More coherent treatment needed for people at high risk of suicide

Many people at imminent risk of suicide seek help, but those who do so receive fragmented, insufficient, or inadequate treatment. Four large groups known to be at high imminent risk of suicide can be identified: patients with hospital contact after a suicide attempt,1,2 patients recently discharged from psychiatric hospital,3,4 patients presenting to a psychiatric emergency department,5 and callers to helplines for suicide prevention.6

To investigate the burden of suicide associated with groups at imminent risk, we estimated the population attributable risk (PAR; the proportion of suicide deaths that could be prevented) to see if it was possible to reduce the excess risk of suicide to the level of risk in the general population. Details on this calculation are in the appendix. The estimated PARs were 7% for patients with hospital contact after suicide attempt, 25% for patients recently discharged from psychiatric hospital, 8% for patients presenting to a psychiatric emergency department, and 9% for callers to helplines for suicide prevention. Summing the PAR across these four high-risk groups totals almost 49%; however, there might be some overlap with individuals belonging to multiple groups. These findings suggest that these groups ought to be the main target for suicide preventive efforts.