The feasibility of suicide rates as an evaluation criterion in community psychiatry: methodological problems

Over the last 30-40 years the reform of psychiatric care in many countries has led to deinstitutionalization and treatment of many patients in community psychiatric services. There is an ongoing discussion on whether this process may lead to a higher suicide rate. There are only a few studies addressing this issue, and empirical data are scarce. Several methodological problems make it difficult to use suicide rates as an evaluation criterion for community psychiatry. These problems are briefly discussed.