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Suicides among persons with psychiatric hospitalizations
Nehama Goldberger1, Ziona Haklai1, Inna Pugachova2
1Health Information Division, Ministry of Health, Jerusalem, Israel.
The Israel Journal of Psychiatry and Related Sciences
|April 5, 2015
Summary
Individuals with severe mental disorders face significantly higher suicide risks, especially after psychiatric hospitalization. Targeted interventions during and after inpatient stays are crucial for suicide prevention efforts.
Area of Science:
- Psychiatry and Mental Health
- Public Health
- Epidemiology
Background:
- Individuals with severe mental disorders exhibit elevated suicide rates compared to the general population.
- Understanding the specific risk profiles of this demographic is essential for effective suicide prevention strategies.
- Changes in psychiatric hospital bed capacity and patient turnover may influence suicide risk.
Purpose of the Study:
- To compare suicide rates between individuals with a history of psychiatric hospitalization and the general population.
- To identify sociodemographic and psychiatric factors associated with suicide risk in this population.
- To analyze temporal trends in suicide rates and the timing of suicide deaths relative to hospitalization.
Main Methods:
- Linked the National Psychiatric Case Register (NPCR) with national death records for Israelis aged 18+ with prior psychiatric hospitalization (1981-2009).
- Calculated age-standardized suicide rates, rate ratios (RR), and standardized mortality ratios (SMR) comparing the ever-hospitalized group to the non-hospitalized population.
- Employed a multivariate logistic model to identify risk factors for suicide among the ever-hospitalized.
Main Results:
- Individuals with psychiatric hospitalization had substantially higher age-standardized suicide rates (17.6x for Jews/Others, 29.7x for Arabs) than the non-hospitalized.
- Suicide risk was elevated among females, younger individuals, and specific immigrant groups, increasing with the number of hospitalizations.
- A significant proportion of suicides occurred around discharge (19% on discharge day, 13% within a month post-discharge), with rising trends in recent years.
Conclusions:
- Psychiatric hospitalization is associated with a markedly increased risk of suicide.
- Urgent suicide prevention interventions are necessary for individuals during inpatient psychiatric care.
- Post-discharge follow-up and community-based support are critical for reducing suicide risk in this vulnerable population.
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