National Suicide Prevention Strategy Research Articles

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.

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

National Suicide Prevention Strategy of India: implementation challenges and the way forward

National Suicide Prevention Strategy of India: implementation challenges and the way forward

Why are Suicides With Unknown Cause the Most Important Reason for Suicide? A Retrospective Study.

This study will help in determining national suicide prevention strategies. Moreover, understanding the reasons for the lack of awareness about completed suicide will strengthen the measures to be taken in this regard. It was determined that the most important rate among the causes 48 419 completed suicide in Turkey in the years 2004 to 2019 was the 22 645 (46.76%) suicides of unknown cause and there was not enough information about the underlying causes. Suicide statistics data of the Turkish Statistical Institute (TUIK) between 2004 and 2019 were analyzed retrospectively in terms of geographical regions, gender, age groups and seasonality. Statistical analyses of the study were performed using the Statistical Package for Social Sciences for Windows (IBM SPSS version 25.0, Armonk, NY, USA) software. It was determined that the highest crude rate of suicide during 16 years was in the Eastern Anatolia region, the lowest rate was in the Marmara region, and the ratio of the number of female suicides with unknown cause to the number of male suicides was higher in Eastern Anatolia than in other regions, the rate of unknown crude suicide in both genders was highest in the under 15 age group, this rate decreased as the age progressed, the lowest rate was in women with unknown age, the effect of the season was observed in women with unknown cause, but not in men. Between 2004 and 2019, suicides with unknown cause were the most important reason for suicide. We think that there may be geographical, gender, age, seasonal, sociocultural and economic factors that may affect this, national suicide prevention and planning strategies will be insufficient unless this issue is adequately examined, and institutional structures should be established, including psychiatrists, where deep forensic investigations can be carried out.

Sexual violence, mental health, and suicidality-Results from a survey in cooperation with idea-driven organizations and their social media platform followers.

We specifically aimed to study if individuals who have been subjected to sexual violence more frequently report psychiatric diagnoses and suicide attempts. We also aimed to investigate if individuals who had been sexually violated reported more or less childhood experiences of family environment with alcohol problems, suicide attempts, and domestic violence than those without sexual violations. In 2019, the nongovernment organization World of no sexual abuse (WONSA) collected data through a web-based survey. The survey was shared via websites of idea-driven organizations working with victims of sexual violence, on social media and through email lists. A total of 4831 individuals participated and 49% answered all questions. Of the participants exposed to penetrating sexual violence, 49% stated that they had or had been diagnosed with depression, compared with 16% in the group not exposed to sexual violence. Similar findings were found for anxiety: 45% versus 12%; fatigue syndrome 28% versus 9%; post traumatic stress disorder 30% versus <0.1% and suicide attempts, 29% versus 3%. More participants in the group exposed to sexual violence had grown up in families with alcohol problems, suicide attempts, or where they have witnessed violence. Steps should be taken to adapt the national suicide prevention strategy to the association between sexual violence and suicide attempts, which has been so clearly demonstrated earlier in both international and national studies, and which is again shown in the present study.

Suicide Misconceptions and Attitudes Toward Suicide Prevention Measures in Taiwan.

Background: Debunking suicide misconceptions is an important suicide prevention measure. Few studies on suicide misconceptions and their correlates have been conducted in East Asia, where suicide is known to be more permissible. Aims: We investigated the prevalence and associated characteristics of suicide misconceptions in Taiwan. Whether holding suicide misconceptions was associated with reduced support for governmental suicide prevention measures was also assessed. Method: A dual-frame nationally representative telephone survey combining landlines and mobiles was conducted with 1,087 respondents. Logistic regression analyses were used to examine factors associated with suicide misconceptions. Results: Nearly 82% of the respondents held at least one type of suicide misconceptions. The most commonly held misconception was "Talking about suicide would encourage suicide" (49.5%), followed by "People who talk about suicide do not mean to do it" (47.3%) and "Most suicides happen suddenly without any warning" (46.5%). Suicide misconceptions were more common in younger people, divorced/widowed individuals, and those with lower educational attainment. Individuals with suicide misconceptions were less likely to support governmental investments in suicide prevention. Limitations: Causality could not be inferred from the cross-sectional study. Conclusions: Suicide misconceptions are prevalent in Taiwan. Debunking suicide misconceptions should be an integral part of national suicide prevention strategies.

8.O. Workshop: New challenges for suicide prevention in the context of Covid-19

Abstract The recent COVID-19 pandemic confronted many societies with profound public health challenges. Although primarily a ‘somatic’ health concern, it becomes clear that Covid-19 and its aftermath also proved to have a substantial impact on mental health and wellbeing of the population in general and on vulnerable subgroups, such as young people and the elderly, in particular. An important public mental health concern in this context is the possible adverse influence of this pandemic on suicidality. Recent studies show that during the outbreak of the coronavirus disease the suicide mortality did not rise, rather on the contrary. However, the impact of the increased number of people with mental distress related to Covid-19 on suicidal ideation as well as the long-term impact on suicide rates is unclear. Also the long-term impact of the Covid-19 restriction measures greatly hindering adequate mental healthcare services and suicide prevention initiatives is uncertain. This workshop will focus on suicidality trends since the pandemic onset in different countries, suicide figures, experiences in the field of suicide prevention and on attitudes towards seeking help. Ann John from UK will talk about suicide trends during Covid-19 pandemic and will present suicide data of 35 countries collected by the international Covid-19 Suicide Prevention Research Collaboration. Fabrice Jollant will present data about the impact of Covid-19 pandemic on suicide attempts in France, and will discuss in this context the new national suicide prevention strategy. John Cachia will show the importance of a broad mental public health approach to suicide prevention in Malta. And finally, Saska Roskar from Slovenia will show how prevention of suicidality in individuals working themselves in the field of mental health can be hindered by self-stigma. Key messages • We must remain vigilant about the possible long-term mental health impact (including suicidal behavior) of the Covid-19 pandemic. • Pandemics like Covid-19 highlight certain weaknesses in suicide prevention strategies.