Authors (including presenting author) :
Chung YL (1),Cheng PYI (1), Sit HT (1), Hui HMH (1), Lai TK (1)
Affiliation :
(1) Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital
Introduction :
Existing literature showing that mental health service users have a higher risk of premature mortality than general population, attributed to different levels of risk factors associated with the mental illness itself, physical comorbidity or other conditions. Majority of death is from preventable physical illnesses and the remaining are unnatural causes. Therefore, exploration of death profile of death cases under CPS care in local context is necessary in order to enhance CPS service provision and service users’ well being.
Objectives :
We aimed to compile the specific causes of death under care of CPS within current 18 months in which can provide a snapshot of the current death trend. We target on the reduction of preventable risk factors of death and to provide new insights and directions to facilitate the enhancement in CPS service provision
Methodology :
All death cases under the care of CPS within the analytical period 1/1/2021- 30/6/2022 are all included in this study. Data was collected from case notes, CMS records, and interviews with case managers. We classified the causes of death into 3 major aspects namely suicide, physical illness and unknown causes of death. On top of basic demographic data and psychiatric diagnosis, additional data for specific death causes are also included.
Result & Outcome :
A total of 61 recorded death cases are included in the study. The average age of death is 62 years old while the median age of death is 63 years old. We found that the major cause of death is related to physical illness (n=41), followed by suicide (n=11) and unknown cause of death (n=9). For suicide cases, 2 cases (18%) had suicidal attempts and 8 cases (73%) had mental relapse within 12 months prior to death. All 11 suicide cases were referred to CPS within 12 months before death, in which 8 cases (73%) were referral less than half a year. For cases died of physical illness, it was observed that 37 cases (90%) had at least one physical comorbidity. Among those 37 cases, 20 cases (54%) had at least one physical comorbidity related to metabolic vascular disease. For unknown reason of death, all 9 the cases were found collapse/ death at home/ hostel. Among these 9 cases, only 1 case was living alone. We recommend to enhance the CPS service provision in two levels. First, to strengthen the post- discharge service provision such as to adjust the frequency of contacts after discharge, or to provide counseling on positive thinking specifically to service users who are identified as high suicide/ relapse risks due to high suicide chance within one year of post-discharge period. Second, to initiate community-based programs through medical-social collaborations to empower service users to increase the awareness of own physical conditions so as to reduce the risk of physical comorbidity and death.
