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Managing suicidality in inpatient care: a rapid review

Nicola Evans (School of Healthcare Sciences, Cardiff University, Cardiff, UK)
Deborah Edwards (School of Healthcare Sciences, Cardiff University, Cardiff, UK)
Phill Chick (NHS Wales Delivery Unit, Bridgend, UK)

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 30 March 2022

Issue publication date: 20 September 2022




The purpose of this mixed methods rapid study was to identify the barriers and facilitators to implement relational and environmental risk management approaches to manage suicidality in inpatient services.


To achieve this within a short timeframe, a rapid review approach was chosen. Both research (qualitative and quantitative studies) and non-research material (policies, guidance and reports) were retrieved. The review was conducted across five databases: MEDLINE, EMBASE, EMCARE, PsycINFO and CINAHL for English language citations within the last ten years (2009 –2019).


A total of 17 primary research papers and a further 73 reviews and grey literature were included. There was evidence that the removal of anti-ligature equipment, by which regular checks of the environment to identify and remove ligature points and increased levels of observation are carried out well, reduces suicide in hospital.

Research limitations/implications

There is a gap in research investigating “engagement activities” eliciting exactly what they are and determining how they might be effective. There is a need for new innovative ways for managing risk of suicide in hospitals that bring together meaningful engagement and maintaining safety.


Keeping people safe during an inpatient stay in a mental health service is a core function of mental health practitioners. This paper brings together what is already known about risk management and highlights areas for further investigation.



The ICMJE Form for Disclosure of Potential Conflicts of Interest has been completed and we have no conflicts of interest to declare.All authors have met the four criteria for authorship:substantial contributions to the conception or design of the work or the acquisition, analysis or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.The author would like to thank NHS Wales.


Evans, N., Edwards, D. and Chick, P. (2022), "Managing suicidality in inpatient care: a rapid review", The Journal of Mental Health Training, Education and Practice, Vol. 17 No. 6, pp. 479-494.



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