Clinical, epidemiological and organizational aspects of outpatient care for suicidents in psychiatric institute clinic

Purposes: to study some socio-demographic, and clinical characteristics, as well as ways of seeking psychiatric (anticrisis) сare, and resources to improve the quality of this care. Materials and methods. An observation retrospective study of medical records of the Moscow psychiatric institute outpatient clinic patients (n=75) with suicidal behavior was conducted. Results and discussion. Patients with suicidal behavior composed relatively small (1.5%) part of the total sample. Average age of suicidents (i.e., 35.41±1.83 for men and 32.83±1.87 years for women) underemphasizes the possible resource saving potential of psychiatric care. Patients with affective disorders (ICD-10) presented near 90% of the group. Duration of untreated disease was up to 5 years. About 50% suicidents were out of the capital, which shows the extant prestige of the Moscow psychiatric institution. The main motives for referral to tertiary psychiatric care were fear of stigmatization, poor quality of everyday psychiatric care in regional facilities. No less % patients had repeated suicide attempts in anamnesis. These typical markers of suicidal behavior institute psychiatrists considered the most important for assessment suicide risk as actual and the basis for further consultations to clarify the conditions of hospital admissions. A small group of patients (3 people) resented of survivors (i.e., relatives of suicide victims) indicates the importance of tertiary suicide prevention (i.e., postventiion). Conclusions. Some obstacles to improve the quality psychiatric (antisuicide) care were identified in aspects of low availability, stigma. Further detailed research of favoring and impeding factors during seeking of psychiatric help is needed. Multilevel assessment of mental health care may be possible with the involvement patients and their relatives positions.