National Suicide Prevention Strategy Research Articles

Talk Time Differences Between Interregional and Intraregional Calls to a Crisis Helpline: Statistical Analysis.

National suicide prevention strategies are general population-based approaches to prevent suicide by promoting help-seeking behaviors and implementing interventions. Crisis helplines are one of the suicide prevention resources available for public use, where individuals experiencing a crisis can talk to a trained volunteer. Samaritans UK operates on a national scale, with a number of branches located within each of the United Kingdom's 4 countries or regions. The aim of this study was to identify any differences in call duration across the helpline service in order to determine whether service varied interregionally and intraregionally and to determine the impact of calls answered in the same region as the caller, compared with calls answered in a different region on the duration of calls made from landlines to Samaritans UK. Calls may be routed by Samaritans, wherein the telephony system sends the call to the next available volunteer, irrespective of location; therefore, individuals may be routed to a branch within the same region as the caller's current region (intraregional calls) or routed to a branch that is in a different region from that of the caller's current region (interregional calls). The origin of calls by region was identified using the landline prefix of the anonymized caller identifier, along with the region of the destination branch (as branch details are recorded in the call details record). First, a Levene's test of homogeneity of variance was carried out for each condition, that is, England calls and Scotland calls. Thereafter, for each condition, a one-way ANOVA or one-way analysis of means was carried out to evaluate any significant differences in call duration. ANOVA results showed that there are significant differences in call durations between intraregional calls and interregional calls (P<.001). Across all conditions within this study, callers stayed on the phone for a shorter period of time when routed to a branch that is within the same region as the call origin than if they were put through to a branch within a different region than the call origin. Statistical analyses showed that there were significant differences between interregional and intraregional calls. On average, callers to crisis helplines stayed on the phone for a shorter period of time if they were routed to a branch within the same region in which the call originated than if they were routed to a branch in a different region of origin. The findings from this study have practical applications, which may allow crisis helplines to manage their resources more effectively and improve caller satisfaction with the service.

Preventing suicide: a call to action.

The public health approach to suicide prevention requires us to move away from thinking about suicide as a purely clinical problem and to pay heed to the array of social determinants (such as financial hardship or domestic violence and abuse) that might lead people to consider suicide as an option. Clinical factors are important, and, indeed, clinical or indicated interventions are entirely appropriate for people who have reached a point of crisis and should be a mainstay of national suicide prevention strategies. However, our Series stresses the need for selective and universal interventions that tackle the pervasive problem of suicide in a more upstream way, preventing people reaching a crisis point. Many social determinants can best be addressed by sectors outside health, so we are calling for a whole-of-government commitment to suicide prevention. We make recommendations for actions in the areas of policy, practice, research, and advocacy. People with lived experience of suicide should have genuine involvement in all of these actions.

Government funded suicide prevention in Australia – an environmental scan

BackgroundSuicide is a worldwide public health problem. In response to this problem, Australia was one of the first countries to develop national suicide prevention policy. Guided by the National Suicide Prevention Office (NSPO), which was established in 2021, suicide prevention in Australia is in a period of reform. The NSPO is driving a nationally consistent and integrated approach to suicide prevention including leading the development of a new National Suicide Prevention Strategy. This article summarises findings from an environmental scan of government-led suicide prevention in Australia, conducted as an input for the development of the new Strategy.MethodsThe scan was conducted from August 2022 to January 2023. We searched relevant government websites and Google to identify policy documents and programs and services. We undertook a desktop review of documents and programs/services using coding templates developed to address the objectives of the scan. Qualitative information was extracted in a systematic manner using these templates.ResultsAustralia’s suicide prevention efforts are significant as demonstrated by activities ranging from policy documents intended to guide and plan activity, the National Mental Health and Suicide Prevention Agreement committing the Federal Government and jurisdictions to work together, and the availability of national, state, local area based, and digital services and programs. Suicide prevention approaches in Australia are mostly selective or indicated. There is less emphasis on universal approaches, wellbeing promotion, strengthening protective factors and mitigating the impact of known drivers of distress. In addition, there is limited evidence to demonstrate a whole-of-government or whole-of-system approach is operating in Australia. Findings should be interpreted in the context that suicide prevention in Australia is currently in a period of transition.ConclusionsCurrent government emphasis on and investment in suicide prevention activity, together with strong commitment to lived experience and cross sectorial collaboration, are substantial and appropriate. There are also many opportunities to further progress cross-portfolio and cross-jurisdiction suicide prevention and response efforts. This requires urgently adopting a shared understanding of suicide, which includes the diverse drivers of suicidal distress, and improving protective factors and social wellbeing.

Advancing suicide prevention in Germany, Austria and Switzerland: a qualitative study.

