Inpatient suicide in a general hospital psychiatric unit. A consequence of inadequate resources?

The incidence of suicide and high lethality attempted suicide in the 20-bed inpatient psychiatric unit of a general hospital was reviewed over a 10-year period. Although locating accurate records was difficult, a trend suggestive of increasing incidence was identified. We noted that this observation corresponded with an increase in the number of patients being treated by staff on the ward, reduced length of stay, and an increase in the proportion of severely disordered patients. Although the ward was accepting a greater number of patients, the available facilities (both physical resources and personnel) were not changed until the early results of this study were known (late 1991). We suggest that the clinical demands placed upon a psychiatric facility may affect the incidence of suicide and attempted suicide. This has particular significance in the general hospital setting where resources may be limited by competing requirements from other units and the current trend to close large mental hospitals places more demand upon them.