IAPDC research identifies risk factors for premature deaths among detained psychiatric patients

Earlier this year we published a statistical analysis of deaths which found that individuals detained under the Mental Health Act (MHA) have the highest mortality rate across all places of detention, including three times higher than prisons.

Our latest report, published today, identifies the risk factors associated with premature mortality – and particularly suicide – among patients detained under the MHA. We carried out a scoping review of existing research in this area and found several potential risk factors, which are categorised below.

• Sociodemographic – male, older age, and being unemployed prior to being detained.
• Clinical – a prior suicide attempt.
• Patient history – mood disorders, substance misuse, and history of aggression.
• Institutional – length of stay, involuntary admission, and a lack of access to appropriate care.

Our research concludes that preventative interventions targeting specific risk groups and conditions could reduce premature deaths among detained patients. These interventions might include suicide prevention initiatives, evidence-based treatments for psychiatric and substance use disorders, and therapies to promote overall well-being in detention settings.

However, a paucity of research in this area means that we continue to have an incomplete understanding of these deaths. We urge the Government and its agencies to prioritise research to help inform effective and evidence-based interventions to help bring down the unacceptable number of deaths.

IAPDC member Professor Seena Fazel, who led on this research with his colleague Dr Amir Sariaslan, said:

“Our research shows that patients detained under the Mental Health Act have a disproportionately high death rate. This review identifies a number of risk factors which contribute to premature mortality among these patients, most notably a previous suicide attempt. Other factors include diagnosis of mood disorders, substance misuse, and a history of aggression. While this is an important step in understanding these deaths, more research is needed in this area to ensure evidence is fully embedded in approaches to improve patient safety.”

Lynn Emslie, IAPDC Chair, added:

“It is well evidenced that people detained under the Mental Health Act have poorer mortality outcomes. A deficit in data collection and research, and independent investigation into deaths of detained patients makes it ever more challenging to ensure we target support to those who are most vulnerable. I am grateful to IAPDC member Professor Seena Fazel and his colleagues at Oxford University for carrying out this review. We now urge the Government to prioritise resources in the effective use of research and data to inform policy to ensure the lives of some of society’s most vulnerable people are better safeguarded.”

You can read the report here.