Primary care contact, clinical management and suicide risk following discharge from inpatient mental health care (12 June 2024)

Summary

There is currently little research about the clinical management of people recently discharged from inpatient psychiatric care who die by suicide. This study in BJGP Open aimed to improve understanding of how people discharged from inpatient mental health care are supported by primary care during this high-risk transition. The authors carried out a nested case-control study using interlinked primary and secondary care records for people who died in England within a year of discharge between 2001 and 2019. Key findings included:

• Over 40% of patients who died within two weeks and 80% who died later had at least one primary care consultation.
• There was infrequent evidence of discharge communication from hospital.
• Within-practice continuity of care was relatively high.
• Those who died by suicide were less likely to consult within two weeks of discharge. They were more likely to consult in the week before death, be prescribed multiple types of psychotropic medication, experience readmission and have a diagnosis outside of the ‘Severe Mental Illness’ definition.

The authors concluded that healthcare professionals working in primary care have opportunities to intervene and should prioritise patients experiencing transition from inpatient mental health care. Clear communication and liaison between services is essential to provide timely support.