Almost 1 500 people die by suicide every year in Sweden and one out of three have been in contact with mental health care services the year before suicide. A high risk for suicide indicates inpatient care at psychiatric hospital and even though inpatient suicide is the most avoidable, death by suicide still occurs while inpatient care. It is essential for the staff to have knowledge of the suicidal process and be aware of suicidal behavior and risk factors. The aim was to retrospectively identify suicidality in medical electronic charts for adult patients who committed suicide 2015 during psychiatric inpatient care. The study was part of a national retrospective project in Sweden where all of Sweden's 21 regional health administrations agreed to participate. Data from 35 inpatient suicides was analyzed according to statistical analyses. There were documentation of suicidal variables in several patients, but no patient had professional supervision in one to one basis and a minority had intermittent supervision in form of 15 min checks. Eight out of thirty five patients (23%) had a documented suicide risk assessment. Suicidality were more frequently documented in the medical charts in patients with previous known suicide attempt (p≤0.001). The result indicates the lifesaving role of high level supervision within the early state of inpatient care and the importance of accurate documentation of risk assessment in the medical chart. Especially for patients with previous suicide attempt and suicidal communication.