Rivart Pauline, Bojanić Lana, Turnbull Pauline, Appleby Louis, Kapur Nav, Hunt Isabelle M
National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, Manchester, UK.
BJPsych Open. 2024 Dec 5;10(6):e228. doi: 10.1192/bjo.2024.822.
Tackling methods of suicide and limiting access to lethal means remain priority areas of suicide prevention strategies. Although mental health services are a key setting for suicide prevention, no recent studies have explored methods used by mental health patients.
To investigate associations between main suicide methods and social, behavioural and clinical characteristics in patients with mental illness to inform prevention and improve patient safety.
Data were collected as part of the National Confidential Inquiry into Suicide and Safety in Mental Health. We examined the main suicide methods of 26 766 patients in the UK who died within 12 months of contact with mental health services during 2005-2021. Associations between suicide methods and patient characteristics were investigated using chi-square tests and univariate and multivariate logistic regression.
Suicide methods were associated with particular patient characteristics: hanging was associated with a short illness history, recent self-harm and depression; self-poisoning with substance misuse, personality disorder and previous self-harm; and both jumping and drowning with ethnic minority groups, schizophrenia and in-patient status.
A method-specific focus may contribute to suicide prevention in clinical settings. Hanging deaths outside of wards may be difficult to prevent but our study suggests patients with recent self-harm or in the early stages of their illness may be more at risk. Patients with complex clinical histories at risk of suicide by self-poisoning may benefit from integrated treatment with substance use services. Environmental control initiatives are likely to be most effective for those at risk of jumping or drowning.
自杀应对方法及限制获取致命手段仍是自杀预防策略的重点领域。尽管心理健康服务是自杀预防的关键场所，但近期尚无研究探讨心理健康患者所采用的方法。
调查精神疾病患者主要自杀方法与社会、行为及临床特征之间的关联，以为预防工作提供信息并提高患者安全性。
数据收集作为国家心理健康自杀与安全保密调查的一部分。我们研究了2005年至2021年期间在英国与心理健康服务机构接触后12个月内死亡的26766名患者的主要自杀方法。使用卡方检验以及单变量和多变量逻辑回归研究自杀方法与患者特征之间的关联。
自杀方法与特定患者特征相关：上吊与病程短、近期有自我伤害行为及抑郁症相关；自我中毒与药物滥用、人格障碍及既往自我伤害行为相关；跳楼和溺水均与少数族裔群体、精神分裂症及住院状态相关。
针对特定方法的关注可能有助于临床环境中的自杀预防。病房外的上吊死亡可能难以预防，但我们的研究表明近期有自我伤害行为或处于疾病早期的患者可能风险更高。有自我中毒自杀风险且临床病史复杂的患者可能受益于与药物使用服务的综合治疗。环境控制措施可能对有跳楼或溺水风险的人最为有效。
