Experiences of Suicidality Following Discharge From a Mental Health Inpatient Unit: A Systematic Review and Meta‐Synthesis

TL;DR

This study reviews experiences of people at risk of suicide after being discharged from mental health units to understand how to reduce suicide risk.

Contribution

The paper is the first to meta-synthesize qualitative research on suicidality following discharge from inpatient mental health units.

Findings

Poor discharge and aftercare experiences increase suicide risk.

Compassionate relationships and support protect against suicide risk.

Collaborative discharge preparation and post-discharge support can reduce suicide risk.

Abstract

People are at increased risk of suicide following discharge from inpatient mental health units. Understanding the reasons for this increased risk is important for reducing the number of people who die by suicide. Whilst reviews of quantitative research have identified risk factors, no reviews of the qualitative literature exist which could provide more nuanced explanations of elevated suicide risk during the post‐discharge period. This systematic review is the first to meta‐synthesise qualitative research on experiences of suicidality after being discharged from inpatient mental health units. We searched PsycINFO, MEDLINE, Web of Science, PubMed and ProQuest using relevant search terms. We identified 29 studies that met inclusion criteria and were included in the review. We analysed the data using thematic synthesis and identified five analytic themes: (1) Feeling prepared for the transition home, (2) Returning from safety to everyday hardship, (3) The need for connection and understanding, (4) Feeling neglected by the system, (5) Taking the reins on recovery. This review indicates that reducing post‐inpatient discharge suicides could be achieved through collaborative discharge preparation, immediate and intensive post‐discharge support, and empowering service‐user recovery.

Studies of experiences of suicidality following discharge from a mental health unit were reviewed.Poor experiences of discharge and aftercare were described by participants as increasing suicide risk.Relationships and being treated with compassion were described by participants as being protective against suicide risk.Clinicians should work to ensure discharge from mental health units is predictable, supportive, personalised, and empowering.

Studies of experiences of suicidality following discharge from a mental health unit were reviewed.

Poor experiences of discharge and aftercare were described by participants as increasing suicide risk.

Relationships and being treated with compassion were described by participants as being protective against suicide risk.

Clinicians should work to ensure discharge from mental health units is predictable, supportive, personalised, and empowering.

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