Psychiatric Interventions Like Admission to a Mental Facility Could Increase Suicide Risk

[A.B.]

University of Copenhagen researchers led a nationwide study in Denmark comparing individuals who died from suicide to matched controls between the years 1996 and 2009. They then graded the type of psychiatric treatment people had experienced within one year of their suicide on a scale which included no treatment, psychiatrically medicated, contact with an outpatient psychiatric clinic, entrance to a psychiatric emergency room, and admission, voluntarily or involuntarily, into a psychiatric hospital.

From 2,429 suicides and 50,323 controls, the researchers found that taking psychiatric medications during the previous year made a person 5.8 times more likely to have killed themselves. If a person had made contact with a psychiatric outpatient clinic, they were 8.2 times more likely to have killed themselves. Visiting a psychiatric emergency room was linked to a 27.9 times greater likelihood of committing suicide. And if someone had actually been admitted to a psychiatric hospital, they were 44.3 times more likely to have commited suicide within the year.

Some discussion about different ways to interpret these findings follows, one of which is that “psychiatric care might, at least in part, cause suicide.”

http://www.alternet.org/personal-he...ions-admission-mental-facility-could-increase

 

[taniaaust1]

I know if Im feeling suicidal and commit me into hospital (its happened to me twice in the past), it does make me feel worst (in my case cause Ive found if one is in a psych place, they ignore the ME needs so end up making a ME person feel sicker) eg I had noise intollerance and needed a nap during the day to stop crashing, but they put me in a room right next to the patient recreation room! It was so hellish.

So yeah I can believe that could make some feel like they want to commit suicide even worst.

 

[ahmo]

My absolute worst fear. Especially when my nervous system was so out of control.

 

[MeSci]

I can well believe that such interventions could increase the risk of suicide; indeed many antidepressants have warnings that they can increase suicidal ideation, which seems bizarre to me, but I think that fluoxetine did this to me.

I was also terrified of being forced into inpatient treatment in the 1970s when I was suffering from drug addiction. I knew that I needed to be in my own home with my cats, which was familiar and felt safe. (Luckily this was what happened.)

But there may also be an element of reverse causation - people deemed to be at greater risk of suicide may be more likely to be subjected to interventions.

 

[Denise]

I think this is the article referred to:
http://link.springer.com/article/10.1007/s00127-014-0860-x

Risk of suicide according to level of psychiatric treatment: a nationwide nested case–control study

• Carsten Rygaard Hjorthøj,
• Trine Madsen,
• Esben Agerbo,
• Merete Nordentoft

Abstract
Purpose
Knowledge of the epidemiology of suicide is a necessary prerequisite of suicide prevention. We aimed to conduct a nationwide study investigating suicide risk in relation to level of psychiatric treatment.

Methods
Nationwide nested case–control study comparing individuals who died from suicide between 1996 and 2009 to age-, sex-, and year-matched controls. Psychiatric treatment in the previous year was graded as “no treatment,” “medicated,” “outpatient contact,” “psychiatric emergency room contact,” or “admitted to psychiatric hospital.”

Results
There were 2,429 cases and 50,323 controls. Compared with people who had not received any psychiatric treatment in the preceding year, the adjusted rate ratio (95 % confidence interval) for suicide was 5.8 (5.2–6.6) for people receiving only psychiatric medication, 8.2 (6.1–11.0) for people with at most psychiatric outpatient contact, 27.9 (19.5–40.0) for people with at most psychiatric emergency room contacts, and 44.3 (36.1–54.4) for people who had been admitted to a psychiatric hospital. The gradient was steeper for married or cohabiting people, those with higher socioeconomic position, and possibly those without a history of attempted suicide.

Conclusions
Psychiatric admission in the preceding year was highly associated with risk of dying from suicide. Furthermore, even individuals who have been in contact with psychiatric treatment but who have not been admitted are at highly increased risk of suicide.

 

[chipmunk1]

i heard of such a case when a person came home from a psych hospital claiming to be completely "cured" and
committing suicide a few weeks later. is there a reliable way to separate cause from correlation? I would not know how this could be done. even when suicide risk is not increased it would be interesting to know if hospital admissions can reduce it. almost everyone would say yes. but has it ever been studied? how can you compare with control groups?

 

[barbc56]

If someone is severly depressed, takes an AD and becomes suicidal one of the factors might be that the person who is severly depressed doesnt necessarily have the wherewithal to act on any suicidal impulses. However, once the patient reaches a certain point when the depression starts to lift but still far from being well, the suicidal ideation can be carried through.

I had a horrible reaction to Wellbutrin and my friends saw how I was acting and got me help.These two examples show how important monitoring is. The social worker would call every few days to check how I was doing. My friends did as well. But not everyone gets this support. I am now on Zoloft which has literally saved my life as well as helping my pain. I was lucky.

I think the concusions of the study have more to do with the population studied.Correlation is not causation. I think the experience of being in the hospital has to do with the fit of the program with our needs.

Barb

 

[Kati]

The irony of this study is that it occured in Denmark, where Karina Hensen has been forced into a mental hospital and ordered CBT and GET. denmark should taste their own medicine.

 

[Little Bluestem]

But there may also be an element of reverse causation - people deemed to be at greater risk of suicide may be more likely to be subjected to interventions.

That was my first thought when I read it. However, it does seem odd that those who were admitted to a psychiatric hospital were nearly twice as likely to commit suicide as those who visited a psychiatric emergency room.