Mental health services, suicide and 7-day working

Br J Psychiatry. 2016 Oct;209(4):334-339. doi: 10.1192/bjp.bp.116.184788. Epub 2016 Jul 7.

Abstract

Background: Patients admitted to hospital at the weekend appear to be at increased risk of death compared with those admitted at other times. However, a 'weekend effect' has rarely been explored in mental health and there may also be other times of year when patients are vulnerable.

Aims: To investigate the timing of suicide in high-risk mental health patients.

Method: We compared the incidence of suicide at the weekend v. during the week, and also in August (the month of junior doctor changeover) v. other months in in-patients, patients within 3 months of discharge and patients under the care of crisis resolution home treatment (CRHT) teams (2001-2013).

Results: The incidence of suicide was lower at the weekends for each group (incidence rate ratio (IRR) = 0.88 (95% CI 0.79-0.99) for in-patients, IRR = 0.85 (95% CI 0.78-0.92) for post-discharge patients, IRR = 0.87 (95% CI 0.78-0.97) for CRHT patients). Patients who died by suicide were also less likely to have been admitted at weekends than during the week (IRR = 0.52 (95% CI 0.45-0.60)). The incidence of suicide in August was not significantly different from other months.

Conclusions: We found evidence of a weekend effect for suicide risk among high-risk mental health patients, but with a 12-15% lower incidence at weekends. Our study does not support the claim that safety is compromised at weekends, at least in mental health services.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • England
  • Female
  • Hospital Mortality*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Discharge / statistics & numerical data
  • Suicide / statistics & numerical data*
  • Time Factors
  • Young Adult