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Published Online:https://doi.org/10.1176/ps.29.2.122

The authors cite seven case histories of inpatients who committed suicide over a five-year period and analyze staff reaction and the changes in policy and procedures that followed. They conclude that staff feelings of guilt and failure brought about by inhospital suicides may result in the implementation of procedures designed to decrease risk, but that such procedures would not necessarily have prevented the suicide that led to their introduction. They maintain that staff acceptance of total responsibility for preventing suicide may achieve short-term safety at the expense of increased long-term risk, and that suicides can occur even when all reasonable precautions have been taken.

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