Suicides in general hospitals in Hong Kong: retrospective study

TP Ho, MSM Tay
Department of Psychiatry, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong

OBJECTIVE. To describe the characteristics of suicidal patients and their suicidal acts occurring in general wards.

DESIGN. Retrospective study.

SETTING. All general public hospitals in Hong Kong.

PATIENTS. Survey data based on hospital records of patients who died of suicide or who attempted suicide in general wards between 2000 and 2002 were studied.

MAIN OUTCOME MEASURES. Demographic information, medical history, and circumstances of the suicidal acts.

RESULTS. Twenty-six hospitals reported a total of 166 suicidal acts, which included 34 completed suicides, corresponding to 9.46 attempted suicides and 1.93 completed suicides per 100 000 admissions. Most suicidal acts occurred in medical wards. Patients were, on average, in their mid-50s, predominantly male, and had been admitted because of physical problems. Fewer than 20% were admitted because of attempted suicide. A significant proportion of suicide attempters used potentially lethal suicide methods in the wards. Wide ranges of objects were used in the suicidal acts. Completed suicides tended to occur after midnight and in the ward toilet. Patients who went missing and then committed suicide acts did so in the first few hours of leaving the hospital. The timing of suicidal acts varied greatly with the reasons of admission.

CONCLUSION. Prevention efforts in general wards are unlikely to be effective if they simply focus on patients admitted for attempted suicide, or on the restriction of suicide means. For patients admitted to general wards because of attempted suicide, the risk is highest just after admission; hence, these patients have to be monitored closely. A high degree of alertness to the possibility of depression and suicidal risk among general ward patients is required.

Hong Kong Med J 2004;10:319-24

Key words: Hospitals, general; Inpatients/statistics & numerical data; Suicide