Objective Most suicide decedents have contact with health services close to their death. Some of these contacts include hospital admissions. This study aims to establish and quantify the risks of suicide following hospital admission for a range of physical and mental health conditions and intentional self-harm.
Methods Morbidity and mortality data extracted from the Victorian Admitted Episodes Dataset and the Victorian Suicide Register were analysed. Hospital admissions among adult patients (>=15 years of age), discharged between 01 January 2011 and 31 December 2016 (2,430,154 admissions) were selected. Standardised Mortality Ratios (SMRs) were calculated for conditions with at least five linked suicides within one year of hospital discharge.
Results Forty-three conditions were associated with at least five subsequent suicides (within one year of hospital discharge); 14 physical illnesses, 5 symptoms, signs and abnormal clinical and laboratory findings, 12 mental health conditions, and 12 injury and poisonings. The highest SMRs were for poisonings (range; 27.8 to 140.0) and intentional self-harm (78.8), followed by mental health conditions (range; 15.5 to 72.9), symptoms, signs and abnormal clinical and laboratory findings (range; 1.4 to 43.2) and physical illnesses (range; 0.7 to 4.9).
Conclusions A greater risk of suicide was associated with mental health conditions and injury and poisonings including self-harm than with physical conditions.
Learning outcomes Depressive episodes, personality disorders and psychotic episodes, injuries caused by intentional-self-harm and poisonings by certain types of drugs, carbon monoxide and hormones such as insulin can be prioritised for targeting suicide prevention initiatives for persons discharged from hospitals.
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