Suicide among psychiatric patients: a case-control study

Objective: To examine patient- and treatment-based differences between psychiatric patients who do and do not die by suicide. Method: By linking databases of deaths and psychiatric service use in Victoria, we compared 597 cases who suicided over 5 years with individually matched controls. Results: Cases and controls could not be distinguished on the majority of patient- or treatment-based characteristics. The exceptions were that cases were more likely to be male, less likely to be outside the labour force, more likely to have recent contact with inpatient and community services, and more likely to have a registration as their last contact. Conclusions: Patients who suicide 'look' similar to those who do not, suggesting prevention approaches should ensure that all psychiatric patients receive optimal care, including appropriate detection, diagnosis, assessment and treatment of mental health problems, and careful, individualised assessment of suicide risk.