Suicide in high security hospital patients

Area of Science:

• Forensic Psychiatry
• Public Health
• Mental Health Research

Background:

• High-security hospitals house individuals with severe mental disorders and a history of violence.
• While violence risk is recognized, suicide potential in this population is often underestimated.
• Understanding suicide rates and risk factors is crucial for patient care and safety.

Purpose of the Study:

• To investigate suicide rates among patients in high-security hospitals, both during and after their residency.
• To identify specific risk factors associated with suicide in this patient group.
• To compare suicide risks in high-security patients with the general population.

Main Methods:

• Data extracted from the Special Hospitals' Case Register (1972-2000) for 5,955 individuals.
• Suicide rates calculated and compared to the general population using standardized mortality ratios (SMRs).
• Poisson regression used to analyze effects of gender, legal status, offending history, and admission length on suicide rates.

Main Results:

• A total of 218 suicides occurred among the study population.
• Suicide rates were significantly higher than the general population: nearly 7x for men and over 40x for women during residency.
• Post-discharge, suicide rates remained elevated: 23x for men and 45x for women. Women had higher in-hospital rates, while men's risk increased post-discharge.

Conclusions:

• Patients in high-security hospitals exhibit substantially higher suicide rates than the general population.
• Gender-specific risk patterns emerged: women at higher risk during residency, men at higher risk after discharge.
• Findings underscore the need for targeted suicide prevention strategies in high-security settings, considering gender-specific trajectories.