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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

DOI

10.1192/bjp.bp.111.104422

Type

Journal article

Journal

Br J Psychiatry

Publication Date

09/2012

Volume

201

Pages

233 - 238

Keywords

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