Implementation of recommendations, particularly in large, deprived catchment areas, lowers rates
THURSDAY, Feb. 2 (HealthDay News) -- Local implementation of national suicide recommendations reduces suicide rates, particularly in deprived catchment areas, according to a study published online Feb. 2 in The Lancet.
David While, Ph.D., of the University of Manchester in the United Kingdom, and colleagues analyzed national suicide data from the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness on individuals who died between 1997 and 2006 and who were in contact with mental health services in the 12 months before death. The Mental Health Minimum Data Set was used when denominator data was missing. Suicide rates for services implementing most of the recommendations were compared with those implementing fewer recommendations, before and after implementation.
The researchers found that, from 1998 to 2006, the average number of recommendations implemented increased from 0.3 to 7.2 per service. Implementation of recommendations correlated with decreased suicide rates. The provision of 24-hour crisis care correlated with the largest reduction in suicide rates: from 11.44 per 10,000 patient contacts per year before implementation to 9.32 afterwards. Falling rates were also significantly associated with local policies on patients with dual diagnosis (10.55 before versus 9.61 after) and post-suicide multidisciplinary review (11.59 before versus 10.48 after). There was little reduction in suicide for services that did not implement recommendations. Services with the most deprived catchment areas and the most patients had the biggest decreases in suicide (incidence rate ratio, 0.90 and 0.86, respectively).
"Our findings suggest that aspects of provision of mental health services can affect suicide rates in clinical populations," the authors write.
Abstract
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