Method Of Suicide Research Articles

Fatal Firearm Violence Among American Indians and Alaska Natives.

There is a dearth of population-based studies regarding firearm-related deaths and years of potential life lost among American Indians and Alaska Natives (AI/AN). Using the Centers for Disease Control and Prevention's (CDC) We Based Injury Statistics Query and Reporting System (WISQARS) data for the three most recent years (2018-2020), we analyzed the demographic characteristics of AI/ANs who succumbed to firearm violence. AI/ANs averaged almost 500 firearm-related deaths per year. The majority of these deaths were observed among individuals 20-39 years of age (53%), males (84.4%), and in the West (55.3%). A plurality of these firearm-related deaths were suicides (48.9%) followed by homicides (43.5%). During the 3-year study period, the age-adjusted firearm death rate increased almost 5 times the growth of the AI/AN population. Also, a staggering 67,050 years of potential life were lost before the age of 80 years (YPLL80) during this period. Firearm suicides were responsible for the largest proportion of YPLL80s (48.5%). Traditional legal interventions [e.g., child access prevention (CAP) laws and extreme risk protection orders (ERPO)], if expanded to more states could potentially help reduce AI/AN firearm mortality. None of the 10 states with the highest firearm mortality of AI/AN have ERPOs and 8 of the 10 do not have CAP laws. Also, a renewed focus on cultural continuity and indigenous protective factors is essential to ameliorate the level of firearm violence in AI/ANs.

GENDER-BASED VIOLENCE IN HOMICIDE–SUICIDE EVENTS: A CALL FOR ADHERENCE TO THE CDC DEFINITION FOR “MERCY KILLING”

Abstract Intimate partner homicide suicide (IPHS) events are overwhelmingly male perpetrated (90%). Gender-based violence (GBV) prevention requires ‘best practices’ for media reporting. Consider the following: In a patient room of a busy hospital, an overwhelmed man (71) suicided after firing shots at his wife (70) who had survived a stroke. The gunfire caused trauma among witnesses. Media reports used the term ‘mercy killing,’ but critical ingredients were missing. The CDC’s NVDRS (2022) defines ‘mercy killing’ as “…Killed, at the victim’s request…to end…pain or distress…Do not assume…murder/suicide by a sick, elderly couple is mercy killing.” Evidence of a clear wish to die, is needed “due to a hopeless or terminal condition.” Our IPHS, news surveillance study was updated 1999-2022 and used content analysis to identify GBV rationalizations, based upon 2219 events and over 5000 fatalities across young (n=987), middle aged (n=699), and older 60+ (n=533) categories. Only the 60+ group had claims of ‘mercy killing,’ mostly without adherence to the CDC definition. Older men who are suicidal may also harm an unsuspecting partner. For women, end of life decision-making is lost in ‘safe spaces,’ like homes or care facilities, which is made worse by rationalized excuses. Women are rarely suicidal and use passive methods (i.e., drugs). When women care for an ailing partner, they don’t commit IPHS. Older men are more suicidal and utilize more lethal firearm methods (similar to the IPHS patterns). Media best practices involve valuing persons with disabilities, publicizing services and recognizing violence is a public health problem.

Examining predictors of suicide by firearm in young, middle, and late adulthood.

Suicide remains a leading cause of death in the U.S., and firearms are one of the most lethal methods of suicide. This study examines personal and contextual factors that predict suicide with a firearm compared to other methods across stages of adulthood. Data on adult suicide decedents from 2009 to 2019 were obtained from Colorado's National Violent Death Reporting System (NVDRS) data (N = 11,512). The dataset includes incident and person characteristics collected by law enforcement and coroners. Zip code level data were integrated from the American Community Survey. Age, sex, race, marital status, military service, substance use, suicide attempt history, mental health, and location characteristics (population density, as well as age, education, veteran status, and household status of population) predicted suicide by firearm. Risk was particularly high for males in older adulthood. We further explored age-specific models (young, middle-aged, and older adults) to determine salient risk factors for each group. This study highlights the need for comprehensive suicide prevention approaches that consider both individual and contextual risk factors, as well as unique risks in each stage of adulthood.

