Suicide by mental health in-patients under observation

Observations in psychiatric in-patient settings are used to reduce suicide, self-harm, violence and absconding risk. The study aims were to describe the characteristics of in-patients who died by suicide under observation and examine their service-related antecedents. A national consecutive case ser...

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Bibliographic Details
Published in:Psychological medicine 2017-10, Vol.47 (13), p.2238-2245
Main Authors: Flynn, S., Nyathi, T., Tham, S.-G., Williams, A., Windfuhr, K., Kapur, N., Appleby, L., Shaw, J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Aggression
Deviation
England - epidemiology
Ethics
Fatalities
Female
Health services
Humans
Inpatients - statistics & numerical data
Intermittent
Male
Mental disorders
Mental health
Mental health care
Mental Health Services - statistics & numerical data
Middle Aged
Nursing
Original Articles
Patient safety
Patient Safety - standards
Patient Safety - statistics & numerical data
Psychiatric-mental health nursing
Psychiatry
Risk reduction
Self injury
Suicide
Suicide - statistics & numerical data
Suicides & suicide attempts
Violence
Wales - epidemiology
Young Adult
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Summary:Observations in psychiatric in-patient settings are used to reduce suicide, self-harm, violence and absconding risk. The study aims were to describe the characteristics of in-patients who died by suicide under observation and examine their service-related antecedents. A national consecutive case series in England and Wales (2006-2012) was examined. There were 113 suicides by in-patients under observation, an average of 16 per year. Most were under intermittent observation. Five deaths occurred while patients were under constant observation. Patient deaths were linked with the use of less experienced staff or staff unfamiliar with the patient, deviation from procedures and absconding. We identified key elements of observation that could improve safety, including only using experienced and skilled staff for the intervention and using observation levels determined by clinical need not resources.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291717000630