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Abstract
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As emphasized by recent papers in Frontiers in Psychiatry, (cites) the suicides of persons recently discharged from psychiatric hospitalization remain among the most distressing and challenging events that confront our field. We consider in this commentary many of these challenges and call for a new generation of studies.
Post-Discharge Suicides Are Harrowing and Complex
Except from the few patients who discharge themselves against medical advice from inpatient stays in mental health facilities, a clinician will have evaluated the discharge plan as safe.
Therefore, post-discharge suicides are usually associated with grief and anger among relatives, frustration, self-blame, sorrow and insecurity among clinicians, and initiatives to improve safety procedures in services among leaders of mental health services. Following the discussions that arise on social media after a post-discharge suicide reveals the depth and intensity of the frustration and despair that is felt by other patients and by relatives. Often, they complain that admission wasn't helpful, that the condition was more or less unchanged between admission and discharge, or that the patient was discharged without sufficient help afterwards.
Living Back in the Community Is Especially Challenging and Risky
Being admitted to inpatient psychiatric care usually constitutes a medical emergency, reflecting both a person's deteriorating state of mind and the inability of local resources to provide adequate care in the community. Whilst hospitalization may help to resolve acute symptoms, it frequently is insufficient to repair deep social strains; returning to life in the community may be a particularly challenging and risky transition that poses a major threat to patient safety. Examples of such challenges could be unpaid bills, inability to maintain a home in a proper condition, threats of eviction, job loss, conflicts with loved ones or neighbors (including legal restraining orders that forbid contact), inability to recreate meaningful daily life routines and activities, recurring use of alcohol and drugs, difficulties obtaining needed medication, and lack of follow-up from health and mental health services...
Language: en |