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Objective: Psychiatric inpatients constitute a population at considerably increased risk for suicide. Identifying those at imminent risk is still a challenging task for hospital staff. This retrospective case–control study focused on clinical risk factors related to the course of the hospital stay.
Method: Inpatient suicide cases were identified by...
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Citations
... In this regard, inpatient suicide occurring in hospital has been poorly studied (Large et al., 2017;Large & Kapur, 2018). It was defined as "the suicide of a patient while hospitalized and also includes self-inflicted deaths occurring during a granted overnight or weekend leave if the continuation of the inpatient treatment was intended" (Deisenhammer et al., 2020). Specifically, it is classified as a sentinel event, which is a "Patient Safety Event that reaches a patient and results in death, permanent harm, or serious temporary harm" (The Joint Commission, 2021). ...
... Subsequently, a total of 198 (4.3%) in-hospital suicides were identified, including 194 inpatients (both patients undergoing voluntary and mandatory hospitalization) and 4 suicide cases of people who were not inpatients but occasionally visited the facility. Although we draw on the definition of inpatient suicide proposed by Deisenhammer and colleagues (Deisenhammer et al., 2020), which also includes self-inflicted deaths that occur during a leave granted for the night or weekend if continued inpatient treatment was planned, our sample consisted only of inpatients who died while in the hospital. The healthcare facilities in which suicide deaths took place were hospitals in the City and Province of Milan (N = 194); nursing homes (N = 2); disability center (N = 1); social-welfare residence (N = 1). ...
Introduction:
Inpatient suicide in hospitals is a worrying phenomenon that has received little attention. This study retrospectively explored the socio-demographic, clinical, and suicide-related characteristics of hospital inpatient suicides in Milan, Italy, which were collected at the Institute of Forensic Medicine during a twenty-eight-year period (1993-2020). In particular, this study compared the features of hospital inpatient suicides in patients with and without psychiatric diagnoses.
Methods:
Data were collected through the historical archive, annual registers, and autopsy reports, in certified copies of the originals deposited with the prosecutors of the courts.
Results:
Considering the global sample, inpatients were mainly men (N = 128; 64.6%), with a mean age of 56.7 years (SD ± 19.8), of Italian nationality (N = 176; 88.9%), admitted to non-psychiatric wards (N = 132; 66.7%), with a single illness (N = 111; 56.1%), treated with psychotropic medications (N = 101; 51%), who used violent suicide methods (N = 177; 89.4%), died of organic injuries (N = 156; 78.8%), and outside the buildings (N = 114; 72.7%). Comparing psychiatric and non-psychiatric inpatients, suicide cases with a non-psychiatric diagnosis were predominantly men (N = 48; 76.2%), hospitalized in non-psychiatric wards (N = 62; 98.4%), assuming non-psychotropic drugs (N = 37; 58.7%), and died in outside hospital spaces (N = 54; 85.7%).
Conclusions:
A fuller characterization of suicide among hospitalized inpatients requires systematic and computerized data gathering that provides for specific information. Indeed, this could be valuable for inpatient suicide prevention strategies as well as institutional policies.
... This is consistent with findings of a previous meta-analysis which reported that inpatient suicides are common [25,26]. A case control study done in Austria reported a suicide rate of 45.7 per 100,000 admissions [27]. These incidences have been linked to the mental illness of the patient and are believed to cause distress to staff that mental health facilities are expected to be safe spaces [28]. ...
Background
Both patients and health care providers working in mental health facilities witness high rates of incidents that have the potential to jeopardize their safety. Despite this, there are few studies that have documented the kind of incidents that are experienced, or explored the potential contributors to these incidents, and solutions that would result in better safety. This study explored various types of safety related incidents occurring in mental facilities in Kenya, perceived contributing factors, and recommendations for improve.
Methods
This qualitative descriptive study was carried out between December 2019 – February 2020. It included 28 mental health staff across 14 mental health unit spread across the country.
Results
All the participants reported having personally experienced an incident that threatened their safety or that of the patients. Most of the respondents (24/26. 91.67%) admitted to have experienced verbal aggression while 54.17%, ( n = 24) had experienced physical assault. Participating health care workers attributed the safety incidents to poor infrastructure, limited human resources, and inadequate medication to calm down agitated patients. Suggested solutions to improve patient safety included; improving surveillance systems, hiring more specialized healthcare workers, and provision of adequate supplies such as short-acting injectable psychotropic.
Conclusion
Incidents that threaten patient and staff safety are common in mental health facilities in Kenya. There is need to strengthen staff capacity and reporting mechanisms, as well as invest in infrastructural improvements, to safeguard patient and staff safety in mental health facilities in Kenya.
... Findings have shown that suicide risk is particularly high during hospitalization and at discharge [37]. In Deisenhammer et al. [38] study, those who died by suicide during hospitalization more frequently had an increased history of attempted suicide; they less often reported future plans and more regularly showed no improvement in mood at discharge. The opportunity to identify the presence of mental pain comorbid with depressive symptoms may help recognize poor future expectations, which is a well-known proxy for completed suicide [39]. ...
Background
Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered.
Methods
2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk.
Results
More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments.
Conclusions
Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.
... More than halfof the facilities in our study had experienced a patient that had tried to harm themselves attempted and complete suicide, This is consistent with ndings of a previous meta-analysis which reported that inpatient suicides are is common (19). (20). ...
Background: Both patients and health care providers working in mental health facilities witness high rates of incidents that have the potential to jeopardize their safety. Despite this, there are few studies that have documented the kind of incidents that are experienced, or explored the potential contributors to these incidents, and solutions that would result in better safety. This study explored various types of safety related incidents occurring in mental facilities in Kenya, perceived contributing factors, and recommendations for improve.
Methods: This mixed methods descriptive study was carried out betweenDecember 2019 – February 2020. It included 28 mental health staff across 14 mental health unit spread across the country.
Results: All the participants reported having personally experienced an incident that threatened their safety or that of the patients. Most of the respondents (24/26. 91.67%) admitted to have experienced verbal aggression while 54.17%, (n=24) had experienced physical assault. Participating health care workers attributed the safety incidents to poor infrastructure, limited human resources, and inadequate medication to calm down agitated patients. Suggested solutions to improve patient safety included; improving surveillance systems, hiring more specialized healthcare workers, and provision of adequate supplies such as short-acting injectable psychotropic.
Conclusion: Incidents that threaten patient and staff safety are common in mental health facilities in Kenya. There is need to strengthen staff capacity and reporting mechanisms, as well as invest in infrastructural improvements, to safeguard patient and staff safety in mental health facilities in Kenya.
