Reduce Suicide Risk Research Articles

The impact of psychological torque on suicidal ideation in elite athletes: the mediating role of psychological distress and the moderating role of sense of belonging.

This study aims to explore the mechanisms through which psychological torque, psychological distress, and sense of belonging influence suicidal ideation among elite athletes. The study hypothesizes that psychological distress mediates the relationship between psychological torque and suicidal ideation, while sense of belonging may moderate the interactions among these three factors. A total of 308 elite athletes were recruited as participants. Data were collected through online questionnaires, including demographic information, psychological torque Scale, psychological distress Scale, Sense of Belonging Scale, and Suicidal Ideation Scale. Descriptive and correlation analyses were conducted using SPSS 23 software, and mediation and moderation analyses were performed using Hayes' PROCESS macro. Descriptive analysis revealed a positive correlation between psychological torque and suicidal ideation, whereas a negative correlation was found between sense of belonging and suicidal ideation. psychological distress partially mediated the relationship between psychological torque and suicidal ideation, indicating that psychological torque increases the risk of suicidal ideation by intensifying psychological distress. Furthermore, sense of belonging moderated the relationship between psychological torque and suicidal ideation, as well as between psychological torque and psychological distress. Higher levels of sense of belonging mitigated the adverse effects of psychological torque on psychological distress and suicidal ideation. The results of the study revealed a complex interaction mechanism between psychological torque, psychological distress, and sense of belonging in the development of suicidal ideation among elite athletes. psychological torque has a direct positive effect on suicidal ideation, with psychological distress acting as a mediating variable, while sense of belonging serves as a moderating variable that can reduce the negative impact of psychological torque and psychological distress on suicidal ideation. These findings provide a theoretical foundation for the prevention and intervention of suicidal behaviors in elite athletes, highlighting that enhancing athletes' sense of belonging could be an effective strategy for reducing suicide risk. The study also suggests future research directions, including the use of longitudinal designs, expanding the sample size, and exploring additional potential moderating variables.

Cognitive anxiety sensitivity: Invariance, longitudinal course, and associations with suicide risk in a large military sample.

This study examined cognitive anxiety sensitivity's invariance, longitudinal course, and associations with suicidal thoughts and attempts within a large military sample (N = 1,147). First, multiple group confirmatory factor analyses assessed the latent structure of cognitive subscale from the anxiety sensitivity index (ASI-C) by group (i.e., Active Military/Veterans and men/women). Second, free-loading latent growth curve modeling assessed the stability of cognitive anxiety sensitivity across each group over four time points. Third, multiple linear regressions tested if cognitive anxiety sensitivity at the previous time point predicted suicidal thoughts and number of attempts at the following study visit, above and beyond previous suicidal thoughts, generalized anxiety, and thwarted belongingness and beyond previous lifetime attempts, respectively. The ASI-C displayed a very well-fitting unifactorial structure and metric invariance across all groups. Overall, cognitive anxiety sensitivity appeared to significantly decrease over time across all groups, significantly more so for Active Military personnel than for Veterans and significantly more so for women than for men. Cognitive anxiety sensitivity predicted future suicidal thoughts at Time Point (T) 4 above and beyond control variables among Active Military and T2 and T3 among men but not for Veterans or women. Further, cognitive anxiety sensitivity predicted future suicide attempts at T3 beyond control variables among Active Military, Veterans, and men but was not for women. Findings suggest that cognitive anxiety sensitivity is worth including in suicide risk screening and, due to its malleability, may be a viable treatment target to reduce suicide risk among Active Military and Veteran men. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Suicidality among inpatients who absconded from a tertiary mental health facility in Uganda: a retrospective study

