European Psychiatry - Volume 41 - April 2017

297 / 916

25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302 S293
tion” were included. Articles that used the most reliable and valid
measurement tools (i.e., Beck Scale for Suicide Ideation and Sui-
cide Probability Scale) for patient evaluation were selected. World
Health Organization guidelines and the Portuguese Suicide Preven-
tion Plan were analyzed and an algorithm was designed based on
the major risk factors identified.
Results No isolated risk factor was successful for preventing
suicide: most are chronic and non-individualized. Having fam-
ily history of suicide, a mental health disease, a suicide plan and
previous suicide attempts are considered major risk factors. The
algorithm is based on these factors and takes into account inter-
personal variability.
Conclusions The best way to prevent a suicide is to ask patients
for major risk factors, and then, by using this algorithm, treat them
accordingly.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0550
Acute psychiatric involuntary
admissions in a general hospital after
suicidal behavior. A 2-year follow-up
J.J. Fernandez Miranda∗, D.F. Frias Ortiz , S. Fernandez Diaz
AGC SM-V-SESPA, Asturian Mental Health Service, Psychiatry and
Mental Health, Gijón, Spain
∗ Corresponding author.
Introduction Patients with a plan, access to lethal means, recent
social stressors and symptoms suggestive of a psychiatric disor-
der should be hospitalized immediately. Sometimes involuntary
hospital admission is used to avoid a suicidal behavior, taking into
account that after a suicide attempt 25% of people repeat attempt
and 10% die by suicide.
Objectives/aims To know hospital admission due to suicide
attempts, and how many of them were involuntary.
Method A 2-year retrospective study (2014–2015) of all cases
admitted after suicidal behavior in an acute psychiatric ward in
a general hospital in Gijón (Spain). Reasons for hospital admission
were registered, including suicide attempts. And also if admissions
were involuntary.
Results The total number of admissions to the psychiatric unit
in 2014–2015 was 2376. Admissions due to suicide attempts were
427; 300 of them were involuntary admissions. There were a total
of 347 involuntary admissions these two years; among them, due
to suicide attempt: 300.
Conclusions Most of involuntary admissions in the psychiatric
unit of the hospital studied followed a suicide attempt, as a pre-
vention of repeated suicidal behavior. Obvious high risk of repeat
suicide attempt generates an urgency to make an accurate assess-
ment and create a safe treatment plan and determine to retain
suicidal patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0551
Mental illness and mental health care
as experienced by persons who die by
suicide; a qualitative analysis of
suicide notes
Z. Furqan ∗, J. Zaheer , M. Sinyor , A. Schaffer
1 University of Toronto, Department of Psychiatry, Toronto, Canada
2 Centre for Addiction and Mental Health, Health Outcomes and
Performance Evaluation HOPE Research Unit, Institute for Mental
Health Policy Research, Toronto, Canada
3 Sunnybrook Health Sciences Centre, Psychiatry, Toronto, Canada
∗ Corresponding author.
Whilemental illness is a risk factor for suicidal behaviour andmany
suicide victims receive mental health care prior to death, there is a
comparative lack of research that explores their narratives of care.
Suicide notes offer unique insight into these subjective experiences.
Our study explores the following questions: “How is mental health
care experienced by those who die by suicide?” and “What role
does this experience play in an individual’s journey to suicide?”
Our sample is a set of 21 purposefully selected notes that explicitly
make mention of mental illness and/or mental health care, from a
larger sample of 255 notes obtained through the Toronto Coroner’s
Office. We utilized a constructivist grounded theory framework to
engage in line-by-line open coding, axial coding, memo-ing and
theorizing of the data. Preliminary themes include (1) perception
of recurrent utilization of mental health care as personal failure,
(2) recurrent utilization of mental health care as a manifestation of
accumulating hopelessness, (3) the construction of suicide as being
beyond the scope of mental health care, (4) tensions between the
conceptualization of mental illness as an inherent part of the self
and mental illness as a disease to be fought or overcome, and (5)
suicide as an exertion of self-autonomy, distinct from the influence
ofmental illness. An exploration of the complexity of an individual’s
relationship with mental illness and mental health care can foster
better identification, understanding and support for those at risk
for suicide.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0552
Understanding the role of
bereavement in the pathway to
suicide
K. Galway ∗, S. Mallon , G. Leavey , J. Rondon-Sulbaran
1 Queen’s University Belfast, Centre for Evidence and Social
Innovation, Belfast, United Kingdom
2 Open University, Health Sciences, Milton Keynes, United Kingdom
3 Ulster University, Bamford Centre for Mental Health and Wellbeing,
Londonderry, United Kingdom
4 Ulster University, Health Sciences, Belfast, United Kingdom
∗ Corresponding author.
Introduction Bereavement is considered to be a common precur-
sor of death by suicide. Studies suggest those bereaved by suicide
may be particularly vulnerable to suicide themselves. Recently,
there has been a concern over the number of deaths by suicide
across UK and Europe. As a result, an increasing number have been
exposed to bereavement by suicide. It remains unclear how these
deaths might impact on future suicide rates.
Objectives To examine a two-year cohort of all suicides in North-
ern Ireland, in order to report on bereavements recorded in the
records of those who died by suicide. To assess the bearing of these
deaths on those left behind.
Aims To provide an estimate of the prevalence and types of
bereavements that may have contributed towards the suicide.
Methods Following the sociological autopsy approach to study-
ing death by suicide, data was collected from a range of sources,
including GP records and Coroner records and interviews with
bereaved relatives. The analyses draw on relatives’ accounts in
order to increase our understanding of the impact of suicide
bereavement. Interviews took place between 18 months and 5
years after the death by suicide.
Results Of the 403 deaths by suicide, 15% of the individuals expe-
rienced bereavement and 9% bereavement by suicide. The results
support the assertion in the literature that bereavement by suicide
increases the risk of suicide through a process of suicide contagion.