4.4 Review

The potential iatrogenic effects of psychiatric hospitalization for suicidal behavior: A critical review and recommendations for research

Journal

CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE
Volume 28, Issue 1, Pages 60-71

Publisher

EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC
DOI: 10.1111/cpsp.12332

Keywords

iatrogenic; psychiatric hospitalization; suicidal behaviors; suicide

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This review examines the treatment of psychiatric hospitalization for individuals with suicidal tendencies and calls for further research. It highlights the potential harm of psychiatric hospitalization for certain individuals and the need for rigorous evaluation.
Suicide rates have risen in the United States, and there has been a simultaneous, nearly ubiquitous decrease in services provided on psychiatric inpatient units (e.g., shorter stays, almost exclusive emphasis on crisis management). Despite limited research demonstrating its efficacy for reducing suicide risk, inpatient hospitalization remains the treatment of choice (and often legally mandated) for highly suicidal individuals. In this review, we discuss the sometimes-confusing guidelines providers follow concerning psychiatric hospitalization for suicidal individuals. We then highlight the considerable evidence of heightened suicide risk and other negative outcomes during and immediately following hospitalization. Finally, we propose critical research directions to rigorously evaluate whether psychiatric hospitalization is iatrogenic, at least for some individuals. Such research has far-reaching implications for practice and policy.

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