- The Washington Times - Thursday, July 6, 2017

More effort is needed to follow up with patients at risk of suicide immediately following their discharge from inpatient treatment and many years after, researchers concluded in a wide-ranging study on suicide patient data from 1948 to 2016.

The study, “Suicide Rates After Discharge from Psychiatric Facilities,” was published in the July issue of the Journal of the American Medical Association and argues that access to long-term care and assistance is necessary for people with suicidal ideas or behaviors.

Conducted by researchers at the University of New South Wales in Australia, the study analyzed data from 100 studies from all over the world that included nearly 5 million patient follow-ups and more than 17,000 suicides. Researchers focused on the rate of suicide after discharge from psychiatric facilities ranging from three months to many years.

“The immediate postdischarge period is a time of marked risk,” the author’s wrote in the conclusion, “but rates of suicide remain high for many years after discharge. Patients admitted because of suicidal ideas or behaviors and those in the first months after discharge should be a particular focus of concern. Previously admitted patients should be able to access long-term care and assistance.”

In an accompanying editorial, psychology professor Mark Olfson at Columbia University Medical Center said that there have yet to be any meaningful gains in decreasing the number of people who commit suicide.

“The clinical message of these findings is clear: universal and continuing suicide prevention interventions are needed for patients after psychiatric hospital discharge,” he said in the JAMA editorial, adding that more support is needed for clinical monitoring in the first few months after a patient is discharged from treatment.

The most shocking aspect of the findings was that even 10 years after hospital discharge, “people continued to be at roughly twenty times higher suicide risk than the general population,” Mr. Olfson said in an email to The Washington Times.

Dr. Christine Moutier is the chief medical officer of the American Foundation for Suicide Prevention and was not involved in the study. She said the findings support the idea that hospitalized treatment, while providing a safe place for patients to explore the triggering factors that led to their suicide attempt or thoughts to attempt suicide, does not offer a quick fix in countering the multiple elements that drive people to the extreme of suicide.

“All of that is not new information, however, I don’t think it’s widely known information,” Dr. Moutier said. “So this is an important study both because it’s the largest meta analysis that’s ever been done on the topic, that I’m aware of, but also because it’s information that is worthwhile for health care providers as well as families, and just citizens to be aware of.”

According to federal data, suicide is the second-leading cause of death among youth and adults aged 15 through 34, and the 10th-leading cause of death in the U.S., with more 44,000 people taking their own lives annually. Suicide rates in the U.S. increased between 2011 and 2015, from 12.3 per 100,000 people to 13.3 per 100,000 people.

Dr. Moutier said these statistics fail to account for the ripple effect suicide has on family, friends and communities.

A 2015 survey conducted by the American Foundation for Suicide Prevention found that 55 percent of U.S. adults have been affected by suicide in some way.

“We’re talking about the majority of the public, and yet … just now, I think, society is coming out of the shadows of being able to talk about this issue. So they don’t know that they’re not alone, so that is a very important part of the culture change that is happening around suicide prevention,” Dr. Moutier said.

Suicide prevention, especially among the young, is part of the federal government’s “Healthy People 2020” goals, which seeks to reduce suicide rates by 10 percent.

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