from Taiwan .. ... A 3-year Taiwan national sample of 87 suicide victims suffering from schizophrenia who died in the 3-month post-discharge period was obtained utilizing a large population-based dataset.
Because the number of schizophrenia patients voluntarily admitted to psychiatric inpatient care was approximately 25 000 per year,
the average suicide rate for such patients is almost 7 times the annual rate in the general population during the study period.
The dependent variable was dichotomous: suicide death (or not) within 90 days of index discharge.
The key independent variables consisted of patient, hospital, and psychiatrist characteristics at index hospitalization.
Information on the relationship between characteristics of mental healthcare providers,
including hospitals and psychiatrists, and postdischarge suicide is scanty.
This study aims to identify the risk factors for suicide among schizophrenia patients in the 3-month post-discharge period.
The study cohort comprised all patients with a principal diagnosis of schizophrenia
discharged from psychiatric inpatient care from 2002 to 2004 who committed suicide within 90 days of discharge.
The control cohort consisted of all surviving schizophrenia patients discharged from psychiatric inpatient care in the same period
and were matched to cases for age, gender, and date of discharge.
There were 87 and 348 cases in the study and control cohorts, respectively.
For suicide cases, death most frequently occurred on the first day after leaving the hospital (16.1%).
The adjusted hazard ratios for committing suicide during the 90-day post-discharge period were
2.639 times greater for patients without previous psychiatric admission
than for those hospitalized more than 3 times in the year preceding the index hospitalization.
The adjusted suicide hazard for schizophrenia patients treated by male psychiatrists was significantly higher
than for patients treated by female psychiatrists, by a multiple of 5.117 (P = .032). The adjusted suicide hazard among patients treated by psychiatrists over age 44 years<
was 2.378 times (P = .043) that for patients treated by psychiatrists aged younger than 35 years.
Who is in charge , who is responsible, and how are they accountable
Phil Hope: MP
Minister of State for Care Services:
Department of Health
Richmond House
79 Whitehall
London SW1A 2NS
A wriiten Q: parliamentary answer.
"The responsibility for providing healthcare, including
specialist *mental* health care services, rests with primary care trusts
(PCTs). The Department provides funding for PCTs to commission, or
provide
healthcare for their local populations from national health
service or independent sector providers.
We are not prescriptive about
how individual PCTs spend their budgets and each PCT decides its own spending levels for specific healthcare treatments and services ....." like this sorry tale
[ Where is the evidence that PCT mental health leads know what is needed,
and know how to persuade their colleagues to fund it ? In the face of the other demands i.e. Sainsbury: Publications A-Z ...go to U nder Pressure; and ... S pending 2008 .... *** !!! NEW ... They are still at it it
[ What does 'not prescriptive' mean: ? we couldn't care less what they do with it ? Their blame, not ours ?
It sounds exactly like the excuses given for delivery failures ... their choice .. not ill as we saw them .. O tempora o mores ]
..."
Since 2001-02, total planned investment in adult mental health services has increased by 50 per cent.
(£2.0 billion), putting in place the extra services and staff needed to transform mental health services.
Nine consecutive years of increased spending by the NHS on mental health services has provided more staff,
and increasing numbers of people with a severe mental illness arereceiving treatment from community teams outside of hospital settings".
[ and Care ? { ed. the care and treatment for schizophrenia is worse... not better ... National Inquiry] ]
Our significant investment in the Improving Access to Psychological Therapies programme (IAPT),
will see annual funding rising to £173 million, 3,600 extra therapists trained and 900,000 more people treated by 2011.
This investment in IAPT will help to add to the existing provision of psychological therapies,
increase capacity, reduce waiting times and drive up quality standards".
[ Ed. Following Layards nose ... to Cognitive Behaviour Therapy .....
CBT described
? where's the evidence for benefit compared with what Eysenck said years ago, just as good is letting time do it's thing, with their families, their friends. .
a pilot page
Put a Question or a topic by email [ mica2@tiscali.co.uk ] - I won't give your email address unless you agree, - and I will give my answer on that page .... *** !!! NEWfirst one ! after two months ! ... other visitors may email to give a different topic
... it may be what to do when frustrated by the aftercare that the professional services do not or cannot deliver ... ?