Suicide is a significant public health problem, impacting individuals, families and communities worldwide. Effective suicide prevention requires a comprehensive approach with diverse integrated interventions and collaboration across sectors, stakeholders and professions. This study aims to identify challenges, gaps and success factors in current suicide prevention efforts in Germany, Austria and Switzerland, providing specific recommendations for advancement. We conducted online, semi-structured interviews with 36 suicide prevention experts from Germany, Austria and Switzerland, incorporating perspectives from policy, science and practice. Interviews were conducted between September 2022 and February 2023, audio-recorded, transcribed verbatim and analyzed using the Framework method. Despite progress in national strategies and coordinated efforts for suicide prevention, challenges such as resource scarcity, stigma and structural issues in psychiatric and psychotherapeutic care persist. The interviewees identified several areas for advancement, including developing targeted prevention measures for men and older people, strengthening collaboration across sectors, stakeholders and professions, and increasing the involvement of individuals with lived experience. While the COVID-19 pandemic has exacerbated challenges in psychiatric and psychotherapeutic care, it has concurrently strengthened interest in suicide prevention among policymakers and the media. National suicide prevention strategies play a crucial role in setting priorities, raising public awareness, and guiding action. However, since most suicide prevention efforts are still predominantly health sector-driven, a more comprehensive approach is needed to promote the involvement of all relevant actors and address suicidality as a collective societal responsibility. Tailoring prevention programs for risk groups like older people and men is important, as these populations show high suicide rates and face a lack of targeted interventions. Our study underscores the importance to continuously monitor, refine and strengthen collaborative and evidence-based suicide prevention efforts.

Characteristics and outcomes of people in suicidal crisis at two emergency departments: a service evaluation.

Emergency departments (EDs) provide critical opportunities for nurses to support suicide prevention. This article details a service evaluation that was undertaken to explore the characteristics and outcomes of people in suicidal crisis at two EDs in the East of England during June 2023. Data routinely collected by the ED mental health liaison team were combined with a retrospective case note review of the local NHS mental health trust's electronic patient records. Attendees had a mean age of 35 years and seven months, and were often diagnosed with depression or emotionally unstable personality disorder. Most had a history of self-harm and were currently known to mental health services. Suicide-specific interventions were rarely recorded by nurses and relapse behaviours were prevalent after presentation. Local and national suicide prevention strategies should encourage nurses to address gaps in support, thereby improving patients' experiences in and beyond the ED.

In Case You Haven't Heard…

Actress and activist Ashley Judd is supporting mental health initiatives on behalf of herself and her late mother Naomi Judd, USA Today reported April 24. Nearly two years after the country music legend's death by suicide, her daughter Ashley Judd appeared on a panel at the White House on April 23 to back the Biden administration's newly formed National Strategy for Suicide Prevention (see related story on page one). “I'm here because I am my beloved mother's daughter and on the day she died, which will be the two‐year anniversary in one week, the disease of mental illness was lying to her, and with great terror convinced her that it would never get better,” the “Someone Like You” actress said. Naomi Judd died in April 2022 at age 76. The country singer's daughters Ashley Judd, 56, and Wynonna Judd, 59, shared the news, saying, “We lost our beautiful mother to the disease of mental illness.” Judd said her mother “lived most of her life with an untreated and undiagnosed mental illness that lied to her and stole from her. It stole from our family, and she deserved better,” she added. “I know the feeling of not wanting to be here, but I had a different experience because I went to treatment in 2006,” Ashley Judd shared. “I've been in good recovery for 18 years and I've had a different outcome than my mother. I carry a message of hope and recovery.”

India’s National Suicide Prevention Strategy, 2022: A Critical Appraisal

Abstract India recently published its National Suicide Prevention Strategy aimed at reducing suicide mortality in the country by 10% by the year 2030. This strategy laid out time-bound objectives and action plans, targeting biological, psychosocial, and cultural risk factors for suicide, which are specific to the region. The strategy is to be implemented by utilizing existing national and regional mental health-care infrastructure and enlisting multisectoral cooperation. This discussion provides a critical appraisal of the National Suicide Prevention Strategy of India, 2022.

