A new study provides the first data driven estimate of the number of suicides in hospitals in the U.S. The study – “Incidence and Method of Suicide in Hospitals in the U.S.”– analyzed national data sets to establish an evidence based estimate of suicides in hospitals and the methods used. Joint Commission researchers published the study in the September issue of The Joint Commission Journal on Quality and Safety.

Key Findings: Suicides in Hospitals

• 49 – 65 hospital inpatient suicides occur each year in the U.S.
• 75% – 80% of the suicides were among psychiatric patients.
• More than 70% of the suicides were by hanging.
• The most commonly used ligature point was a door, door handle, or door hinge (53.8%).
• Approximately half occurred in the bathroom and 1/3 in the bedroom. The remainder were in the closet (4%), shower (4%) or other location (8%).
• The estimate of 49 – 65 suicides annually is far below the widely cited figure of 1500 per year.

Ligature Resistant Environments

The study’s findings clearly support the recommendations of TJC’s Expert Panel on Suicide Prevention to make inpatient psychiatric units ligature resistant. The panel focused specifically on locations and methods commonly used for suicides in hospitals. The data from this study supports that approach.  As a result of the panel’s recommendations, many hospitals have made dramatic improvements to the safety of their environments. Other are still in the process of doing so.

Future Initiatives for Suicide Risk Reduction

This recent study provides valuable data about the rate and methods used for suicides in hospitals. Indeed, this type of data is critically important for guiding continued prevention efforts. For this reason, TJC will enhance its process for collecting sentinel event data on suicides. They plan to collect additional information about location, method, and observational status at the time of the suicide.

National Patient Safety Goal NPSG.15.01.01 – Suicide Risk Assessment

In 2019, TJC will also revise NPSG.15.01.01. It will require an evidence based tool, risk rating, and documentation of interventions.  For more on this topic, see our recent post National Patient Safety Goal NPSG.15.01.01: Changes Coming in 2019.

Undoubtedly, better data and more guidance on suicide prevention will greatly contribute to the shared goal of reducing suicides in hospitals. To be sure, we will keep you posted as developments unfold in these arenas.