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'Renewed emphasis' on preventing in-patient suicide needed

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A “renewed emphasis” on preventing people from killing themselves on in-patient wards is needed in order to return to previous reductions in suicide rates, experts from a national inquiry have said.

In the past, annual UK in-patient suicide rates dropped by 39% between 2005 and 2010, from 190 to 115, according to this year’s National Confidential Inquiry into Suicide and Homicide by People with Mental Illness.

But this has slowed in recent years, and between 2010 and 2015 there was just a 10% reduction, from 115 to 103, said the report published yesterday by researchers at the University of Manchester.

This year’s report found there was no change in the number of UK in-patients who killed themselves between 2014 and 2015, the most recent year for which data is available.

However, in England – where most suicides in this setting occur – there was a slight reduction, dropping from 85 to 81.

“There should be a renewed emphasis on suicide prevention on in-patient wards”

National Confidential Inquiry into Suicide

The inquiry, which looks at a range of statistics about suicide and homicide, found the total number of all UK patients who killed themselves in 2015 was 1,538, down from 1,572 the year before. This was almost all down to reductions in England.

It also highlighted that the number of suicides by UK patients recently discharged – within three months – from hospital had continued to fall in recent years, down from 299 in 2011, to 230 in 2015. In England, it had reduced from a high of 227 in 2011, to 175 in 2015.

The inquiry highlighted that these downward trends had occurred despite more patients being treated by mental health services.

The most common method of suicide by patients in all UK countries was hanging. Among those that killed themselves off the ward, the majority (between 52% and 84%) were on leave or had left with staff agreement.

“There should be a renewed emphasis on suicide prevention on in-patient wards, with the aim of re-establishing the previous rate of decrease in in-patient suicide,” said the inquiry report in its list of recommendations.

It called on organisations and staff to improve the physical environment of wards, such as by removing low-lying ligature points.

Staff should also look at measures to reduce instances where patients left wards without agreement from professionals by, for instance, improving ward exit and entry points and reviewing observation protocols.

Experts also suggested mental health hospitals should ensure care plans were always in place for patients during periods of agreed leave from wards.

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