Originally published 2014: T Rigby

Researchers call for suicides soon after discharge to be ‘never events’ in NHS.

Mental health patients are at their highest risk of dying by suicide in the first two weeks after leaving hospital – a report out today (16/7/14) shows.

Around 3,225 patients died by suicide in the UK within the first three months of their discharge from hospital – 18% of all patient suicides, between 2002-2012.

The University of Manchester’s National Confidential Inquiry into Suicide and Homicide by People with Mental Illness found that 526 patients died within the first week, the peak time of risk in England, Northern Ireland and Scotland; it is the first two weeks in Wales.    

The Inquiry data, commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, the Health Department of the Scottish Government, the Welsh Government, DHSSPS Northern Ireland and Jersey, was being presented to healthcare professionals and service users at a launch event in Manchester today. 

Professor Louis Appleby, Director of the National Confidential Inquiry, who led the study said:

Our latest data shows the first three months after discharge remain the time of highest risk but especially in the first 1-2 weeks. This increased risk has been linked to short admissions and to life events so our recommendations are that careful and effective care planning is needed including for patients before they are discharged and for those who self-discharge.

Early follow-up appointments should be strengthened and reducing the length of in-patient stay to ease pressure on beds should not be an aim in itself. Instead health professionals should ensure the adverse events that preceded the admission have been addressed.

The research team call for suicides within 3 days of hospital discharge and deaths and serious injuries caused by restraint to be NHS ‘never events’. 

There were 18,017 patient suicides between 2002 and 2012 in the UK, 28% of suicides in the general population during this time.    

Hanging remains a common method for suicide with an increase in this method.  In 2012, there were 2,994 suicides by hanging in the UK, 813 in mental health patients.   

Professor Nav Kapur, Head of Suicide Research at the National Confidential Inquiry, said:

The increase in hanging may be related to restrictions on the availability of other method and the misconception that hanging is a quick and painless way to die – but this is not the case and is also highly distressing for family members who discover the body.