, were assessed. A total of 44 attempts were made by 31 inpatients. The majority of patients had a diagnosis of psychotic & mood […]

Parasuicidality and Patient Careerism: Treatment Recidivism and the Dialectics of Failure

The author interprets parasuicidal behaviour as a means certain individuals use to sustain patient careers. Contrary to the current trend to identify this behaviour solely as the defining symptoms of borderline personality disorder, the author argues that parasuicidality often emerges from the symbiotic relationship between individuals with particular existential needs & the medicalized institutions that […]

Changes in Institutional Psychiatric Care and Suicidal Behaviour: a Follow-Up Study of Inpatient Suicide Attempters in Baerum, Norway

This study investigated whether extensive change in institutional psychiatric care resulted in shortened psychiatric hospitals stays for suicide attempters. It also examined if length of hospital stay & time period in which patients received treatment were related to the risk of a repeat suicide attempt &/or dying by suicide. All cases of suicide attempters hospitalized […]

Changes in Suicide Numbers in Psychiatric Hospitals: an Analysis Using Log-Linear Time-Trend Models

The hypothesis that there was an increase in the number of psychiatric patient suicides was examined. Data from 5 psychiatric hospitals/departments in Baden-Wurttemberg were recorded for the period, 1970-1992. Log-linear time-trend models tested several hypotheses, compared their goodness of fit, & corrected for related factors. Results showed that the model of a constant number of […]

Suicide Attempts by Psychiatric Patients in Acute Inpatient, Long-Stay Inpatient and Community Care

This study examined rates of risk factors associated with suicide attempts by psychiatric patients in acute inpatient, long-stay inpatient, & community care. 12,229 patients in 13,632 episodes of care were rated on the Health of the Nation Outcome Scales Item 2. Incidence densities per 1000 episode days were 5.4 for patients in acute inpatient settings, […]

The Utility and Effectiveness of 15-Minute Checks in Inpatient Settings

Implementing harm reduction is among the administrative tasks used for maintaining a safe unit for psychiatric inpatients. Included in nursing procedures for observing suicidal patients is the practice of 15-minute checks. In reviewing the standard forms used in several major hospitals across the United States, the authors noticed a wide variation in the format & […]

Identifying the High Risk Suicidal Patient

The presenter discussed a retrospective exploratory study done at the Homewood Sanitarium to identify those patients most at risk of dying by suicide. A sample of 43 patients who died by suicide, either in hospital or after discharge, between 1960-1974 was drawn. A method group was also rated independently. Results of the study enabled the […]

The Psychological Autopsy as Part of a Suicide Prevention Program

In November 1997, a policy statement by the Department of Mental Hygiene of the State of New York instructed directors of psychiatric centres to review all suicides at their institutions by means of a psychological autopsy. This presentation discussed the initial effects of this directive & examined staff reactions to the process. The implications for […]

Revisiting “Suicide Proofing” an Inpatient Unit Through Environmetal Safeguards: a Review

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Commentary: Let’s Think About Human Factors, not Human Failings

See SIEC #2009-0022 for Janofsky’s article.

A Resource Guide for Implementing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) 2007 Patient Safety Goals on Suicide Featuring the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T)

This document serves as a resource guide, using the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) protocol to facilitate implementation of patient safety goals on suicide. The model involves identifying risk factors; identifying protective factors; asking about suicide thoughts, plans, behaviours, & intent; determining level of risk & choosing appropriate interventions; & documenting the assessment […]

Letters to the Editor. Prevention of Suicide in an Inpatient Adolescent Unit by Environmental Safety Modification

On Suicide Prevention in Hospitals: Empirical Observations and Psychodynamic Thinking(IN: Relating to Self-Harm and Suicide. Psychoanalytic Perspectives on Practice, Theory and Prevention, ed. by S Briggs, A Lemma and W Crouch)

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A Study of Suicide and non-Fatal Deliberate Self-Harm Among Patients of Alberta Hospital Edmonton 1975-1984