Over the ten year period between 1997 and 2006. 26 per cent of all those who had committed suicide during this time had been in contact with mental health services during the previous year.
The authors focus particularly on cases where the people concerned were inpatients in the care of mental health services at the time of their death, of which there were 1851 cases during the ten years. 25 per cent committed suicide after absconding from the ward, and the main purpose of the paper is to show how absconding and suicide might be prevented amongst inpatients, based on the social and clinical characteristics of these cases.
The researchers found that compared to those who died whilst absent from the ward with permission, absconders were more likely to be young, homeless, unmarried and unemployed, and to have a record of substance abuse and violence. They were also significantly more likely to have a diagnosis of schizophrenia, to be in the first week of admission, and to be considered ‘non compliant’ with their medication. Ward design seems to have been an important factor impeding the observation of those who had absconded. The authors suggest that rates of absconding and suicide by absconders could be reduced by improving management of exits; by assessing the suitability of the environment for high risk patients; and by enhancing observation during the first week after admission. Efforts to make the ward seem ‘less oppressive’ are also important, such as engagement and support by staff and a variety of activities.
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