Mental health services should aim to improve safety

About a quarter of all people who commit suicide have been in contact with psychiatric services in their last year; in these, a sixth are inpatients and nearly a quarter were discharged from hospital less than three months before they died. These are the findings of the first paper from the national confidential inquiry into suicide and homicide by people with mental illness (p 1235). The inquiry collected detailed clinical data on a national sample of people who committed suicide over two years and on a sample of those who committed homicide over 18 months. In a second paper (p 1240) the inquiry reports high rates of mental disorder in people convicted of homicide. Most, however, had a personality disorder or substance dependence rather than severe mental illness, and most had not been in contact with mental health services. Both papers highlight problems of non-compliance, loss of contact with services, and drug and alcohol misuse.

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