[SUICIDES DURING PSYCHIATRIC HOSPITALIZATION - CHARACTERISTICS AND WAYS OF COPING]

It is known as a circumstantial background to suicide that patients with psychiatric disorders admitted to a psychiatric hospital are at risk of suicide. Most of the reasons offered for suicide during hospitalization link them to the circumstances of the need for psychiatric hospitalization: the existence of a significant mental disorder and the condition of a crisis, that in many cases, cover a complete life span: psychological, social and medical. In Israel, the multi-year average number (1990-2013) of suicides during psychiatric hospitalization is about 13.6, which account for 3.4% of the total of 400 suicide incidents per year. It reflects one suicide incident in 1,614 hospitalizations. Hanging and then jumping are the most common suicide methods during hospitalization. Other common measures are self-suffocation, overdose of drugs, self-ignition, vein / arterial cutting. The highest risk group is of schizophrenic patients that express one of the following manifestations: depressive symptoms, suicidal attempts in the past, and a history of many hospitalizations. The most prominent risk factors identified among all patients are a history of self-harming attempts, feelings of hopelessness, guilt, sense of inadequacy, low mood, suicidal thinking, and a history of suicide in the family. The response of the psychiatrists and the treatment teams to a suicide event in their unit is traumatic, at a level that significantly affects future therapeutic decisions, decreases morale in the team, and even affects the quality of their personal lives. The two most important tools for preventing suicide during hospitalization are: firstly, reducing the availability of measures in the context of the hospitalization medium, ie, creating a physically safe environment that includes appropriate design of walls, ceilings, doors, toilets and showers. A second tool is the therapeutic relationship and its level of availability.