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Fu T, Liu H, Chen C, Zhang B, Chen G, Bai Y, Li J, Hou F. Preventing post-discharge suicides in psychiatric patients: insights from patients, lay healthcare supporters, and mental health professionals-a qualitative analysis. BMC Public Health 2024; 24:64. [PMID: 38166746 PMCID: PMC10762919 DOI: 10.1186/s12889-023-17475-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Discharged psychiatric patients are at higher risk of suicide due to various risk factors in their lives compared to the general population. However, specific problems and needs of these patients after discharge remain unclear. This research constitutes a segment of a broader implementation study designed to formulate an interventional strategy targeting post-discharge suicide among Chinese psychiatric patients. The present study seeks to qualitatively investigate the problems and needs from the perspectives of patients, their lay healthcare supporters (LHSs), and mental health professionals (MPs), aiming to enhance the efficacy of the interventional strategy. METHODS This study is part of a larger implementation study based on Shenzhen Kangning Hospital (SKH) in Shenzhen, Guangdong, China. Under the community-based participatory research framework, we recruited discharged psychiatric patients, their LHSs, and MPs as a collaborative community team, and we conducted individual in-depth interviews for patients and LSHs and focus group interviews with MPs. We utilized a thematic analysis approach to identify sub-themes and themes from interviews through systematically coding and analyzing the data. RESULTS A total of 45 participants were recruited for interviews, comprising 17 patients, 8 LHSs, and 20 MPs. We conducted 25 individual in-depth interviews and 3 focus group interviews. Through the interviews, we identified three themes of post-discharge problems: problems related to self, family-related problems, societal and community-related problems. We also identified four themes related to reducing post-discharge suicide: proactive self-management, multifunctional relatives, multifunctional MP group, and a warm society. The tangible support from LHSs and emotional support from MPs are strongly emphasized. Follow-up interventions were identified as the most significant way to addressing these unmet needs. Instrumental support from the community and a caring and non-discriminatory environment for individuals with mental disorders are essential for reducing suicide risk. CONCLUSIONS Establishing an integrated mental health care service network that connects psychiatric patients, LHSs, and MPs cross community and societal sectors, with patient-centered follow-up care at its core, is a practical approach to better address patients' needs and reduce post-discharge suicide. TRIAL REGISTRATION Registration number: NCT04907669. Date of registration: May 26th,2021.
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Affiliation(s)
- Tiantian Fu
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2Nd Road, Guangzhou, 510080, Guangdong, China
- Sun Yat-Sen University Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Huiming Liu
- Department of Public Health, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, No.1080, Cuizhu Road, Shenzhen, 518020, Guangdong, China
| | - Chang Chen
- Department of Public Health, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, No.1080, Cuizhu Road, Shenzhen, 518020, Guangdong, China
| | - Bin Zhang
- Department of Public Health, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, No.1080, Cuizhu Road, Shenzhen, 518020, Guangdong, China
| | - Guanjie Chen
- Department of Public Health, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, No.1080, Cuizhu Road, Shenzhen, 518020, Guangdong, China
| | - Yuanhan Bai
- Department of Bipolar Disorders, Shenzhen Mental Health Center, Shenzhen Kangning Hospital (Pingshan Campus), Shenzhen, Guangdong Province, China
| | - Jinghua Li
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2Nd Road, Guangzhou, 510080, Guangdong, China.
- Sun Yat-Sen University Global Health Institute, Sun Yat-Sen University, Guangzhou, China.
| | - Fengsu Hou
- Department of Public Health, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, No.1080, Cuizhu Road, Shenzhen, 518020, Guangdong, China.
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