Experiences of suicidality following discharge from a mental health inpatient unit: A systematic review and meta-synthesis

People are at increased risk of suicide following discharge from inpatient mental health units. Understanding the reasons for this increased risk is important for reducing the number of people who die by suicide. Whilst reviews of quantitative research have identified risk factors, no reviews of the qualitative literature exist which could provide more nuanced explanations of elevated suicide risk during the post-discharge period. This systematic review is the first to meta-synthesise qualitative research on experiences of suicidality after being discharged from inpatient mental health units. We searched PsycINFO, MEDLINE, Web of Science, PubMed and ProQuest using relevant search terms. We identified 29 studies that met inclusion criteria and were included in the review. We analysed the data using thematic synthesis and identified five analytic themes: 1) Feeling prepared for the transition home, 2) Returning from safety to everyday hardship, 3) The need for connection and understanding, 4) Feeling neglected by the system, 5) Taking the reins on recovery. This review indicates that reducing post-inpatient discharge suicides could be achieved through collaborative discharge preparation, immediate and intensive post-discharge support, and empowering service-user recovery.