Few studies have reported specifically on suicide in general hospital psychiatric inpatient units. Results of a study over a 10-year period of nine patients who committed suicide while being treated in such a unit are presented. Total admissions during the study period were 6 961 giving an average suicide rate of 1,4 suicides per 1 000 admissions. More males committed suicide than females. Most patients were unemployed with a history of parasuicide and psychiatric hospitalization. Psychiatric diagnoses of schizophrenia, affective disorder, and alcohol dependence predominated. Jumping from high-rise buildings near the hospital was the most common suicide method. Ward milieu and staff changes may have influenced suicide rates and the results are discussed in terms of psychological aspects with reference to system theory.
Get full access to this article
View all access options for this article.
References
1.
AchtéK.A., StenbäckA., & TeräväinenH. (1966). On suicides committed during treatment in psychiatric hospitals. Acta Psychiatrica Scandinavica, 42, 272–284.
2.
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders. (3rd ed.). Washington D.C.: American Psychiatric Association.
3.
BuglassD., & McCullochJ.W. (1970). Further suicidal behaviour: The development and validation of predictive scales. British Journal of Psychiatry, 116, 483–491.
4.
BusteedE.L., & JohnstoneC. (1983). The development of suicide precautions for an inpatient psychiatric unit. Journal of Psychosocial Nursing and Mental Health Services, 21, 15–19.
5.
ChapmanR.F. (1965). Suicide during psychiatric hospitalization. Bulletin of the Menninger Clinic, 29, 35–44.
6.
CohenE., MottoJ.A., & SeidenR.H. (1966). An instrument for evaluating suicide potential: A preliminary study. American Journal of Psychiatry, 122, 886–891.
7.
DeanR.A., MiskiminsW.M., De CookR., WilsonL.T., & MaleyR.F. (1967). Prediction of suicide in a psychiatric hospital. Journal of Clinical Psychology, 23, 296–301.
8.
FarberowN.F., GanzlerS., CutterF., & ReynoldsH. (1971). An eight-year survey of hospital suicides. Life Threatening Behavior, 1, 184–202.
9.
FloodR.A., & SeagerC.P. (1968). Retrospective examination of psychiatric case records of patients who subsequently committed suicide. British Journal of Psychiatry, 114, 443–450.
10.
GaleS.W., MesnikoffA., FineJ., & TalbottJ.A. (1980). A study of suicide in state mental hospitals in New York. Psychiatric Quarterly, 52, 201–213.
11.
Leading Article. (1978). Suicide and parasuicide. British Medical Journal, 2, 1246–1247.
12.
LevinA. (1978). Modern psychiatry in a general hospital. South African Medical Journal, 54, 743–747.
13.
LevinA., SchlebuschL., WillgooseL., & NaidooN.K. (1981). Admissions to a South African general hospital psychiatric unit. Journal of General Hospital Psychiatry, 3, 165–170.
14.
LevyS., & SouthcombeR.H. (1953). Suicide in a state hospital for the mentally ill. Journal of Nervous and Mental Disease, 117, 504–514.
15.
LitmanR.E., CurpheyT., ShneidmanE.S., FarberowN.L., & TabachnikN. (1963). Investigations of equivocal suicides. Journal of the American Medical Association, 184, 924–929.
16.
MenningerK. (1969). Expression and punishment. In ShneidmanE.S. (Ed.), On The Nature of Suicide. San Francisco: Jossey-Bass.
17.
MenningerK., MaymanM., & PruyserP. (1963). The vital balance. New York: Viking.
18.
MinnaarG.K., SchlebuschL., & LevinA. (1980). A current study of parasuicide in Durban. South African Medical Journal, 57, 204–207.
19.
NeillK., BenensonH.S., FarberA.N., & ResnickH.L. (1974). The psychological autopsy: A technique for investigating hospital suicide. Journal of Hospital and Community Psychiatry, 25, 33–36.
20.
PasnauR.O., & RussellA.T. (1975). Psychiatric resident suicide: An analysis of five cases. American Journal of Psychiatry, 132, 402–406.
21.
RipleyH. (1979). Suicide in general hospitals. The Western Journal of Medicine, 130, 408–410.
22.
RotovM. (1970). Death by suicide in the hospital. American Journal of Psychotherapy, 24, 216–227.
23.
SacksM., & SpencerE. (1981). Pathological identification as a cause of suicide on an inpatient unit. Journal of Hospital and Community Psychiatry, 32, 36–40.
24.
SchlebuschL. (1985a). Self-destructive behaviour in adolescents. South African Medical Journal, 68, 792–795.
25.
SchlebuschL. (1985b). The etiology of parasuicides in adolescents. Paper presented at the Fifth South African National Congress of the Association of Child Psychology, Psychiatry and Allied Disciplines, Stellenbosch.
26.
SchlebuschL. (1985c). Current management of parasuicide. In CarlileJ.B. (Ed.), Update on psychiatric management. Proceedings of the 4th National South African Congress of Psychiatry. Durban: Department of Psychiatry, University of Natal.
27.
SchlebuschL., & LuizH.A. (1985). Characteristics and post-hospital perceptions of patients refusing inpatient treatment in a South African general hospital psychiatric unit. Journal of General Hospital Psychiatry, 7, 163–170.
28.
SchlebuschL., & MinnaarG.K. (1980). The management of parasuicide in adolescents. South African Medical Journal, 57, 81–84.
29.
SchwartzD.A., FlinnD.E., & SlawsonP.F. (1975). Suicide in the psychiatric hospital. American Journal of Psychiatry, 132, 150–153.
30.
ShapiroS., & WaltzerH. (1980). Successful suicides and serious attempts in a general hospital over a 15-year period. Journal of General Hospital Psychiatry, 2, 118–126.
31.
ShneidmanE.S. (1984). Aphorisms of suicide and some implications for psychotherapy. American Journal of Psychotherapy, 38, 319–328.
32.
SlettenI.W., BrownM.L., EvensonR.C., & AltmanH. (1972). Suicide in mental hospital patients. Journal of Diseases of the Nervous System, 33, 328–334.
33.
TemochA., PughT.F., & MacMahonB. (1964). Suicide rates among current and former mental institution patients. Journal of Nervous and Mental Disease, 138, 124–130.
34.
Von BertalanffyL. (1974). General system theory and psychiatry. In ArietiS. (Ed.), American Handbook of Psychiatry. New York: Basic Books.
35.
WeinerI.B. (1970). Psychological disturbance in adolescence. New York: Wiley.
36.
WeissJ.M.A. (1974). Suicide. In ArietiS. (Ed.), American Handbook of Psychiatry. New York: Basic Books.
37.
WilsonG.C. (1968). Suicide in psychiatric patients who have received hospital treatment. American Journal of Psychiatry, 125, 752–757.
38.
World Health Organization. (1968). Prevention of suicide. Public Health Papers, No. 35. Geneva: World Health Organization.
