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Home treatment for mental health patients linked to high suicide risk

New research suggests that treating some mental health patients on psychiatric wards rather than at home could lead to a drop in suicides.

Figures published in the journal Lancet Psychiatry show that the number of mental health inpatients suicides fell from 163 in 2003-04 to 76 in 2011-12 − a drop of more than 50%.

“Inpatient care might reduce suicide risk more effectively than crisis resolution home treatment”

Isabelle Hunt

However, a total of 163 patients who were cared for by crisis resolution home treatment (CRHT) teams at home committed suicide in 2011-12, more than twice the figure of 80 in 2003-04.

It was also found that the overall rate of suicides among home patients continues to be higher than the inpatient rate, at 14.6 per 10,000 episodes under home care compared with 8.8 per 10,000 hospital admissions − even though the home patient rate fell by nearly a fifth between 2003 and 2011.

Experts from the University of Manchester analysed data from the National Confidential Inquiry into Suicide and Homicide by people with Mental Illness and the Mental Health Minimum Dataset.

They found the average number of people cared for by CRHT teams and committing suicide was 140 per year, 23 − or around 20% − more than those treated on psychiatric wards, between 2003 and 2011.

The figures also showed that close to half (44%) of home care patients who killed themselves lived alone, and one in three home care suicides happened within three months of the patients being discharged from a psychiatric ward.

Study leader Dr Isabelle Hunt said the findings suggested CRHT was linked to a high suicide risk among mental health patients, and that inpatient care could help tackle the problem more effectively.

“CRHT has been used increasingly during the period we have studied and the number of patients dying by suicide is growing,” she said. “Inpatient care might reduce suicide risk more effectively than crisis resolution home treatment.”

Professor Nav Kapur, senior author of the study, added that home treatment might not be the best option for certain patients, such as those who live on their own or have only recently been discharged from hospital.

Readers' comments (2)

  • There will be less suicides in hospital one because there are fewer people admitted to hospital and secondly, it is more restrictive practice and service users are being observed 24 hours a day. So it's not a very surprising finding

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  • No surprises there then. Home treatment services are woefully inadequate in terms of what they can offer and what resources are available to them within the community. Not blaming the staff, services have been set up to save money and as with anything else in mental health care, are underfunded. The acutely mentally ill who are actively suicidal NEED to be in hospital for their own safety. A periodic visit by a mental health practitioner, with the best will in the world is not enough.

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