Suicides in psychiatric patients : identifying health care-related factors through clinical practice reviews

Michaud, Laurent (McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal (Québec), Canada ; Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland) ; Stiefel, Friedrich (Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland) ; Moreau, Delphine (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Dorogi, Yves (Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland) ; Morier-Genoud, Anouk (Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland) ; Bourquin, Céline (Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland)

The objective of this study was to identify health care-related factors associated with death by suicide in psychiatric patients and to gain insight into clinician views on how to deal with suicidality. The study material derived from a clinician committee in a psychiatric department reviewing every outpatient and inpatient suicide in a standardized way. Reports’ conclusions and corresponding plenary discussion minutes regarding 94 suicides were analyzed using inductive thematic content analysis. Health care-related factors were categorized into 4 themes: patient evaluation, patient management, clinician training, and involvement of relevant non-clinical partners. Clinician views on the themes were expressed through statements (i) promoting or restricting an aspect of care (here called recommendations), which mainly followed existing guidelines and were consensual and (ii) without precise indication (here called comments), which departed from mainstream opinions or addressed topics not covered by existing policy. Involvement of non-clinical partners emerged as a new key issue for suicide prevention in psychiatric departments and should be openly discussed with patients. Clinicians preferred balanced conclusions when they reviewed suicide cases.


Keywords:
Article Type:
scientifique
Faculty:
Santé
School:
HESAV
Institute:
Unité de recherche en santé, HESAV
Date:
2020-01
Pagination:
25 p.
Published in:
Archives of suicide research
Numeration (vol. no.):
2020, vol. 24, suppl. 2, pp. S150-S164
DOI:
ISSN:
1381-1118
Appears in Collection:



 Record created 2020-10-02, last modified 2020-10-27

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