Rapid reduction of nurse-rated suicidality among psychiatric patients shortly following hospitalization

Abstract

Background Suicidality is a major reason for psychiatric hospitalization but there have been no studies of the short-term changes in suicidality following psychiatric admission. To assess the short-term changes in suicidality during the first three days after psychiatric admission, when medications and other specific therapies are not likely to have taken effect and the primary benefit is likely to be from hospitalization. Methods A retrospective study of inpatients at risk for suicide was based on nurse-rated suicide assessments documented in medical records at a large psychiatric hospital in southern China. Suicidality was assessed with the Nurses' Global Assessment of Suicide Risk (NGASR) every day (1–3) following admission. Reduction of suicidality from first- to third-day were compared by using McNemar’s Chi-square tests and T-tests, followed by logistic regression to identify correlates of having high risk on day 3 following admission. Results The sample (n = 562) showed a relatively high level of average suicidality (NGASR = 9.2 ± 3.3) at admission with 33.8% reporting a prior suicide attempt. Significant reductions in suicidality were apparent by the third hospital day compared to baseline with NGASR-5 change items score declining from 6.3 ± 2.8 to 4.6 ± 3.0 (p < .001, Cohen’s d = .578), indicating a moderately large change. Compared with those unemployed, being currently employed was associated with greater reduction in likelihood of being at high-risk on day 3 (OR = .568, 95%CI [.361, .895], p = .015). Conclusion This study demonstrates short-term substantial reduction in suicidality after only three days of hospitalization suggesting significant benefit from admission to a safe secure environment.