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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302


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.


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.


The best way to prevent a suicide is to ask patients

for major risk factors, and then, by using this algorithm, treat them


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


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.


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.


To know hospital admission due to suicide

attempts, and how many of them were involuntary.


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.


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.


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.


Mental illness and mental health care

as experienced by persons who die by

suicide; a qualitative analysis of

suicide notes

Z. Furqan

1 ,

, J. Zaheer


, M. Sinyor


, A. Schaffer



University of Toronto, Department of Psychiatry, Toronto, Canada


Centre for Addiction and Mental Health, Health Outcomes and

Performance Evaluation HOPE Research Unit, Institute for Mental

Health Policy Research, Toronto, Canada


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.


Understanding the role of

bereavement in the pathway to


K. Galway

1 ,

, S. Mallon


, G. Leavey


, J. Rondon-Sulbaran



Queen’s University Belfast, Centre for Evidence and Social

Innovation, Belfast, United Kingdom


Open University, Health Sciences, Milton Keynes, United Kingdom


Ulster University, Bamford Centre for Mental Health and Wellbeing,

Londonderry, United Kingdom


Ulster University, Health Sciences, Belfast, United Kingdom

Corresponding author.


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.


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.


To provide an estimate of the prevalence and types of

bereavements that may have contributed towards the suicide.


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.


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.