Evaluation of psychiatric consultations with suicide attempters

Diagnosis, management and disposition were evaluated in 120 psychiatric consultations with patients referred to a university hospital following an attempted suicide. Data were registered by hospital nurses and psychiatric consultants, and the patients were extensively interviewed after discharge. Many patients (43%) had been admitted to a psychiatric hospital on previous occasions or at the time of the suicide attempt. In almost one third of the cases, the consultants did not take sufficient interest in the patients' accounts of the last and previous suicide attempts. Their estimation of the reoccurrence of suicidal behaviour had a low predictive value (54%). One fourth to one half of the patients were negative about or not satisfied with the consultation. The compliance with the psychiatric consultants' referrals, however, was very high (79%). Although a large group of patients received effective care, the consultants did not pay enough attention to the group of (former) in-patients with recurrent suicidal behaviour. Possible causes and consequences of these findings are discussed.