Trends and causes of psychiatric inpatient deaths: A ten-year retrospective study at a secure forensic psychiatric centre in Canada

Psychiatric inpatient population within the correctional system is different from psychiatric inpatient facilities in the community. This study aimed to better understand the trends and causes of deaths among inpatients in a secure forensic psychiatric centre. Data collected on all deaths during a ten-year period revealed that there were 18 natural deaths (Crude Mortality Rate (CMR) of 9.6 per 1000 per year) and one death due to suicide (CMR = 0.6 per 1000 per year) constituting an overall CMR of 10.2 per 1000 per year. Among the 19 deaths during the study period, 18 (94.7%) were pre-mature (< 75 years of age). The average potential years of life lost was 22.3 years (SD = 10.8, n = 18, 95% CI = 16.9 -27.6). Respiratory diseases (44.4%, n = 8) were a leading cause of natural deaths followed by gastrointestinal diseases (38.9%, n = 7), cardiovascular diseases (11.1%, n = 2), and renal diseases (5.6%, n = 1). Nurses attended to the deceased patients on the day of their deaths in all cases and the interval in terms of the number of days a patient was seen by clinical staff prior to death was least for the nursing staff compared to other staff categories (Mean = 1.1, SD = 1.4, n = 19). In conclusion, most of the deaths were pre-mature, due to natural causes and death by suicide was extremely uncommon at the study site. Similar studies need to be conducted in other centres.