Incomplete decapitation in suicidal vehicle-assisted ligature strangulation: A case report and a review of the literature

Vehicle-assisted ligature strangulation is an extremely rare suicide method. We report a case of a 43-year-old man who secured one end of a nylon rope to a tree and the other end around his neck, then got inside his vehicle and stepped on the gas, leading to an incomplete decapitation. A sharply demarcated encircling ligature mark was found upon external examination, along with a deep laceration in the anterior region of the neck. The severance plane passed between the third and fourth cervical vertebrae, with diffuse haemorrhagic infiltration of the cervical muscles, in accordance with autopsy findings reported in the literature. The lung histological examination described a large amount of red blood cells and pulmonary oedema. A review of the literature concerning suicidal vehicle-assisted ligature strangulation cases allowed us to investigate some common autopsy findings, as well as the rope features relevant to the beheading.

Reasons and Patterns of Self-Poisoning Among Adult Females in Bangladesh

Background: Suicide is a prevalent cause of unnatural death in Bangladesh and a long-standing social concern. Self-poisoning is a frequently observed method of suicide in this area. Domestic abuse, stalking, eve-teasing, physical and sexual assault, demands for dowry, failure in exams, and romantic disappointments were prominent reasons for suicide among Bangladeshi females. Aim of the Study: The purpose of the study was to assess the reasons and patterns of self-poisoning among adult females in Bangladesh. Method: This descriptive cross-sectional study was carried out from January 2016 to June 2016 at the Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh. This study relied on 100 adult female self-poisoning patients as study participants. MS Excel and the SPSS version 23.0 application were used to handle the research. Result: The participants' average age was 28.19±9.84 years. Most were from rural areas (62%), 75% were Muslims, 55% were from joint families, and the role of 'housewife' (30%) was the most common job. Family disharmony was the reported reason for self-poisoning in more than one-third (35%) of our participants, while romantic disappointment accounted for 27% of the cases, both notable ratios. Additionally, 8% cited education-related issues, 12% mentioned misunderstandings with parents, 9% attributed self-poisoning to poverty, 5% to chronic illness, and 4% to various other reasons. Conclusion: Among adult females in Bangladesh, family disharmony and romantic disappointment are the most common reasons for self-poisoning. Additionally, education-related issues, misunderstandings with parents, poverty, and chronic illness are also cited as contributing factors for incidents of self-poisoning.

Depression in older women who died by suicide: associations with other suicide contributors and suicide methods

Suicides among older women have received little research attention. In this study based on the 2017–2019 National Violent Death Reporting System data, we examined the prevalence of depression in older female suicide decedents (N = 3,061), associations between depression and other suicide precipitants, and the associations between suicide methods and depression. Descriptive statistics and generalized linear models (GLM) for a Poisson distribution with a log link were used to examine the research questions. Of the decedents, 15.0% had depressed mood without a reported diagnosis and 41.8% had a depression diagnosis. Nearly one-half of the decedents with reported depression were receiving mental health/substance use treatment at the time of injury. The likelihood of depression was lower among those who were age 85 and older compared to those were age 65–74, but higher among those who had anxiety disorder (IRR = 1.50, 95% CI = 1.33–1.69), history of suicidal ideation (IRR = 1.22, 95% CI = 1.10–1.35), history of suicide attempt (IRR = 1.27, 95% CI = 1.14–1.41), and bereavement problems (IRR = 1.45, 95% CI = 1.27–1.65). Those who had depression were less likely to have used firearms (IRR = 0.85, 95% CI = 0.75–0.97) but more likely to have used hanging/suffocation (IRR = 1.37, 95% CI = 1.13–1.67). The findings show that gun ownership was likely an important factor for firearm use. The high prevalence of depressed mood and/or depression diagnosis among older female suicide decedents at the time of their fatal injury underscores the importance of assessing depression and providing evidence-based depression treatment as an essential suicide prevention approach.

