A Survey of Unexpected Deaths among Psychiatric In-Patients and Ex-Patients

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Abstract
The foundation of charitable institutions for the care of the mentally ill began towards the end of the eighteenth century as a result of concern amongst the articulate for the disadvantaged in society. It was not long before this same concern was again aroused; this time at the high death rate within many of these asylums. In the case of the York Asylum, which was the subject of a Parliamentary Select Committee in 1815, this was found to be due to poor conditions (Digby, 1983). Recently the Royal College of Psychiatrists has focussed attention on the continuing problem of patients who kill themselves while receiving treatment in hospital (Crammer, 1983). Particular attention was drawn to the reluctance of psychiatrists and those around them to examine the events leading to death; this compares unfavourably with the attitudes of anaesthetists and obstetricians, who have an established procedure for confidential inquiries into unexpected deaths.

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