{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T22:55:05Z","timestamp":1762642505662,"version":"3.40.5"},"reference-count":29,"publisher":"Royal College of Psychiatrists","issue":"2","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec id=\"S2056472421000028_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Homelessness in England and Wales is on the rise together with the mortality rate among homeless people. Many homeless people have a mental illness, which is a risk factor for suicide.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472421000028_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>This study used data from the National Confidential Inquiry into Suicide and Safety in Mental Health to examine demographic and clinical characteristics of homeless people who died by suicide and were in recent contact with mental health services.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472421000028_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We have compared 514 patients (2% of the total sample) who died by suicide and who were reported as being homeless or having no fixed abode by their clinicians with patients in stable accommodation between 2000 and 2016 to identify differences in sociodemographic characteristics and clinical care.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472421000028_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Our analysis suggests that homeless patients who died by suicide had more acute (alcohol: 47% <jats:italic>v<\/jats:italic>. 25%, <jats:italic>P<\/jats:italic> &lt; 0.01, drug: 39% <jats:italic>v<\/jats:italic>. 15%, <jats:italic>P<\/jats:italic> &lt; 0.01) and chronic (alcohol: 72% <jats:italic>v<\/jats:italic>. 44%, <jats:italic>P<\/jats:italic> &gt; 0.01, drug: 64% <jats:italic>v<\/jats:italic>. 31%) substance misuse issues than patients in stable accommodation. Homeless patients were also more likely to die as in-patients (21% <jats:italic>v<\/jats:italic>. 10%, <jats:italic>P<\/jats:italic> &lt; 0.01) or within 3 months of discharge (32% <jats:italic>v<\/jats:italic>. 19%, <jats:italic>P<\/jats:italic> &lt; 0.01).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472421000028_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Homeless patients who died by suicide more often had known risk factors for suicide than patients in stable accommodation. As a result of the higher percentages of post-discharge and in-patient suicides in homeless patients as well as the high prevalence of substance misuse, this study recommends closer integration of services as well as awareness of risks during in-patient admission and in the weeks immediately after discharge.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2021.2","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T07:51:06Z","timestamp":1615535466000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Suicide by homeless patients in England and Wales: national clinical survey"],"prefix":"10.1192","volume":"7","author":[{"given":"Paul","family":"Culatto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2067-2966","authenticated-orcid":false,"given":"Lana","family":"Bojani\u0107","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Appleby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Turnbull","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"S2056472421000028_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-006-0087-6"},{"key":"S2056472421000028_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-020-01952-3"},{"key":"S2056472421000028_ref6","doi-asserted-by":"publisher","DOI":"10.1027\/0227-5910.25.2.51"},{"volume-title":"The Homelessness Monitor: England 2017","year":"2017","author":"Fitzpatrick","key":"S2056472421000028_ref13"},{"key":"S2056472421000028_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckt025"},{"key":"S2056472421000028_ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-013-0774-z"},{"key":"S2056472421000028_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60747-2"},{"key":"S2056472421000028_ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-019-2361-7"},{"key":"S2056472421000028_ref24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7193.1235"},{"volume-title":"A Fresh Approach to Drugs","year":"2012","author":"UK Drug Policy Commission","key":"S2056472421000028_ref29"},{"volume-title":"Rough Sleeping Statistics Autumn 2018","year":"2019","key":"S2056472421000028_ref1"},{"key":"S2056472421000028_ref26","unstructured":"26 Keats, H , Cockersell, P , Johnson, R , Maguire, N . Psychologically Informed Services for Homeless People. Good Practice Guide. Communities and Local Government, 2012 (https:\/\/www.pathway.org.uk\/wp-content\/uploads\/2013\/05\/Psychologically-informed-services-for-Homeless-People.pdf)."},{"volume-title":"Annual Report: England, Northern Ireland, Scotland and Wales","year":"2019","key":"S2056472421000028_ref21"},{"volume-title":"Harmonisation of Definitions of Homelessness for UK Official Statistics: A Feasibility Report","year":"2019","key":"S2056472421000028_ref14"},{"key":"S2056472421000028_ref20","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.4.765"},{"volume-title":"Safety First: Five-year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness","year":"2001","author":"Appleby","key":"S2056472421000028_ref15"},{"key":"S2056472421000028_ref22","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-10-14"},{"key":"S2056472421000028_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291702006943"},{"volume-title":"Stata Statistical Software","year":"2017","key":"S2056472421000028_ref16"},{"key":"S2056472421000028_ref23","unstructured":"23 Taylor, H . Being Homeless And Experiencing Mental Health-Related Difficulties: Listening To And Learning From The Experiences Of Service Users Of A Designated Homeless Psychology Service. PhD, Leicester University, 2012."},{"volume-title":"Homeless and Inclusion Health","year":"2019","author":"Doyle","key":"S2056472421000028_ref28"},{"volume-title":"National Rough Sleeper Count, November 2018","year":"2019","key":"S2056472421000028_ref2"},{"volume-title":"Homeless and Inclusion Health standards for commissioners and service providers","year":"2018","key":"S2056472421000028_ref27"},{"key":"S2056472421000028_ref11","first-page":"665","article-title":"The prevalence of mental illness in homeless people in Germany","volume":"114","author":"Schreiter","year":"2017","journal-title":"Dtsch Aerzteblatt Online"},{"key":"S2056472421000028_ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050225"},{"volume-title":"Deaths of Homeless People in England and Wales: 2018","year":"2019","key":"S2056472421000028_ref3"},{"key":"S2056472421000028_ref7","doi-asserted-by":"publisher","DOI":"10.1177\/0706743717705354"},{"key":"S2056472421000028_ref25","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.2.370"},{"key":"S2056472421000028_ref8","article-title":"Mental Ill Health in the Adult Single Homeless Population: A Review of the Literature","author":"Rees","year":"2009","journal-title":"Crisis,"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472421000028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T07:51:28Z","timestamp":1615535488000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472421000028\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["S2056472421000028"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2021.2","relation":{},"ISSN":["2056-4724"],"issn-type":[{"type":"electronic","value":"2056-4724"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","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 in any medium, provided the original work 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"}],"article-number":"e65"}}