Development of mental health first-aid guidelines for suicide risk: a Delphi expert consensus study in Argentina and Chile

BackgroundSuicide continues to pose a significant global public health challenge and ranks as one of the leading causes of death worldwide. Given the prevalence of suicide risk in the community, there is a significant likelihood of encountering individuals who may be experiencing suicidal thoughts or plans, creating an opening for non-health professionals to offer support. This study aims to culturally adapt the original Australian Mental Health First Aid Guidelines for suicide risk to the Chilean and Argentine context.MethodsA two-round Delphi expert consensus study was conducted involving two panels, one comprising individuals with personal experience in suicide thoughts/attempts or caregiving for those with such experiences (n = 18), and the other consisting of professionals specialized in suicide assessment and support for individuals at risk (n = 25). They rated a total of 179 items mainly derived from guidelines developed by Australian experts and translated into Spanish (168), and new items included by the research team (11). The panel members were requested to assess each item utilizing a five-point Likert scale. During the second round, items that received moderate approval in the initial round were re-evaluated, and new items suggested by the local experts in the first round were also subjected to evaluation in the next round. Inclusion in the final guidelines required an 80% endorsement as “essential” or “important” from both panels.ResultsConsensus of approval was reached for 189 statements. Among these, 139 statements were derived from the English-language guidelines, while 50 locally generated statements were accepted during the second round. A significant difference from the original guideline was identified concerning the local experts’ reluctance to discuss actions collaboratively with adolescents. Furthermore, the local experts proposed the inclusion of an entirely new section addressing suicide risk in older individuals, particularly focusing on suicide methods and warning signs.ConclusionsA Delphi expert consensus study was conducted to culturally adapt mental health first aid guidelines for assessing suicide risk in Chile and Argentina. This study involved professionals and individuals with lived experience. While many items were endorsed, some related to inquiring about suicide risk and autonomy, particularly for adolescents, were not. An additional section for older individuals was introduced. Future research should explore the implementation and impact of these adapted guidelines in training courses. This is vital for enhancing mental health support and implementing effective suicide prevention strategies in Chile and Argentina.

Women Veterans' perspectives, experiences, and preferences for firearm lethal means counseling discussions.

Firearms have become an increasingly common method of suicide among women Veterans, yet this population has rarely been a focus in firearm suicide prevention research. Limited knowledge is available regarding the preferences, experiences, or needs of women Veterans with respect to firearm lethal means counseling (LMC), an evidence-based suicide prevention strategy. Understanding is necessary to optimize delivery for this population. Our sample included forty women Veterans with lifetime suicidal ideation or suicide attempt(s) and firearm access following military separation, all enrolled in the Veterans Health Administration. Participants were interviewed regarding their perspectives, experiences, and preferences for firearm LMC. Data were analyzed using a mixed inductive-deductive thematic analysis. Women Veterans' firearm and firearm LMC perspectives were shaped by their military service histories and identity, military sexual trauma, spouses/partners, children, rurality, and experiences with suicidal ideation and attempts. Half reported they had not engaged in firearm LMC previously. For those who had, positive aspects included a trusting, caring relationship, direct communication of rationale for questions, and discussion of exceptions to confidentiality. Negative aspects included conversations that felt impersonal, not sufficiently comprehensive, and Veterans' fears regarding implications of disclosure, which impeded conversations. Women Veterans' preferences for future firearm LMC encompassed providers communicating why such conversations are important, how they should be framed (e.g., around safety and genuine concern), what they should entail (e.g., discussing concerns regarding disclosure), whom should initiate (e.g., trusted caring provider) and where they should occur (e.g., safe spaces, women-specific groups comprised of peers). This study is the first to examine women Veterans' experiences with, and preferences for, firearm LMC. Detailed inquiry of the nuances of how, where, why, and by whom firearms are stored and used may help to facilitate firearm LMC with women Veterans.

