Suicide, substance use and natural causes are respectively the most important causes of mortality in the first year post discharge from psychiatric hospitals

COMMENTARY ON: Walter F, Carr MJ, Mok PLH, et al . Premature mortality among patients recently discharged from their first inpatient psychiatric treatment. JAMA Psychiatry 2017;74:485–92. People with mental health conditions such as schizophrenia and mood or anxiety disorders have an elevated all-cause mortality.1 Those who have been admitted to psychiatric hospitals are at particular risk.2 Some of this increased mortality can be explained by suicides,3 but it is generally believed that the majority of the premature deaths of mentally ill people are from natural causes.1 However, suicide rates are alarmingly high in the year after discharge from psychiatric hospitals,4 but the relative contribution of suicide and natural death to premature mortality in this period is under-researched. The present study examined the relationship between the independent variable of psychiatric admission and dependent variables of all-cause mortality, natural mortality and mortality from unnatural causes (suicides, unintentional death and alcohol-related death) among Danish nationals born between 1967 and 1996 who were …