The prevention of suicide while in psychiatric care

The increase in the number of recorded suicides among inpatients in psychiatric care in Sweden can, to a great extent, be attributed to more suicides in the population as a whole, and to an increase and changes in the psychiatric population as well as to improved recording methods. The number of suicides in connection with psychiatric care is, however, higher than usually assumed. If "definite" suicides and "controversial cases" are included, as well as those which occur within a week of discharge, then this figure is 2.5 times the registered number of definite suicides. The importance of various background factors is discussed. Suicidal behaviour can be considered both from a longitudinal as well as from a cross sectional perspective. The insight in the fact that there is a similarity between the suicidal act and accidents leads to important consequences for the prevention of suicide. The present work concludes by suggesting an overall philosophy and recommendations as to preventive work within the field of psychiatry.