Suicide Prevention in the Hospital

Hospitals, both neuropsychiatric and medical-surgical, are responsible for preventing the suicide of patients under their care. Hospital populations are at higher risk because they include people in heightened physical or emotional distress and because the patients frequently have no other resources, making the hospital a primary source of support. Suicide does, in fact, occur in the hospital at a rate higher than in the general community. Review of such cases and of the suicide prevention policies of a wide variety of hospitals suggests a number of guidelines for suicide prevention in the areas of identification, environmental and procedural safeguards, communication, and general attitudes. Legal attitudes over the years have changed markedly with the courts continuing to stress the principle of foreseeability but now recognizing that pursuit of therapeutic goals requires the hospital to assume "therapeutic risks." These risks are evaluated primarily by the criterion of accepted community standards of care.