Citation

Navin K, Kuppili PP, Menon V, Kattimani S. Indian J. Psychol. Med. 2019; 41(5): 403-412.

Affiliation

Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Copyright

(Copyright © 2019, Indian Psychiatric Society, South Zone, Publisher Medknow Publications)

DOI

10.4103/IJPSYM.IJPSYM_169_19

PMID

31548762

PMCID

PMC6753714

Abstract

BACKGROUND: In-patient (IP) suicides contribute a small but significant proportion of overall suicides. Despite this, suicide prevention strategies focusing on the general hospital IP population remain relatively underresearched. This paper is intended to provide an overview of various proposed suicide prevention approaches in the general hospital, including psychiatric IP, settings, and their evidence base.

METHODOLOGY: Electronic searches of MEDLINE through PubMed, ScienceDirect, and Google Scholar databases were performed to identify potentially relevant articles from inception till January 2019. The generated abstracts were systematically screened for their eligibility to be included in the review. Included articles were grouped under five broad themes: environmental modification, staff education, pharmacotherapy, psychotherapy, and brain stimulation. Data extraction was done using a structured proforma.

RESULTS: Environmental modifications and educating the health care professionals appear to be the most promising strategies to reduce suicide-related mortality among IPs. Among pharmacological methods, ketamine has shown initial promise in reducing suicidal ideations. Follow-up data are lacking for most of the described methods. Limited but positive evidence exists for cognitive therapies focusing on the immediate postadmission period and brain stimulation techniques, and it warrants further replication.

CONCLUSION: There is a striking paucity of original research on IP suicide prevention. Given the ethical and methodological issues in carrying out studies with IP suicide as the primary outcome, there is a need to focus on intermediate suicide outcome measures, such as knowledge, attitude, and skills among staff handlers of suicidal patients.

Language: en

Keywords

In-patient suicide; psychiatry; review; suicide; suicide prevention