Hospital inpatient suicides: A retrospective comparison between psychiatric and non-psychiatric inpatients in Milan healthcare facilities

Introduction: Inpatient suicide in hospitals is a worrying phenomenon that has received little attention. This study retrospectively explored the socio-demographic, clinical, and suicide-related characteristics of hospital inpatient suicides in Milan, Italy, which were collected at the Institute of Forensic Medicine during a twenty-eight-year period (1993-2020). In particular, this study compared the features of hospital inpatient suicides in patients with and without psychiatric diagnoses. Methods: Data were collected through the historical archive, annual registers, and autopsy reports, in certified copies of the originals deposited with the prosecutors of the courts. Results: Considering the global sample, inpatients were mainly men (N = 128; 64.6%), with a mean age of 56.7 years (SD +/- 19.8), of Italian nationality (N = 176; 88.9%), admitted to non-psychiatric wards (N = 132; 66.7%), with a single illness (N = 111; 56.1%), treated with psychotropic medications (N = 101; 51%), who used violent suicide methods (N = 177; 89.4%), died of organic injuries (N = 156; 78.8%), and outside the buildings (N = 114; 72.7%). Comparing psychiatric and non-psychiatric inpatients, suicide cases with a non-psychiatric diagnosis were predominantly men (N = 48; 76.2%), hospitalized in non-psychiatric wards (N = 62; 98.4%), assuming non-psychotropic drugs (N = 37; 58.7%), and died in outside hospital spaces (N = 54; 85.7%). Conclusions: A fuller characterization of suicide among hospitalized inpatients requires systematic and computerized data gathering that provides for specific information. Indeed, this could be valuable for inpatient suicide prevention strategies as well as institutional policies.