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STUDY - Psych Inpatient Suicides Fall, But Post-Discharge Suicides May Be on the Rise

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(May 17, 2012) The rate of psychiatric inpatient suicide in England fell by nearly one-third from 1997-2008, according to a new study, but the risk of suicide by patients following discharge appears to be on the rise, making “swift and effective support” for discharged patients “even more important.”

hung-close-upSounds like a case for assisted outpatient treatment (AOT) to us.

“Psychiatric in-patient care and suicide in England, 1997 to 2008” (Psychological Medicine, May 17) attributed the 29-31% drop in suicide rates to “Increased awareness of risk, a safer ward environment and improved professional practice,” according to summary in MedicalXpress (May 16). The drop was greatest among young patients and those with schizophrenia and exceeded the drop in the general population.

But lead author Nav Kapur said, “(A)s in-patient services are now dealing with patients who may be more unwell than in the past, swift and effective support for people following discharge has become even more important. We also need to keep a careful watch on suicide in services and settings which are alternatives to in-patient admission.”

Assisted outpatient treatment is a vital strategy for providing "swift and effective support" following discharge. As an increasing number of US states shutter or shrink state hospitals and increasing numbers of psychiatric patients are left with more limited inpatient care or no inpatient care at all, the use of AOT as a means of maintaining stability in psychiatrically fragile individuals becomes more urgently needed.  

There’s no reason to think the English trend would not hold in the US as well. Let’s hope it doesn’t take former patients taking their own lives to drive home the point that court-ordered outpatient treatment can play a lifesaving role in recovery from psychiatric crisis. 

(A copy the paper is available upon request from the University of Manchester.)

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