Mental health front-liners: Police officers’ knowledge and attitudes towards suicide in Malta

IntroductionPolice-officers are in a strategic position of providing the first immediate response to a crisis as mental health frontliners.ObjectivesIn this nation-wide cross-sectional study, we explored knowledge and attitudes towards suicide in the local police force, a crucial first step in the design and implementation of effective suicide prevention programmes.MethodsAn online, anonymous questionnaire was distributed to all local police-officers (n=2600). It contained questions about their demographics and their experience with suicide while on duty, along with 34 statements from the validated tool Attitudes Towards Suicide (ATTS) (Renberg &amp; Jacobsson. Suicide Life Threat Behav. 2003; 33 52-64), scored on a 5-point Likert Scale (1 = Strongly Disagree, 5 = Strongly Agree).ResultsThe sub-scale “Suicide as a right” was positively correlated with “Tabooing” (r (201) = .25, p=&lt;.001), “Normal-common ” (r (201) = .29, p=&lt;.001), and “Resignation” (r (201) = .47, p=&lt;.001), but negatively correlated with “Incomprehensibility” (r (201) = -.26, p=&lt;.001), and “Preparedness to Prevent” (r (201) = -.19, p=&lt;.001), meaning such individuals had a more permissive attitude towards suicide. On the other hand, the subscale Preventability was found to be positively correlated with Incomprehensibility (r (201) = .21, p=&lt;.001) and Preparedness to Prevent (r (201) = .30, p=&lt;.001).Females scored higher in the sub-scale Non-communication (M=3.40, 95% CI [3.29, 3.51]) while males scored higher in Preventability (M=3.35, 95% CI [3.27, 3.44]). The higher the educational status of police-officers, the more they adopt a pro-prevention attitude to suicide (M=3.67, 95% CI [3.44, 3.89]) and the more likely they are to appreciate that suicidal thoughts and behaviour can be common (M=3.40, 95% CI [3.20, 3.60]). Participants with a mixed/different composition at home (M=4.05, 95% CI [3.86, 4.24]) and/or have experienced only between 0 to 2 situations related to suicide in the past one year alone (M=4.05, 95% CI [3.94, 4.16]), were the most likely to feel prepared to prevent suicide.Conclusions This study brings out different attitudes police-officers hold towards different aspects of suicide, influenced by their gender, educational background, personal life at home and total exposure to suicide during their career. Training programmes can help improve their knowledge and attitudes towards suicide, leading to a more positive behavioural response to individuals in crisis and create a safer environment. Malta, through an EU-funded programme, is currently investing its resources on drafting a national suicide prevention strategy, and such educational opportunities for our frontliners will ensure we have the right tools in screening, identifying, treating, and saving more lives.Abbreviations:M: Mean score; CI: Confidence IntervalDisclosure of InterestNone Declared

The Development, Progress, and Impact of National Suicide Prevention Strategies Worldwide.

National suicide prevention strategies have been identified as evidence-informed interventions that require multisectoral efforts by governments. This article reviews the rationale for national strategies, the need for a whole-of-government approach, and current progress on national strategies worldwide, including successes and challenges regarding implementation. We highlight the limitations of existing evidence and describe how future research may help to address knowledge gaps. We conclude that national strategies are an important tool for suicide prevention worldwide. However, a more robust evidence base evaluating the impact of strategies on suicide-related outcomes is needed.

Review of National Suicide Prevention Strategy and Other Suicide Prevention Initiatives in India

India's launch of the National Suicide Prevention Strategy in 2022 underscores the gravity of suicides as a pressing public health issue. Globally, suicides rank as the fourth leading cause of death among individuals aged 15 to 29, with low and middle-income countries bearing the brunt. Within India, suicides increased by 7.2% from 2020 to 2021, with Maharashtra and Tamil Nadu reporting the highest numbers. Despite decades of initiatives, including the National Mental Health Program (NMHP) since 1982, challenges persist in policy implementation, skilled manpower, and political hurdles, impeding desired outcomes. While commendable, the recent National Suicide Prevention Strategy faces limitations in execution. A critical review of government efforts reveals gaps in resource allocation and execution, hindering the impact of mental health programs. Addressing these challenges demands enhanced policy implementation, mental health infrastructure, and resource allocation. Additionally, public awareness and destigmatization are crucial components. In conclusion, India's efforts in suicide prevention reflect progress, yet significant gaps remain. Sustained commitment and innovative strategies are needed to mitigate the escalating burden of suicides. This review underscores the urgency for comprehensive measures to combat rising suicide rates effectively.

Suicide prevention in India

India accounts for nearly 18 % of the global population but approximately 28 % of global suicides. Similar to many countries around the world, suicide in India is known to result from a complex interplay of social, economic, and personal factors. To address this important issue, India released its first national suicide prevention strategy in 2022. The strategy follows the WHO-recommended model of a multisectoral approach to suicide prevention, incorporating a mix of primary prevention interventions (focusing on whole populations), secondary prevention interventions (targeting 'high-risk' individuals), and tertiary prevention interventions (aimed at individuals affected by suicide). This paper delves into the details of these primary, secondary, and tertiary prevention interventions and explores how they apply to the Indian context, while arguing for the need to prioritize primary prevention interventions, at least in the short term, to reduce suicides.

