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Untoward Events in People With Severe Mental Illness in the Year After Hospitalisation

Leads: Dr Domenico Giacco (Youth Mental Health), Dr Nick Parsons, Dr Angela Noufaily (Meths)

Researchers will work with Public Contributors linked to the Youth Mental Health theme.

Dates: December 2020 - March 2021


Untoward events in mental health care include death for all causes, completed suicide, suicide attempts, violent incidents and serious side effects of treatment requiring hospitalisation. The time which immediately follows a psychiatric hospitalisation is widely considered as a critical period for untoward events. However, no large scale cohort studies are available in England. Such studies would provide an understanding of how frequent are untoward events following hospitalisation in the NHS and what are the subgroups of patients who are at higher risk of these events.

Policy and Practice Partners:

Mental health clinicians involved in developing care planning. Service managers designing care planning forms, risk assessment forms and developing pathways for transition between inpatient and outpatient mental health care. Service users with severe mental illness and their carers.

Co-Funding Partners:


Aims and Objectives:

In the current study we address the following questions:

  1. How many patients experience untoward events (death, suicide attempts, violent incidents and serious side effects of treatment requiring hospitalisation) within one year from hospitalisations?
  2. What are the patient subgroups with a higher incidence of untoward events after discharge from hospital?


Secondary analysis of a one-year cohort study following up 2,706 patients who were hospitalised in psychiatric wards in England because of primary psychotic, mood or anxiety disorders. Participants were recruited consecutively. The analysis will identify rates of individual untoward events and socio-demographic and clinical correlates in order to establish what is the extent of the problem and who are the patients and groups with higher incidence of untoward events.

Main Results:

We are currently designing the analysis plan. The dataset that will be used includes data on patients consecutively admitted to the hospitals in eleven NHS mental health trusts from 1 October 2014 to 31 December 2015, if they provided consent to participating in this research. Study protocol and main paper from the original study in this cohort are reported in the References section.



Implications for Implementation:

Identifying correlates of untoward events after discharge from psychiatric wards can inform tailored discharge care planning, care planning policies and service re-design to minimise risk related to mental health problems for service users and others. The findings will be disseminated to service managers, clinicians and service users in order to inform the development of co-produced care planning documents and quality improvement activities.