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Mike Crawford is a senior lecturer in psychiatry in the Department of Psychological Medicine at Imperial College London (Claybrook Centre, Claybrook Road, London, W6 8LN, UK. Tel: 0207 386 1233; fax: 0207 386 1216; e-mail: m.crawford{at}imperial.ac.uk). He specialises in mental health services research and is involved in the development and evaluation of complex psychosocial interventions.
The risk of suicide is higher during the period immediately following discharge from in-patient psychiatric care than at any other time in a service users life. Demographic and clinical risk factors for suicide in this period are similar to those for suicide at other times and may not be specific enough to enable identification of those at greatest risk. Epidemiological studies suggest that factors related to service organisation and delivery (e.g. social support and continuity of care) are also important in the aetiology of suicide following hospital discharge. Interventions aimed at helping people in the period immediately following discharge from in-patient care have been developed. Although the effect of these interventions on suicidal behaviour has not been examined, available evidence suggests that efforts to increase patients confidence and level of social support may be of value.
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