Incidence and Predictors of Suicide Attempts and Suicide Deaths among Individuals Recently Hospitalized for a Mental Disorder: A Population-Based Study

Objective: To examine the incidence and predictors of suicide attempts and deaths in the year after psychiatric hospitalization. Methods: A population-based dataset was used to develop a cohort of individuals 18 years or older admitted with a mental disorder (defined by ICD-10 codes) from 2005 to 2016 (n = 26,975) in Manitoba, Canada. Using Cox regression, hazard ratios were calculated for each covariate among those who attempted and died by suicide in the year following hospitalization, while adjusting for confounders. Results: In the year following hospitalization for a mental disorder, 0.7% of the individuals died by suicide and 3.5% attempted suicide. Statistically significant risk factors for suicide in the year after discharge from psychiatric hospitalization included male sex (hazard ratio [HR], 1.47; 95% confidence interval [CI], 1.10–1.97) and urban location (HR, 1.37; 95% CI, 1.02–1.85) and for attempting suicide included female sex (HR, 0.63; 95% CI, 0.55–0.72), living rurally (HR, 0.66; 95% CI, 0.58–0.75), a previous mental disorder (HR, 1.63; 95% CI, 1.38–1.92), justice involvement (HR, 1.48; 95% CI, 1.28–1.70), and being on income assistance (HR, 1.17; 95% CI, 1.01–1.35) (P< .05 for all). Age (HR, 0.99; 95% CI, 0.99–0.99) (P< .05) was associated with a reduced rate of suicide attempts. Conclusions: Further research into interventions to address the identified risk factors for suicide in the recently discharged population is critical to improve management.