Epidemiology of suicide mortality in Mexican young people (ages 15-29) from 1990 to 2020

Introduction. In 2020, suicide was the third leading cause of death in Mexico among young people ages 15 and 29, accounting for 43.0% of all suicides in the country, making it a major public health issue. Objective. To explore changes in the geographic distribution of suicide rates by state and to analyze the magnitude, distribution, and pattern of suicide mortality in young Mexicans ages 15 to 29 between 1990 and 2020. Method. Descriptive, ecological time-series study, based on official information. Standardized mortality rates were calculated using information on deaths (INEGI) and population estimates (CONAPO). The magnitude, distribution, and patterns of suicide mortality at the national level and by state were analyzed using the Joinpoint segmented regression model. Results. From 1990 to 2020, suicide mortality in young people increased by 198% and was higher in women (285%) than men (178%). The states with the highest suicide mortality rates from 2016 to 2020 were Chihuahua (18.5 suicides/100,000 young people ages 15-29), Aguascalientes (16.6), Yucatán (14.4), Guanajuato (14.1), and San Luis Potosí (12.9), accounting for 23.0% of total suicide deaths. Discussion and conclusion. The study of mortality trends could contribute to the management of a national suicide prevention strategy in young Mexicans, providing support for public health decision-making, such as the identification of the states and regions that should be prioritized.

Indonesian first national suicide prevention strategy: key findings from the qualitative situational analysis.

Indonesian first national suicide prevention strategy: key findings from the qualitative situational analysis.

Unemployment and underemployment are causes of suicide.

Epidemiological studies indicate that labor underutilization and suicide are associated, yet it remains unclear whether this association is causal. We applied convergent cross mapping to test for causal effects of unemployment and underemployment on suicidal behavior, using monthly data on labor underutilization and suicide rates in Australia for the period 2004-2016. Our analyses provide evidence that rates of unemployment and underemployment were significant drivers of suicide mortality in Australia over the 13-year study period. Predictive modeling indicates that 9.5% of the ~32,000 suicides reported between 2004 and 2016 resulted directly from labor underutilization, including 1575 suicides attributable to unemployment and 1496 suicides attributable to underemployment. We conclude that economic policies prioritizing full employment should be considered integral to any comprehensive national suicide prevention strategy.

Addressing Substance Use: National Suicide Prevention Strategy of India from an Addiction Psychiatry Perspective.

Addressing Substance Use: National Suicide Prevention Strategy of India from an Addiction Psychiatry Perspective.

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

Effectiveness of a targeted brief intervention for recent suicide attempt survivors: a randomised controlled trial protocol

IntroductionEffective, brief, low-cost interventions for suicide attempt survivors are essential to saving lives and achieving the goals of the National Strategy for Suicide Prevention and Zero Suicide. This study aims...

The National Suicide Prevention Strategy of India: New vistas, new hopes

The National Suicide Prevention Strategy of India: New vistas, new hopes

Secular trends of suicide risk for residents in mainland China (2004 to 2019): An updated age–period–cohort analysis

BackgroundThe overall suicide rate in China has dropped substantially since the 1990s, but a slowdown in the decrease and even a reversing trend was observed in specific groups in recent years. This study aims to investigate the latest suicide risk in mainland China by using the age-period-cohort (APC) analysis. MethodThis population-based multiyear cross-sectional study included Chinese ages 10 to 84 years using data from the China Health Statistical Yearbook (2005–2020). Data were analyzed by the APC analysis and intrinsic estimator (IE) technique. ResultsThe data satisfactorily fit the constructed APC models. The cohort effect indicated a high risk of suicide among people birth in 1920–1944 and a sharp decline in the 1945–1979 cohort. The lowest risk occurred in the 1980–1994 cohort before a sharp increase in generation Z (birth years in 1995–2009). The period effect showed a declining trend since 2004. The age effect indicated that the suicide risk increased over time, except for a gradual decline from age 35 to 49. The suicide risk increased greatly in adolescents and reached the highest among the elderly. LimitationsThe aggregated population-level data and the non-identifiability of the APC model could result in bias in the accuracy of results in this study. ConclusionsThis study successfully updated the Chinese suicide risk from the age, period and cohort perspective using the latest available data (2004–2019). The findings enhance the understanding of suicide epidemiology and provide evidence supporting policies and strategies at the macro-level for suicide prevention and management. Immediate action is needed to focus on a national suicide prevention strategy that targets generation Z, adolescents and the elderly which will require a collaborative effort by government officials, public/community health planners and health care agencies.

India's National Suicide Prevention Strategy: considerations to enhance desired outcomes

India's National Suicide Prevention Strategy: considerations to enhance desired outcomes