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Suicide among psychiatric patients could be prevented by improving ward design and after-care, new research claims.

Almost a quarter of the 20,927 people who committed suicide in England and Wales from 1996 to 2000 were in contact with mental health services in the year before their death, the study says.

Of those, 16 per cent were in-patients at the time and 23 per cent had recently been discharged.

The majority of cases of in-patient suicide were by hanging and around a quarter died within seven days of admission.

The study, part of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, based at the University of Manchester, raises concerns about observation on in-patient wards. It suggests structure and layout should be reviewed and potential ligature points removed.

Post-discharge suicide was most frequent in the first two weeks after leaving hospital, according to the study, which was published in the British Journal of Psychiatry. It also proposes early follow-up in the community for at-risk patients.