SUICIDE WITHIN A DAY OF DISCHARGE - FAILURE OF RISK ASSESSMENT

Five suicides committed within a day of discharge from a psychiatric h ospital between 1991 and 1994 in the province of Kuopio, Finland, are described. The suicides occurred when psychiatric services in the regi on were being reorganized and when there also was great pressure for r eductions in the number of psychiatric beds and for changes in the nat ure of psychiatric inpatient treatment. Common to all cases was a poss ible neglect of individual clinical assessment and consequent underest imation of the severity of the patients' symptoms. The case histories also suggest that internal and external pressures on treatment communi ties and staff can result in problems relating to basic clinical tasks . Careful individual examination and appropriate treatment based on th e results of such examination continue to be of the utmost importance in preventing suicides among psychiatric patients.