Locked Wards May Not Prevent Inpatient Suicide, Absconding

HealthDay News — For patients in psychiatric wards, treatment on locked wards seems not to prevent suicide, suicide attempts, or absconding, according to a study published online July 28 in The Lancet Psychiatry.

Christian G. Huber, MD, from Universität Basel in Switzerland, and colleagues conducted a 15-year naturalistic observational study involving 349 574 admissions to 21 German psychiatric inpatient hospitals. Propensity score matching was used to select 145 738 cases for an analysis of the causal inference on the effect of ward type on suicide, suicide attempts, and absconding.

The researchers found that hospitals with an open door policy did not have increased odds of suicide (odds ratio [OR], 1.326; 95% confidence interval [CI], 0.803 to 2.113), suicide attempts (OR, 1.057; 95% CI, 0.787 to 1.412), and absconding with return (OR, 1.288; 95% CI, 0.874 to 1.929) and without return (OR, 1.090; 95% CI, 0.722 to 1.659). Treatment on open versus locked wards was associated with reduced odds of suicide attempts (OR, 0.658; 95% CI, 0.504 to 0.864), absconding with return (OR, 0.629; 95% CI, 0.524 to 0.764), and absconding without return (OR, 0.707; 95% CI, 0.546 to 0.925); the odds of completed suicide were not reduced (OR, 0.823; 95% CI, 0.376 to 1.766).

“Locked doors might not be able to help prevent suicide and absconding,” the authors wrote.

References

1. Huber CG, Schneeberger AR, Kowalinski E, et al. Suicide risk and absconding in psychiatric hospitals with and without open door policies: a 15 year, observational study. The Lancet Psychiatry. 2016; doi:10.1016/S2215-0366(16)30168-7.

2. Burns T. Locked doors or therapeutic relationships? The Lancet Psychiatry. 2016; doi:
10.1016/S2215-0366(16)30185-7.