Background Little is known about the long-term mortality and causes of
death after first psychiatric admission. Method A consecutive series
of 87 patients admitted for the first time from a strictly defined cat
chment area to Saxondale Hospital, Nottinghamshire, who were discharge
d in 1974 and 1975, were traced in 1992 to either their general practi
tioner or death. The causes of their deaths were ascertained and the o
bserved mortality was compared with expected mortality. Results Twelve
subjects had died. None had committed suicide, and there were no open
verdicts or accidental deaths. Although the observed mortality was hi
gher than expected, there was no significant excess. Conclusions There
may be little scope for reducing suicide rates by targeting patients
for careful follow-up after discharge from their first psychiatric adm
ission. More research is required before large investments are made in
potentially fruitless interventions to achieve the objectives of The
Health of the Nation.