Abstract
BackgroundIt is unclear who is at risk of being involved in a suicide cluster and whether suicide clusters are influenced by the social transmission of suicidal behaviour, assortative relating, or a combination of both.MethodsSuicide clusters involving two or more young people were identified from the free text of electronic police and coroners reports in Australia's National Coronial Information System in a nationwide cross-sectional study. The duration of survival among exposed cases were estimated using time-to-event methods. The casewise concordance of demographic, social and clinical characteristics and circumstances of death were examined among index and exposed cases.FindingsWe identified links between 117 young people (51 suicide clusters). 50% of young people died within 90 days of the index suicide. Individuals exposed to railway suicide had an 80% probability of dying by the same method. Those exposed to the suicide of a person aged 10–18 years had an 86% probability of being from the same age group. Young people had a 67% and 60% probability of sharing the same characteristics as the index suicide when the index suicide resided in a remote community or was of Aboriginal and Torres Strait Islander descent.InterpretationSuicide clusters may be associated with both the social transmission of suicidal behaviour and assortative relating. Individuals who were close to the deceased should be provided with access to postvention support, particularly within the first 90 days of exposure to an index suicide.FundingAustralian Rotary Health, National Health and Medical Research Council.
Highlights
Suicide is the second leading cause of death in young people aged 10À24 years, worldwide and accounts for approximately 150,000 preventable deaths in young people under age of 25, each year [1]
This study investigated characteristics and circumstances of death of 117 young people aged 10À24 years who died in suicide clusters in Australia in 2006À2015
By examining the concordance of demographic, social and clinical characteristics of index and exposed cases in a cluster, we found that the presence of pre-existing clinical characteristics such as mental-ill health, substance misuse, and history of binge drinking among index cases were not significantly associated with the probability that the same characteristics were present among exposed cases
Summary
Suicide is the second leading cause of death in young people aged 10À24 years, worldwide and accounts for approximately 150,000 preventable deaths in young people under age of 25, each year [1]. Studies of suicide clusters in community settings typically characterise suicide clusters on the basis of shared social links between two or more suicides in specific settings such as schools, inpatient units, and remote communities [6,7] Clusters of this nature have been linked to prior exposure to suicide, a known risk factor for later suicide [8], and can lead to widespread speculation about the antecedents and circumstances of the deaths [9,10], prolonged grief [11] and heightened fear and anxiety among members of the community of the prospect of future suicides [2,9].
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