By Jay Kumar
A new study published in The Joint Commission Journal on Quality and Patient Safety found that the estimated number of hospital inpatient suicides annually is far lower than previously believed.
The study was an analysis of data from 27 states reporting to the National Violent Death Reporting System (NVDRS) for 2014-2015 and from hospitals reporting to The Joint Commission’s Sentinel Event database from 2010 to 2017. The study was conducted to provide a more accurate estimate of the rate of inpatient suicides and the method and location of suicides within United States hospitals.
Based on the hospital inpatient suicides reported to the NVDRS, it was estimated that between 48.5 and 64.9 hospital inpatient suicides occur annually in the U.S. Of that total, 31 to 51.7 are expected to involve psychiatric inpatients.
The study’s estimated number of hospital inpatient suicides is much lower than the widely cited figure of 1,500 per year. The researchers, led by Scott C. Williams, PsyD, director of TJC’s Department of Research, wrote that the previous estimate is based on a 1984 article about United Kingdom that posited that inpatient suicide accounts for about 5% of the annual total of suicide deaths in that country. No source was given for the estimate, but it was later used in another article in 1993 that mentioned that there were approximately 30,000 suicides per year in the U.S., with 5% to 6%, or about 1,500, occurring in hospitals. The article was cited in a 2003 clinical practice guideline from the American Psychiatric Association and the figure has been widely referred to since then, the researchers wrote.
The most common method of inpatient suicide in both the NVDRS and TJC Sentinel Event databases was hanging (71.7% and 70.3%, respectively). According to the Sentinel Event database, which noted the location and ligature fixation point for hangings, 50.8% of sentinel event suicides took place in the bathroom, 33.8% in the bedroom, 4.1% in the closet, 3.6% in the shower, and 7.7% in another location. A door, door handle, or door hinge was the most commonly used fixture point (53.8%).