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Hospital Suicides Much Lower Than Believed

By Jay Kumar  
   September 12, 2018

The widely cited figure of 1,500 hospital suicides per year is debunked by a new study.

Editor's note: This article originally appeared on PSQH.

The estimated number of hospital inpatient suicides annually is far lower than previously believed finds a new study published in The Joint Commission Journal on Quality and Patient Safety.

Based on the hospital inpatient suicides reported to the National Violent Death Reporting System, it was estimated that between 48.5 and 64.9 hospital inpatient suicides occur annually in the U.S., and of that total, 31 to 51.7 are expected to involve psychiatric inpatients.

This is significantly lower than the widely cited figure of 1,500 hospital inpatient suicides per year.

The study analyzed data from 27 states reporting to the 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

The researchers, led by Scott C. Williams, PsyD, director of TJC’s Department of Research, write that the previous estimate is based on a 1984 article that posited inpatient suicide accounts for about 5% of the annual total of suicide deaths in the United Kingdom. No source was given for the estimate, but it was later used in another article in 1993 that mentioned 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 write.

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, of sentinel event suicides:

  • 50.8% took place in the bathroom
     
  • 33.8% in the bedroom
     
  • 4.1% in the closet
     
  • 3.6% in the shower
     
  • 7.7% in another location

 A door, door handle, or door hinge was the most commonly used fixture point (53.8%).


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