Suicide rates and attempts are far higher in patients who have had a psychiatric hospitalization, compared with the general population and even patients with similar psychiatric disorders who were not hospitalized, according to a research review in the Harvard Review of Psychiatry.
The “findings underscore the need for improved monitoring and care of patients discharged from psychiatric hospitalization,” researchers advised.
The review included 48 studies involving 1.7 million patients. The studies were published between 1964 and 2017.
The suicide rate within 12 months of discharge was 2.41 per 1000 psychiatric discharges, according to data from 41 studies. That equates to 1 suicide in every 415 discharges.
Attempted suicides occurred at a rate of 1 in every 46 discharges—nearly 9 times higher than the rate of completed suicides, data from 6 studies showed.
The risk of suicidal acts was highest soon after discharge across all 48 studies.
“More than one-quarter of all suicidal acts (26%) arose within the first month after discharge,” researchers wrote, “over 40% within 3 months, and 73% within 1 year.”
Compared with the general population, the suicide rate was more than 20 times higher in patients who recently experienced psychiatric hospitalization. The suicide rate in the study population was also higher than the rate in large clinical samples of patients with comparable disorders who were not necessarily hospitalized.
The findings highlight the importance of a sound assessment of suicidal risk before discharge as well as solid plans for post-discharge care, researchers cautioned.
“Ideally, planning and implementing of post-discharge care should occur prior to discharge and pursued without delay into aftercare,” they wrote, “with clinicians remaining especially alert to elevated suicidal risk for at least several months.”