[Guidelines and their observance in the psychiatric care of failed suicides in general hospitals]

To gain insight into the guidelines established for the care of failed suicides in general hospitals, and into the degree to which these guidelines are observed in practice.

Descriptive, retrospective.

Department of Psychiatry, Rijnstate Hospital, Arnhem, the Netherlands.

An inventory of guidelines for the care of failed suicides was made by interviewing seven psychiatrists on the staff of general hospitals. The inventory was limited to access (interval between admission and referral/consultation), and the coordination of the care (i.e. adjustment to the patient's condition, transfer of information). Subsequently, the cases of all failed suicides admitted to these hospitals in 1991 were studied to find out how these guidelines were observed in practice; use was made for this purpose of data from a more extensive European study.

All seven hospitals proved to have rules for coping with tailed suicides. Guidelines concerning accessibility of care were fairly similar in the various hospitals; regarding the coordination of care, more local variants were found to exist. The accessibility of care was found to be mostly in accordance with the guidelines. There were more deviations from the guidelines where the coordination of care was concerned; in addition, there were substantial differences between the hospitals in the degrees to which deviation from the guidelines occurred.

Guidelines for the care of failed suicides admitted to general hospitals were not in all respects similar; the observance differed markedly, especially regarding the coordination of care.