Association Between the New York SAFE Act and Firearm Suicide and Homicide: An Analysis of Synthetic Controls, New York State, 1999‒2019.

Objectives. To assess the association between the New York Secure Ammunition and Firearms Enforcement Act (NY SAFE Act) and firearm suicide and homicide rates. Methods. We employed a synthetic controls approach to investigate the impact of the NY SAFE Act on firearm suicide and firearm homicide rates. We collected state-level data on firearm mortality from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (WONDER) database for the period 1999-2019. We derived statistical inference by using a permutation-based in-place placebo test. Results. The implementation of the NY SAFE Act was associated with a significant reduction in firearm homicide rates, demonstrating a decrease of 63%. This decrease corresponds to an estimated prevention of 1697 deaths between 2013 and 2019. However, there was no association between the NY SAFE Act and firearm suicide rates. Conclusions. As the responsibility for enacting firearm policies increasingly falls on states instead of the federal government, this study provides valuable information that can assist states in making evidence-based decisions regarding the development and implementation of firearm policies that prioritize public safety and aim to prevent firearm-related fatalities. (Am J Public Health. 2023;113(12):1309-1317. https://doi.org/10.2105/AJPH.2023.307400).

Notes from the Field: Firearm Suicide Rates, by Race and Ethnicity - United States, 2019-2022.

Notes from the Field: Firearm Suicide Rates, by Race and Ethnicity - United States, 2019-2022.

Comparison of all completed suicides in Frankfurt am Main (Hessen) before and during the early COVID-19 pandemic.

To research the effect of the COVID-19 pandemic on mental health, the prevalence and characteristics of all completed suicides in the city of Frankfurt am Main were compared for a 10-month period before the pandemic (March 2019-December 2019) with one during the early pandemic (March 2020-December 2020). Medicolegal data collected in the context of the FraPPE suicide prevention project were evaluated using descriptive statistical methods. In total, there were 81 suicides during the early pandemic period, as opposed to 86 in the pre-pandemic period. Though statistically not significant, the proportion of male suicides (73%) was higher during the early pandemic period than before (63%). The age-at-death was comparable in the pre-pandemic and pandemic periods (average, 54.8 vs. 53.1years). Between these two periods, there was no difference in respect to the three most commonly used suicide methods by men: fall from a height (26% vs. 22%), intoxication, and strangulation (each 24% vs. 19%). For women, there was, however, a shift in methods from strangulation (38%), intoxication (28%), and fall from a height (19%) to fall from a height (50%), strangulation (18%), intoxication, and collision with a rail vehicle (14% each). There was a trend towards more suicides among non-German nationals during the early pandemic (suicide rate/100,000 inhabitants: German, 14.3 vs. 11.5; non-German, 4.4 vs. 8.8). Before the pandemic, 54% of the suicides were known to have a mental illness in contrast to 44% during the early pandemic. Overall, no increase in completed suicides could be observed in Frankfurt am Main during the early pandemic.

Adherence to the WHO guidelines of newspaper-reporting on suicides in Pakistan: a content analysis

There is a lack of evidence regarding the rate of adherence to the World Health Organization (WHO) media guidelines of vernacular newspapers reporting on suicides in Pakistan. Also, the relevance of this report is based on the lack of official data regarding the number of suicides across the country. The aim of this study was to explore the rate of adherence to the WHO guidelines of two popular newspapers in reporting on suicides in Pakistan. We daily analysed the online version of two popular newspapers in Pakistan, the daily Jeejal (in Sindhi) and daily Jang (in Urdu), from 1 August 2021 to 31 July 2022; we performed a content analysis of news reporting on national suicides and evaluated their rate of adherence to the WHO media guidelines. One hundred and seventy-three reports of suicides were identified and analysed; 84% of them reported the names of victims, 70% reported their age, and 46% included information regarding their occupation. Characteristics of suicide methods were reported in 87% of reports, reasons for suicide in 66%, as well as locations in 87%. In general, 84% of newspapers reported incomplete information regarding suicide prevention and help-seeking, so we may conclude they were not fully adherent to the WHO recommendations. This study indicates that national vernacular newspapers may improve their reporting on suicides and should revise their policy in order to be adherent to the WHO guidelines. Also, better and responsible reporting may provide an accurate epidemiological source regarding suicide where official data are missing at the national level.

