Suicides in general hospitals: Meta-analysis of incidence and trends

To synthesise the primary literature reporting the incidence of suicide in general hospitals.

Peer-reviewed papers reporting suicides among the medically and surgically admitted patients of general hospitals were located by searches of MEDLINE, PsycINFO and EMBASE between 1946 and 2025. Random effects meta-analyses were used to estimate the number of suicides per 1,000,000 admissions, the rate of suicide per 100,000 patient years and the proportion of suicides by common suicide methods. Temporal trends were examined with mixed-effects meta-regression.

The pooled number of suicides per 1,000,000 admissions was 16.3 (95% confidence interval = [9.8, 27.0]). The pooled rate of suicide per 100,000 patient-years was 82.7 suicides (95% confidence interval = [49.6, 115.7]). Jumping accounted for 52.1% (95% confidence interval = [39.4, 64.4]) of suicides, and 20.6% (95% confidence interval = [13.1, 30.8]) were by hanging. The number of suicides per admission declined over time (point estimate of slope = -0.039, standard error = 0.01, p < 0.0004) to 4.7 suicides per 1,000,000 admissions (95% confidence interval = [1.7, 12.9], I² = 97) in nine studies published after 2010. The rate of suicide per patient year was unchanged over 60 years of primary research (slope ⩽ -0.0001, standard error = 0.0001, p = 0.97).

The rate of suicide in general hospital inpatients is an order of magnitude higher than the global suicide rate. While general hospital suicide is a critical patient safety concern, the stability in suicide rates over time highlights the persistent difficulty of suicide prevention in this setting.