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Opinion EDITORIAL Nightmare and Disgrace Merete Nordentoft, DMSc; Annette Erlangsen, PhD; Trine Madsen, PhD It is devastating when a person who has recently been dis- verely ill group of patients who also have a higher risk for sui- charged from a psychiatric hospital dies by suicide. The act cide after discharge. Furthermore, the US sample did not cover demonstrates the patient’s suffering, lack of hope, disap- persons who were privately insured or uninsured (ie, not eli- pointment, and despair. gible for Medicaid services). Access to mental health care in Family members and next of the United States largely depends on insurance coverage, and Related article page 1119 kin are hit by sorrow and cri- findings indicate that persons with no insurance but a mental sis. Often they will blame themselves or feel that the psychi- disorder are less likely than all types of insurance holders to atric services were inadequate. For the psychiatrist who see a health care professional. treated the patient, a postdischarge suicide can be associated Apart from mental disorders, a history of deliberate self- with self-blame and the risk for being accused of misconduct. harm (DSH) has been linked to an elevated risk for suicide af-
JAMA Psychiatry – American Medical Association
Published: Nov 21, 2016
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