Postdischarge suicide: A psychodynamic understanding of subjective experience and its importance in suicide prevention

Bull Menninger Clin. 2016 Winter;80(1):80-96. doi: 10.1521/bumc.2016.80.1.80.

Abstract

Recent discharge from a psychiatric inpatient facility is associated with a high risk of suicide. There are multiple factors that may contribute to this increase in risk. Psychodynamic considerations about the patient's subjective experience of suicidality, hospitalization, and discharge are often overlooked but are critical to understanding this phenomenon. Qualitative research has begun to provide empirical support for the importance of the psychological aspects of discharge, and the heightened state of vulnerability that patients experience during this time. Review of the literature and careful consideration of clinical experience is helpful in elucidating this experience in a way that can inform effective treatment. This article integrates a psychodynamic understanding of suicidality in the postdischarge period with a review of empirical research and formulates clinical recommendations for suicide prevention.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Hospitals, Psychiatric
  • Humans
  • Interpersonal Relations
  • Length of Stay
  • Medication Adherence
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Patient Discharge*
  • Risk Factors
  • Social Support
  • Suicidal Ideation
  • Suicide / psychology
  • Suicide Prevention*

Substances

  • Antidepressive Agents