Adolescent Predictors of Firearm Suicide Over Four Decades of Life in U.S. Men

There are meager individual-level data on long-term predictors of firearm suicide. This was an analysis of males (N=189,558) in the Project Talent cohort, a national probability sample of high school schools in 1960 when students completed a baseline Project Talent self-report inventory. Mortality follow-up was contingent on survival until 1979, the onset of the National Death Index when the cohort had a mean age of 35.7 years. Mortality follow-up continued until death or age 75 years, reached by all surviving members by 2018. Analyses were conducted in 2022, with the main outcome being firearm suicide deaths (n=479). Factor analyses of Project Talent items yielded three key factors: (1) interests in firearm-related professions (i.e., military service, police force), (2) interests in hunting or fishing and knowledge of long guns, and (3) stereotypic masculinity. Survival analyses showed that long-term risk for firearm suicide was associated with 1-SD increases in firearm-related vocational interests in adolescence (adjusted hazard ratio [95% CI]=1.23 [1.09, 1.40]) and masculinity (adjusted hazard ratio [95% CI]=1.15 [1.04, 1.28]). Decreased long-term firearm suicide risk was associated with increased hunting interests and knowledge of long guns in adolescence (adjusted hazard ratio [95% CI]=0.86 [0.77, 0.96]) and competitive sports participation, an exploratory variable (adjusted hazard ratio [95% CI]=0.89 [0.80, 0.99]). Prevention efforts are needed to lower long-term firearm suicide risk among adolescent males with high stereotypic masculinity and those interested in military or police service. Potential protective effects of competitive sports participation and socialization to long guns through hunting require further study.

Causes of Death of Transgender and Gender Diverse Veterans

Transgender and gender diverse (TGD) veterans face numerous challenges due to stigma and marginalization, which have a significant impact on their health and well-being. However, there is insufficient data on cause-specific mortality in TGD veteran populations in the U.S. The purpose of this study was to describe the leading causes of death in a sample of TGD veterans who received care from the Veterans Health Administration. A secondary data analysis was conducted using Veterans Health Administration electronic health record data matched with death certificate records from the National Death Index from October 1, 1999 to December 31, 2019. Using record axis codes from National Death Index data, the 25 most frequent underlying and all causes of death were summarized. Deaths occurred in 1,415 TGD veterans. Ranking by any mention on the death certificate, mental and behavioral disorders due to psychoactive substance use (17.2%), conduction disorders and cardiac dysrhythmias (15.3%), chronic obstructive pulmonary disease (15.1%), diabetes mellitus (13.9%), and chronic ischemic heart disease (13.3%) were the top five causes of death. Three distinct methods of suicide appeared as the 7th (firearms), 17th (self-poisoning), and 24th (hanging) underlying causes of death for TGD veterans. Targeted prevention efforts or interventions to reduce the frequency and severity of causes of death, particularly mental and behavioral health disorders and metabolic disorders, could prevent premature mortality among TGD adults.

