Clinical messages

On this page:

• Clinical care and acute mental health care settings
• Real-time surveillance
• Suicide and bipolar disorder
• Suicide after missed service contact and/or non-adherence
• Suicide after recent bereavement

The following clinical messages are intended for clinicians, mental health services, Integrated Care Boards (ICBs) and Health Boards.

Clinical care and acute mental health care settings

Our findings on patient suicide highlight acute mental health settings where there appear to be changing patterns of suicide risk important to prevention. Specifically, the findings call for a greater focus on ward safety, on reversing the apparent increase in suicide amongst people recently discharged from in-patient care, and on recognition of risk after self-harm.

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Real-time surveillance

Real-time surveillance of suspected in-patient and post-discharge suicides is being established nationally. We are asking all mental health trusts and clinical staff to take part. This new safety initiative will provide early warning of safety concerns.

• Visit: Real-time surveillance of mental health patient suicide

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Suicide and bipolar disorder

Many patients with bipolar disorder who die by suicide appear not to be receiving optimal treatment. This should be provided in line with NICE guidance, including lithium treatment and consideration of psychological interventions, as a key suicide prevention measure.

• Visit: Suicide in mental health patients with bipolar disorder

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Suicide after missed service contact and/or non-adherence

Non-receipt of planned care is a crucial precursor of patient suicide. Services should place priority on follow-up efforts for patients losing contact with services or who are non-adherent with medication. These patients have multiple clinical and social problems that are likely to add to risk and that need to be addressed in their care plan. Involvement of the patient’s family or carers should form part of engagement efforts.

• Visit: Suicide following missed contact and/or non-adherence with medication

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Suicide and recent bereavement

Clinicians should be aware that bereavement may add to suicide risk and be alert to symptoms such as insomnia and alcohol misuse. Enquiring about significant dates such as anniversaries of deaths should be a routine part of assessment. Services should make personalised bereavement support available.

• Visit: Suicide and recent bereavement in mental health patients

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