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BACKGROUND: Risk of self-harm and suicide is greatly increased in the period after discharge from psychiatric in-patient care. AIMS: To investigate the impact on suicide of a series of policy initiatives to enhance care in the immediate post-discharge period. METHOD: A time series analysis was based on 1997-2007 data from the National Confidential Inquiry into Suicide and from Hospital Episode Statistics for England. RESULTS: There was no evidence of a reduced risk of suicide in the first 12 weeks following discharge in 2003-2007 compared with 1997-2002. In contrast, the relative risk of non-fatal self-harm in the 12 weeks after discharge declined. The risk ratio for self-harm (2003-2007 v. 1997-2002) at 0-1 week post-discharge was 0.86 (95% CI 0.80-0.92) and at 2-4 weeks it was 0.89 (95% CI 0.85-0.94). CONCLUSIONS: These findings provide some support for the impact of recent policy changes on the risk of non-fatal self-harm in the immediate period after discharge from psychiatric in-patient care.

Original publication




Journal article


Br J Psychiatry

Publication Date





233 - 238


Adolescent, Adult, Aged, Aged, 80 and over, Community Mental Health Services, England, Health Policy, Hospitals, Psychiatric, Humans, Middle Aged, Patient Discharge, Prognosis, Quality of Health Care, Risk Factors, Self-Injurious Behavior, Suicide, Young Adult