Myth: Inpatient Hospitalization Is Best for People with Suicidal Ideation
There is no evidence that inpatient mental health hospitalization is best for people who are struggling with suicidality.
Fact: Inpatient Hospitalization Has No Evidence of Efficacy, and Discharge is a High-Risk Time
The highest risk for suicide of any time is immediately following discharge from a mental health inpatient unit. In addition to the lack of evidence of the efficacy – or inefficacy – of inpatient hospitalization, we do have evidence that says that the time immediately after discharge is particularly risky.
More critically, many people who have suicidal thoughts have them because of real challenges that are exacerbated by inpatient hospitalization. Whether the concern is losing a job or relationship or having enough money to pay for things like food and shelter, involuntary commitment to an inpatient psychiatric facility can make these real problems worse.
If the struggles are more psychological in nature, they find themselves away from their comfort objects, in an unfamiliar but required routine, and deprived of freedom. These factors are destabilizing for even psychologically stable people. As a result, they may find that their “coping with life” challenges may be larger as well.
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One of the greatest fears for those who are struggling with suicidal thoughts is that their freedom will be taken from them when they disclose these suicidal thoughts to someone. They fear the call to 911 – instead of 988 – because they believe they may be removed by a police officer and placed in an involuntary hold. Many mental health providers, healthcare workers, and well-intended others are not comfortable in the presence of someone with suicidal thoughts and immediately move to transfer responsibility to someone else – even when that someone else may be worse.
Evidence
No evidence of efficacy and solid evidence of negative outcomes after hospitalization make it a dangerous, if sometimes necessary, strategy for managing suicidal ideation.
In Support of the Myth
None identified.
To Refute the Myth
"Suicidal Risk Following Hospital Discharge: A Review" (2019)
A thorough review of the research indicates strong, consistent high risk post-discharge.
Suicide risk is highest immediately after discharge but remains elevated for years.
Unclear or Mixed Support
"Psychiatric hospitalization and the risk of suicide" (2018)
“Irrespective of the length of stay, it is likely that some patients bide their time until the protections of hospital are removed by discharge. Further, some vulnerable patients are likely so affected by stigma and so traumatized that they suicide at an early opportunity after discharge.”
Learn more about suicide myths – and the truths behind them – by following the links below.