Inpatient Suicides in Swedish Psychiatric Settings - A Retrospective Exploratory Study from a Nursing Perspective

Area of Science:

• Psychiatry
• Public Health
• Medical Record Analysis

Background:

• Suicide remains a significant public health concern in Sweden, with approximately 1,200 deaths annually.
• While inpatient suicide is infrequent, it underscores the need for rigorous safety protocols within psychiatric facilities.

Purpose of the Study:

• To retrospectively analyze documentation of suicide risk, safety measures, and patient characteristics for individuals who died by suicide during psychiatric inpatient care.
• To compare documented suicide risk factors and interventions between patients with and without prior suicide attempts.

Main Methods:

• A national retrospective study analyzing medical records of 41 patients who died by suicide during psychiatric inpatient care in 2015.
• Data extraction focused on documented suicidal variables, previous suicide attempts, diagnoses, risk assessments, supervision levels, and circumstances at the time of death.

Main Results:

• Suicidal variables were documented in 80% of cases; 59% had a history of suicide attempts, and 63% had mood disorder diagnoses.
• Elevated suicide risk was assessed in 41%; hanging/suffocation was the most common method (68%).
• 22% died within 24 hours of admission, one-third on agreed leave, and no patients had constant one-to-one supervision.

Conclusions:

• The findings highlight critical gaps in supervision, particularly within the initial phase of inpatient psychiatric care.
• Implementing enhanced, high-level supervision, especially for high-risk patients and shortly after admission, is vital for suicide prevention in psychiatric settings.