Gender Differential in the Choice of Methods of Dying by Suicide in Southwest Nigeria

Abstract Background: The choice of method of dying by suicide can determine the lethality of a suicide attempt, especially among males and females. However, a less attention has been paid to this area of research among Nigerian authors. Objective: The objectives of this study were to investigate the distribution of completed suicide across methods of suicide among decedents and to examine the odds ratio of males using hanging or poisoning methods. Materials and Methods: This retrospective chart-based study was conducted among those who died by suicide and whose cases were reported at the police stations. The data were collected by checking the files at the homicide and suicide departments at the police headquarters in southwest Nigeria. Ethical approval was obtained for the study. Descriptive statistics and logistic regressions were used to analyze the data. Results: The results revealed that 78.3% were male, while females were 21.7%. 53.7% of the sampled population died by hanging and 23.2% died by poisoning. 8.9% of the decedents died by self-harm suicide. Suicide choices traceable to mental illness and jumping/drowning were 6.4% and 6.4%, respectively, while suicide by gunshot (1.5%) was less prominent. Furthermore, the result showed that there was a 3% likelihood that a male would die by hanging. Conclusion: Males are 3% more likely to die by hanging and are less likely to die by poisoning.

Organophosphorus Compound as Suicidal Poison in Rural Areas of Bangladesh: A Medicolegal Study

Background: Suicide by poisoning is a major public health problem in Bangladesh and other developing countries in the world. Among the poisonous substances, Organophosphorus compounds (OPC) poisoning is more common. Easy accessibility of the poison is the number one reason for the preference of OPCs as suicidal agents. Objective: This study was designed to find out demographic characteristics and postmortem findings related to suicide by OPC poisoning in Manikganj. Methodology: This retrospective cross-sectional study was carried out during January, 2019 to December, 2020 in the district hospital, Manikganj, Bangladesh. Results: During the study period, a total of 381 medico-legal autopsy have been done- among them, 83 (21.78%) cases were death due to OPC poisoning. Maximum (24, 28.91%) deaths were between ages of 21-30 years, among them majority were males (49, 59.03%). People of different occupations were involved in OPC poisoning- maximum of them were housewives (27, 32.53%), followed by agricultural workers (13, 15.66%). Regarding motive of poisoning, the most common was suicidal intent (58, 69.88%) among both males (22, 37.93%) and females (36, 62.07%), followed by accidental (25, 30.12%). About one third of the cases were illiterate (26, 31.33%). Financial constraint was the main cause of suicide. Conclusion: OPC poisoning is a burning problem in our health sector. Improvement of awareness, elimination of unemployment, financial stability, limiting availability and banning more toxic compounds would reduce the OPC poisoning rate to a considerable number. Journal of Monno Medical College, June 2023; 9 (1): 07-10

Epidemiological Evaluation of Suicidal Deaths due to Organophosphorus Compound Poisoning

Background: One of the most widespread suicide methods, especially emerging in developing countries like Bangladesh, is poisoning. Organophosphorus compound (OPC) is a common chemical used for self-poisoning that is also inexpensive and easily accessible. Objectives: To evaluate the demography of suicidal deaths due to OPC poisoning. Methods: This was a retrospective study with the departmental records of autopsy among deaths due to OPC poisoning. The study was carried out to ascertain the epidemiological evaluation of 242 OPC poisoning suicidal deaths during January, 2016 to December, 2017 at the mortuary of Sylhet MAG Osmani Medical College, Bangladesh. Results: Majority of the victims (184, 76.03%) were below 40 years of age and females were predominant (142, 58.67%). Most of the victims resided in Companygonj (47, 19.42%), followed by Kotwali (40, 16.52%), and Gowainghat (35, 14.52%) of Sylhet district. Most of the dead bodies (192, 79.33%) were brought to the morgue under Kotwali police station. The most common (218, 90.08%) cause of death was respiratory failure. Conclusion: Suicide with OPC was the most common in younger women. Establishment of national suicide surveillance is now a time demanded step and responsible authority should take some necessary steps to address it. Journal of Monno Medical College, June 2023; 9 (1): 20-23

Cardiovascular drugs and suicide death: Determination of carvedilol, amlodipine, doxazosin and diltiazem in two fatal cases

