Mental health service improvements may lower suicide rates

Service changes in mental health institutions may lower suicide rates, according to a report from researchers at the University of Manchester.

From 1997 to 2011, 23,406 people died by suicide within 12 months of receiving mental health services, representing 26% of all suicide deaths that occurred in the United Kingdom during that time.

Data were collected from individuals aged at least 10 years who died by suicide from 1997 to 2011. Based on a previous study, researchers chose 17 service recommendations to study in relation to suicide rates. The recommendations were categorized into five groups: ward safety, community services (such as outreach programs and home treatment teams), staff training, policies and National Institute for Health and Clinical Excellence guidelines.

Researchers found that institutions that implemented 11 to 16 service changes had lower suicide rates than those that implemented 0 to 10 service changes. In 2007, institutions that implemented more than 10 changes had suicide rates 21% lower than their peers. In 2008, institutions that adhered to more than 10 recommendations had 24% lower suicide rates. In 2011, suicide rates were 36% lower in institutions that made more than 10 changes compared with those that implemented fewer than 10 changes.

Changes in policies regarding in-house patients who escaped, National Institute for Health and Clinical Excellence depression guidelines, and policies regarding patients with two diagnoses had the most significant effect on suicide rates.

“We found that the implementation of service changes and recommendations was associated with lower patient suicide rates in mental health service providers. This shows that there are positive steps all mental health service providers can make. Providing specialist community services for patients is particularly important for trusts to implement,” researcher Louis Appleby, MD, FRCPsych, director of the University's National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, said in a press release.

For more information:

National Confidential Inquiry into Suicide and Homicide by People with Mental Health Illness (NCISH). Patient Suicide: the impact of service changes. A UK wide study. Manchester: University of Manchester 2013.

Disclosure: The researchers report no relevant financial disclosures.