{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:10:38Z","timestamp":1788304238513,"version":"build-2803163510"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291723003628_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Psychiatric in-patients have a greatly elevated risk of suicide. We aimed to examine trends in in-patient suicide rates and determine if characteristics of in-patients who died by suicide have changed over time.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723003628_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We identified all in-patients in England who died by suicide between 2009 and 2020 from the National Confidential Inquiry into Suicide and Safety in Mental Health. Suicide rates were calculated using data from Hospital Episodes Statistics.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723003628_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The rate of in-patient suicide per 100 000 bed days fell by 41.9% between 2009\u20132011 and 2018\u20132020. However, since 2016 the rate has remained static with no significant fall. Rates fell in men, those aged 30\u201359, and those with schizophrenia and other delusional disorders or personality disorder. Rates also fell for suicide by hanging (including hanging on the ward) and jumping. No falls were seen in suicide rates among women, younger and older age groups, and those with affective disorder. There was no indication of a transfer of risk to the post-discharge period or to home treatment\/crisis care. More in-patients in the latter part of the study were aged under 25, were on authorised leave, and had psychiatric comorbidity.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723003628_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>In-patient suicide has significantly fallen since 2009, suggesting patient safety may have improved. The recent slowdown in the fall in rates, however, highlights that renewed preventative efforts are needed. These should include a greater focus on women, younger and older patients, and those with affective disorder. Careful reviews prior to granting leave are important to ensure a safe transition into the community.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291723003628","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T07:49:06Z","timestamp":1705045746000},"page":"1702-1708","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Psychiatric in-patient care in England: as safe as it can be? An examination of in-patient suicide between 2009 and 2020"],"prefix":"10.1017","volume":"54","author":[{"given":"Isabelle M.","family":"Hunt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Baird","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Turnbull","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saied","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Appleby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nav","family":"Kapur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"S0033291723003628_ref30","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2021.41"},{"key":"S0033291723003628_ref33","unstructured":"Office for National Statistics. (2021). Suicides in England and Wales: 2020 registrations. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/bulletins\/suicidesintheunitedkingdom\/2020registrations (Accessed 23 February 2023)."},{"key":"S0033291723003628_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-021-02215-5"},{"key":"S0033291723003628_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13221"},{"key":"S0033291723003628_ref20","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291706008373"},{"key":"S0033291723003628_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291712000864"},{"key":"S0033291723003628_ref32","unstructured":"NHS England. (2023). Acute inpatient mental health care for adults and older adults. July 2023. https:\/\/www.england.nhs.uk\/long-read\/acute-inpatient-mental-health-care-for-adults-and-older-adults\/ (accessed 2nd August 2023)."},{"key":"S0033291723003628_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61848-6"},{"key":"S0033291723003628_ref26","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.188.2.129"},{"key":"S0033291723003628_ref12","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4001793"},{"key":"S0033291723003628_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2018-210781"},{"key":"S0033291723003628_ref39","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12765"},{"key":"S0033291723003628_ref40","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-019-01656-3"},{"key":"S0033291723003628_ref38","volume-title":"Stata statistical software: Release 16","year":"2019"},{"key":"S0033291723003628_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(14)70250-0"},{"key":"S0033291723003628_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12416"},{"key":"S0033291723003628_ref9","doi-asserted-by":"publisher","DOI":"10.1108\/JMHTEP-05-2020-0023"},{"key":"S0033291723003628_ref36","first-page":"58","article-title":"The chronological assessment of suicide events: A practical interviewing strategy for the elicitation of suicidal ideation","volume":"59","author":"Shea","year":"1998","journal-title":"Journal of Clinical Psychiatry"},{"key":"S0033291723003628_ref41","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2021.996"},{"key":"S0033291723003628_ref1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.145706"},{"key":"S0033291723003628_ref29","unstructured":"National Patient Safety Agency. (2009). Never events. Framework 2009\/10. Process and action for primary care trusts 2009\/10. London. Retrieved from https:\/\/assets.publishing.service.gov.uk"},{"key":"S0033291723003628_ref31","unstructured":"NHS. (2019). The NHS long term plan. Retrieved from https:\/\/www.longtermplan.nhs.uk\/"},{"key":"S0033291723003628_ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s00115-016-0111-3"},{"key":"S0033291723003628_ref25","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08656"},{"key":"S0033291723003628_ref23","doi-asserted-by":"publisher","DOI":"10.1521\/suli.34.4.448.53740"},{"key":"S0033291723003628_ref28","unstructured":"National Confidential Inquiry into Suicide and Safety in Mental Health. (2023). Annual Report: UK patient and general population data, 2010\u20132020. The University of Manchester. 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Suicides in England and Wales: 2021 registrations. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/bulletins\/suicidesintheunitedkingdom\/2021registrations (Accessed 12 April 2023)."},{"key":"S0033291723003628_ref10","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.118.3.392"},{"key":"S0033291723003628_ref5","first-page":"u209837.w5117","article-title":"Absconding: Reducing failure to return in adult mental health wards","volume":"5","author":"Bailey","year":"2016","journal-title":"British Medical Journal Open Quality"},{"key":"S0033291723003628_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)00063-8"},{"key":"S0033291723003628_ref8","unstructured":"Department of Health and Social Care. (2016). Out of area placements in mental health services for adults in acute inpatient care. https:\/\/www.gov.uk\/government\/publications\/oaps-in-mental-health-services-for-adults-in-acute-inpatient-care\/out-of-area-placements-in-mental-health-services-for-adults-in-acute-inpatient-care (accessed 4th March 2023)."},{"key":"S0033291723003628_ref18","doi-asserted-by":"publisher","DOI":"10.1027\/0227-5910\/a000117"},{"key":"S0033291723003628_ref37","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.22"},{"key":"S0033291723003628_ref11","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201900452"},{"key":"S0033291723003628_ref13","first-page":"25","article-title":"Suicides among persons with psychiatric hospitalizations","volume":"52","author":"Goldberger","year":"2015","journal-title":"Israel Journal of Psychiatry and Related Sciences"},{"key":"S0033291723003628_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291712002401"},{"key":"S0033291723003628_ref2","unstructured":"Appleby, L. , Shaw, J. , Kapur, N. , Windfuhr, K. , Ashton, A. , Swinson, N. , \u2026 While, D. (2006). Avoidable Deaths. Five Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. 2006. Department of Health: London. Retrieved from: https:\/\/sites.manchester.ac.uk\/ncish\/reports\/"},{"key":"S0033291723003628_ref4","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15071425"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291723003628","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T08:54:39Z","timestamp":1716886479000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291723003628\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,12]]},"references-count":42,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["S0033291723003628"],"URL":"https:\/\/doi.org\/10.1017\/s0033291723003628","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,12]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2024. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}