A number of medical conditions are identified as risk factors for suicide death; in particular, cardiovascular illnesses are recognized as a major suicide risk factor. In this case, self-poisoning is the common method of suicide and cardiovascular drugs are among the major medications associated with fatal overdose, with calcium channel blockers being one of the most common agents. The present study describes two different fatal suicide cases involving four cardiovascular drugs: carvedilol, doxazosin and amlodipine (case 1) and diltiazem (case 2). The concentrations of the target cardiovascular drugs in the different biological specimens (central and femoral blood, urine, liver, brain) are presented, giving information about the potentially fatal data and the distribution of the drugs in the body. The study led to the implementation of a fast, sensitive and simple method for the detection and quantification of the four commonly prescribed cardiovascular drugs in post-mortem specimens including fluids and tissues for forensic purposes. The method was fully validated. The toxicological results of the studied cases are discussed, along with the autopsy results, histopathological evidence, and circumstances of death. The toxicological findings presented in the study provide new data regarding cardiovascular drugs in different post-mortem specimens, which will contribute to the currently limited knowledge about the toxicological profile of cardiovascular drugs and their distribution.

Identifying U.S. regions with the highest suicide rates and examining differences in suicide methods among Asian American, Native Hawaiian, and Pacific Islander Veterans.

The suicide rate among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Veterans increased from 2001 to 2020. Identifying regions where suicide rates are elevated and increasing among AANHPI Veterans would inform targeted prevention efforts for members of this cohort. We conducted a population-based retrospective cohort study of 377,833 AANHPI Veterans to examine suicide rates and methods (2005-2019) by United States (US) region and over time (2005-2009, 2010-2014, 2015-2019), using US Veteran Eligibility Trends and Statistics and Joint DoD/VA Mortality Data Repository data. AANHPI Veterans across most regions experienced increases in suicide rates from the earliest to latest period; however, patterns differed by region. Age-adjusted suicide rates increased across all three periods among those in the Northeast and West, but increased, then declined in the Midwest and South. In 2015-2019, the age-adjusted suicide rate among AANHPI Veterans was highest in the Northeast (42.0 per 100,000) and lowest in the West (27.5). However, the highest percentages of AANHPI Veteran suicide deaths in 2005-2019 occurred in the West (39.5%) and South (34.7%), with lower percentages in the Midwest (15.0%) and Northeast (10.8%). Across regions, those ages 18-34 had the highest suicide rates. Firearms were the most frequently used suicide method across regions (44.4%-60.2%), except the Northeast (35.2%), where suffocation was more common (38.3%). Results suggest particular needs for suicide prevention efforts among AANHPI Veterans in the Northeast and to ensure that lethal means safety initiatives for AANHPI Veterans encompass both firearms and suffocation, with some variations in emphasis across regions.

Quality of online media reports of suicide and attempted suicide in India.

News media reporting of suicide may influence the masses toward or against suicidal behavior. So, responsible reporting by news media is important to protect vulnerable people from the deleterious effects of media reporting. World Health Organization has issued guidelines for media reporting of suicide in this regard. We planned this research to evaluate the quality of online news media reports of suicide and attempted suicides in India. We assessed a total of 210 news reports about suicide and attempted suicides (70 English, 70 Malayalam, and 70 Hindi) to evaluate the reporting of harmful and protective characteristics in news according to the World Health Organization guidelines for reporting suicide in media. We found all three language media reported almost all potentially harmful characteristics with gender (100%), location/site of suicide in the headline (97.61%), precipitating life events (95.24%), mentioning term 'Suicide' in the headline (98.10%), monocausal explanation for suicidality (90.95%), suicide method in the headline (90.95%), an accompanying photo (92.38%), and suicide method (93.81%) being reported with highest frequency. Potentially protective characteristics were not included in most news reports with poor focus on awareness information. Vernacular language media were poor as compared to English news media about the quality of reporting suicide. We found poor adherence to reporting guidelines by online news media for reporting of suicide with poor coverage of educative and awareness information for the general public. It underlines the need for improving awareness among media professionals about responsible reporting of suicide.