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Changes in institutional psychiatric care and suicidal behaviour: a follow-up study of inpatient suicide attempters in Bærum, Norway

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Abstract

Background

During the past decades, extensive reformatory changes in institutional psychiatric care have been implemented in Norway.

Aims

The objective of the present study was to investigate whether these changes have resulted in shortened length of psychiatric hospital stays for suicide attempters. Further, to examine if length of hospital stay and time period in which the patients received treatment were related to the risk of a repeated suicide attempt and/or committing suicide.

Methods

All cases of suicide attempters hospitalised between 1984 and 2006 in the municipality of Bærum, a suburb outside Oslo, were examined. The period of observation was further subdivided in two time intervals on the basis of the de-institutionalisation of psychiatric care, which started to plateau in 1996.

Results

Among 1,574 patients consecutively admitted to the local general hospital after a suicide attempt, 330 were admitted to inpatient psychiatric care. Patients admitted in the period 1996–2006 had significantly shorter hospital stays than patients in the preceding period 1984–1995 (Log Rank P < 0.001). Neither the time period of treatment variable nor the length of hospital stay variable was significantly associated with the risk of a repeated suicide attempt or suicide.

Conclusions

Psychiatric de-institutionalisation appears as not having affected suicide attempt repetition. It is possible that reduced length of hospital stay has been compensated by improved mental health care in general and extended outpatient services in particular.

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Acknowledgments

This study was funded by the Research Council of Norway. The authors thank Professor Bjørgulf Claussen and Melanie Straiton for valuable comments on earlier versions of the manuscript.

Conflict of interest statement

None.

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Authors and Affiliations

  1. Division of Mental Health, Department of Suicide Research and Prevention, Norwegian Institute of Public Health, 0403, Oslo, Norway

    Håkon A. Johannessen, Gudrun Dieserud & Per-Henrik Zahl

  2. Hospital of Asker and Bærum, Postboks 83, 1309, Rud, Norway

    Fredrik Jakhelln

  3. Australian Institute for Suicide Research and Prevention, Mt Gravatt Campus, Griffith University, Brisbane, QLD, 4111, Australia

    Diego De Leo

Authors
  1. Håkon A. Johannessen
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  2. Gudrun Dieserud
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  3. Fredrik Jakhelln
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  4. Per-Henrik Zahl
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  5. Diego De Leo
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Corresponding author

Correspondence to Håkon A. Johannessen.

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Johannessen, H.A., Dieserud, G., Jakhelln, F. et al. Changes in institutional psychiatric care and suicidal behaviour: a follow-up study of inpatient suicide attempters in Bærum, Norway. Soc Psychiat Epidemiol 44, 845–851 (2009). https://doi.org/10.1007/s00127-009-0006-8

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  • DOI: https://doi.org/10.1007/s00127-009-0006-8

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