In Sweden approximately 1 200 individuals die by suicide every year. When there is a high risk of suicide, inpatient specialist psychiatric care is indicated, and even though inpatient suicide is rare, death by suicide still occur. Therefore, it is essential for the personnel to have knowledge of the suicidal process and to be able to create a therapeutic alliance with the suicidal patient. Then they are able to identify those with a high risk and act in suicide prevention to obtain patient safety. This study was part of a national retrospective project covering data from all patients' medical records for the two years before the death by suicide in 2015. For this study, 41 patients who died by suicides while admitted to psychiatric care were identified. The aim was to retrospectively identify documentation of suicide risk, safety measures and comparison between those with and without suicide attempts, for patients who committed suicide during psychiatric inpatient care.
There was documentation of suicidal variables in 80% of the patients; 59% had a previous known suicide attempt; 63% were diagnosed with mood disorder and 41% were assessed with elevated suicide risk. The most common suicide method was strangulation (71%) and 22% had died by suicide within 24hours after admission. Almost three quarters (71%) were on voluntary care. No patient had constant professional supervision on a one-to-one basis, 17% had intermittent supervision in form the of 15 min checks. One third (32%) were on agreed leave at the time of the suicide. The result gives ground for emphasizing the lifesaving role of high-level supervision within the early state of inpatient care and the importance of accurate documentation concerning suicidality.