Hospitals 'must tighten suicide safeguards'

The lives of 250 people who commit suicide could be saved every year, and six murders could be avoided, if hospitals tightened their care of the mentally ill, a report says today.

The lives of 250 people who commit suicide could be saved every year, and six murders could be avoided, if hospitals tightened their care of the mentally ill, a report says today.

Many patients hanged themselves while patients on psychiatric wards and NHS trusts have been ordered to remove all curtain and shower rails and rigid bed frames by March 2002 to reduce this likelihood.

The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness examined 5,582 suicides and 186 homicides by psychiatric patients between 1996 and 2000.

It said a third of the 600 murders that occur in the UK each year are committed by people with a mental illness. More than half of these were alcoholics, drug addicts or had a personality disorder. Just 5 per cent of all homicides were committed by people with schizophrenia and they were more likely to attack friends or family than strangers.

Dr Jenny Shaw, assistant director of the inquiry, said: "The low figures for stranger homicides show that the risk to the general public from patients with a mental illness has been greatly exaggerated. The public are more at risk from heavy drinkers."

A quarter of those who committed suicide did so within three months of being discharged from hospital but nearly half of them failed to attend their first follow-up appointment. The report says appointments should be arranged within seven days for all high-risk patients.

Nearly half of the suicides were among people being supervised in the community under the care programme approach which involves professionals from different disciplines working as a team. But half of these were not taking their drugs when they died or had missed their last appointment with community services.

Professor Louis Appleby, director of the inquiry and the Government's mental health tsar, said: "Around 40 per cent of patient suicides happen during or soon after in-patient care and we should make the prevention of these deaths a priority. The picture is different on homicide. Most perpetrators do not have the kind of illnesses that are easily treated."

The report concludes 17 per cent of suicides and 9 per cent of homicides were preventable.

John Hutton, the Health minister, said the report "clearly demonstrates that the Government's proposals [in the mental health white paper published in December] will help save lives". Legislation proposed in the paper will allow for the detention of people assessed as being dangerous and severely personality disordered for as long as they pose a significant risk of serious harm to others. Doctors have protested that this means innocent people will be locked up.