[Possibilities for Suicide Prevention Through Architecture in Child and Adolescent Psychiatry]. / Suizidpräventive Architektur in der Kinder- und Jugendpsychiatrie.

Possibilities for Suicide Prevention Through Architecture in Child and Adolescent Psychiatry Abstract. In Germany, departments of Child and Adolescent Psychiatry are responsible for the treatment of young people with acute suicidal tendencies. Therefore, it is important to consider means of preventing suicide already during the construction and business operations of these institutions. Approaches to structural suicide prevention can be divided into restrictive and atmospheric-therapeutic measures. The latter includes ways to create an antisuicidal environment and to establish a setting amenable to close support and care by mental-health professionals. Restrictive measures comprise security measures and means of avoiding potential hazards, for example, through life-threatening jumps (e. g., staircases) or intentional strangulation (e. g., employing materials with predetermined breaking points). In addition to security issues, architectural and creative aspects must be incorporated to enable a suicide-preventive atmosphere, that is, satisfying protective needs, creating positive distractions (panoramic views, activities, occupational therapy opportunities), and using positive physiological and natural influences (such as colors and light). Secure access to a pleasant and protected external area as well as exercise spaces is also essential. Architects and construction managers should work closely with the institution's health personnel (e. g., doctors, therapists, and psychiatric nursing staff) during the planning stages for Departments of Child and Adolescent Psychiatry in order to come up with solutions that comprise appropriate, practical, and functional requirements and safety-restrictive measures. Thus, an inviting and atmospherically pleasant space can be created that simultaneously provides suicide prevention and protection, where adolescents with psychiatric disorders can be treated by mental-health professionals.

[Suicides of Psychiatric Inpatients - A Systematic Recording in Switzerland of the Years 2000 to 2010]. / Suizide während psychiatrischen Hospitalisationen.

OBJECTIVE: To analyze characteristics of suicide methods of psychiatric inpatients that were carried out within and outside of psychiatric hospitals in order to identify adequate suicide prevention measures. METHODS: Data of 436 inpatient suicides were included in the data base of all institutes of forensic medicine in Switzerland for the years 2000 - 2010. We compared details of suicide methods that were applied within and outside psychiatric hospitals. RESULTS: About two thirds of all suicides were carried out outside psychiatric hospitals. Inpatients most often used jumping in front of a train, jumps from heights and drowning outside of the hospital. Within psychiatric care units patients most often died by hanging, jumps from height and self-poisoning. Heights of fall were significantly lower in suicides carried out within the hospital (Median 9 versus 22 m). In psychiatric hospitals incomplete hanging was found in 75.6 %. Waist belts were the tools most often employed. CONCLUSIONS: Windows and other spots in inpatient units should be secured if higher than first storey respectively 4 meters. Suspension points have to be secured at a low level especially in non-public rooms.