The second case-control study relates to the risk of suicide within two weeks of discharge from psychiatric inpatient care. Out of 100 psychiatric patients who died by suicide fifty-five percent of suicides occurred within a week of discharge, 49% of whom died before their first follow-up appointment. Analyses indicated that recent adverse life events and a short (less than one week) final admission were independently associated with post discharge suicide, as were older age and comorbid psychiatric disorders. Receiving enhanced aftercare (under the Care Programme Approach) was protective of suicide.
Implications for Practice: Discharged patients viewed as being at high risk of suicide (based on mental state assessment prior to discharge) require immediate community follow-up. Mental health services should be mindful of discharging patients after a short admission. The potential role of detrimental life experiences indicates that mental health clinicians need to be aware of the circumstances into which patients are being discharged. Use of enhanced levels of care, such as that offered by the Care Programme Approach, may play a strong role in preventing suicide within two weeks of discharge.
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