The incidence of suicide in palliative care patients.

Anecdotal reports from hospices show a low incidence of suicide, yet depression is increased in cancer patients, and the likelihood of suicide is increased in depressed patients. Suicide would be expected to be more common in terminally ill patients. A postal survey was undertaken of 43 palliative care units. They were asked to report the number of suicides, parasuicides and the total number of referrals for the five-year period from 1990 to 1994. Thirty-four units replied (79%). Complete data were available from 24 (56%) units. Total referrals were 72,633 in the five-year period. Nine units (38%) had one or more suicides, with a total of 21 suicides reported. Sixteen units (67%) had one or more attempted suicides (total 37). There are implications in the study both for direct patient care, but also data collection, staff support and training.