Managing suicidality in inpatient care: a rapid review

Purpose The purpose of this mixed methods rapid study was to identify the barriers and facilitators to implement relational and environmental risk management approaches to manage suicidality in inpatient services. Design/methodology/approach To achieve this within a short timeframe, a rapid review approach was chosen. Both research (qualitative and quantitative studies) and non-research material (policies, guidance and reports) were retrieved. The review was conducted across five databases: MEDLINE, EMBASE, EMCARE, PsycINFO and CINAHL for English language citations within the last ten years (2009 –2019). Findings A total of 17 primary research papers and a further 73 reviews and grey literature were included. There was evidence that the removal of anti-ligature equipment, by which regular checks of the environment to identify and remove ligature points and increased levels of observation are carried out well, reduces suicide in hospital. Research limitations/implications There is a gap in research investigating “engagement activities” eliciting exactly what they are and determining how they might be effective. There is a need for new innovative ways for managing risk of suicide in hospitals that bring together meaningful engagement and maintaining safety. Originality/value Keeping people safe during an inpatient stay in a mental health service is a core function of mental health practitioners. This paper brings together what is already known about risk management and highlights areas for further investigation.