Suicidal Ideation Research in Hospital Settings: A Systematic Review

Resumen

Suicidal ideation and suicidal behaviour constitute major public health concerns and represent key predictors of suicide, particularly in psychiatric hospital settings and during the post-discharge period. Evidence consistently indicates that suicide risk remains elevated after discharge from psychiatric hospitalisation, especially among adolescents and young adults. The objective of this systematic review was to synthesize empirical evidence on suicidal ideation in hospital contexts, with a specific focus on predictors, trajectories, and post-hospitalisation outcomes. A systematic search was conducted using the Web of Science database with the keywords “suicidal ideation” and “hospitalisation,” applying filters for open-access articles published in English over the last two decades. From an initial pool of 718 records, 50 studies met inclusion criteria based on relevance, methodological rigor, and direct focus on suicidal ideation or suicidal behaviour in inpatient or post-discharge contexts. The results indicate that suicidal ideation following hospitalisation follows heterogeneous longitudinal trajectories, with chronic and persistent patterns conferring the highest risk for suicide attempts and rehospitalisation. Key risk factors include hopelessness, emotional dysregulation, prior suicide attempts, trauma exposure, and adverse psychosocial environments, whereas family connectedness and continuity of care emerge as protective factors. The discussion underscores that psychiatric hospitalisation may temporarily stabilize acute crises while shifting vulnerability to the post-discharge phase, highlighting discharge as a critical intervention point. In conclusion, suicide risk after psychiatric hospitalisation is a dynamic and multidimensional process. Effective prevention requires sustained and temporally responsive strategies that extend beyond hospitalisation and integrate clinical, psychosocial, and emerging digital approaches.