BackgroundSuicidality and absconding from psychiatric care are two critical phenomena that complicate mental health care in developing countries. The aim of this study was twofold. First, to determine the prevalence of suicidality among absconders over two decades. Secondly, we set out to determine overall factors that influence the likelihood of having suicidal behaviors among absconders, as well as factors specific to each diagnosis.MethodsThis was a retrospective chart review of files of patients who absconded from inpatient psychiatric care at a tertiary psychiatric facility in southwestern Uganda between 2000 and 2020. A pre-tested electronic questionnaire was used for data abstraction of sociodemographic characteristics, documented suicidality, and other clinical variables. Data cleaning and analysis were conducted using STATA V.17. Logistic regression was performed for factors associated with suicidality.ResultsAmong the absconders, 9.5% exhibited suicidality. Factors that heightened the odds of suicidality among absconders included being divorced or separated (adjusted odds ratio [aOR] = 2.00, 95% Confidence Interval [CI]: 1.20–3.31, p = 0.007), having depression (aOR = 5.41, 95% CI: 2.47–11.82, p < 0.001), a history of substance use (aOR = 1.50, 95% CI: 1.01–2.23, p = 0.049), and experiencing violence before hospitalization (aOR = 1.83, 95% CI: 1.14–2.94, p = 0.013). In contrast, substance use disorder (aOR = 0.25, 95% CI: 0.10–0.62, p = 0.003) and having schizophrenic spectrum disorders (aOR = 0.35, 95% CI: 0.18–0.68, p = 0.002) were linked to a decreased likelihood of suicidality among those who absconded.ConclusionThis study reveals a high burden of suicidality among individuals who abscond, with important risk factors such as marital status, depression, and a history of experiencing violence. It was noted that substance use disorder and schizophrenia spectrum disorders are associated with a reduced suicide risk. This study shows a significant interplay between clinical and demographic factors in predicting suicidality.

The Dark Triad Traits and Suicide Risk in Turkish University Students

Abstract: Aim: It is important to identify the factors associated with suicide risk. This study examines how depression mediates the relationship between the Dark Triad personality traits and suicide risk. Methods: We collected data from 448 Turkish university students (mean age=21.14 ± 1.97; females 72.8%) using an online survey that included the Dark Triad Dirty Dozen Scale, the Depression, Anxiety, and Stress Scale, and the Suicide Probability Scale. Results: The findings indicated that Machiavellianism, psychopathy, and narcissism positively correlated with depression, low self-perception, anger/impulsivity, hopelessness/loneliness, and suicidal ideation. Depression was more associated with Machiavellianism and psychopathy than with suicide ideation. Depression was found to have a significant positive relationship with suicide probability and acted as a mediator between the Dark Triad personality traits and suicide risk. There were stronger direct pathways from psychopathy to suicide ideation than to impulsivity. Discussion/conclusion: These results suggest that the combination of the Dark Triad traits and depression could increase the probability of suicide. Our study highlights the importance of addressing both Dark Triad traits and psychological distress, such as depression, in efforts to reduce suicide risk among university students.

A cross-lagged panel network analysis of loneliness, internet use, and depression among Chinese college students.

A cross-lagged panel network analysis of loneliness, internet use, and depression among Chinese college students.

Medicaid and teen suicide

ABSTRACT We examine whether increases in Medicaid coverage among teens reduced suicide risk. Youth are at elevated risk for depression but receive the least care. We exploit state-level variation in Medicaid coverage controlling for crowd-out to identify effects on risk for suicide. We build an age-group/state/year panel measuring suicide rates from CDC data and age-specific rates of insurance coverage from the American Community Survey from 2009 to 2021. We estimate that among those between the ages of 15 and 19, suicide rates fell by 0.023 log points or 1% of the mean with each 1% increase in the population of teens covered by Medicaid. This decline was larger for teens than any other group. We assess whether our TWFE estimated effect of a continuous treatment approximates an average causal response by comparing treatment effects at different margins. We form 47 treatment-control groupings of states changing key features of Medicaid enrolment policies in different years along with always/never treated states. Our treatment effects of Medicaid expansion at these various margins are within confidence bounds for our average effects. This article provides the first evidence on the role of public health insurance coverage on teen suicide in the U.S.

Dealing with the directive to restrict access to lethal means: parents' perspectives.

Youth suicidal ideation and behaviour are major significant concerns, with suicide being the third leading cause of death among youth. In recent years, the trend toward deinstitutionalisation has caused parents of high-risk youth to face increasing emotional and practical challenges, including managing lethal means restriction (LMR) to reduce suicide risk. This qualitative study explores the experiences of parents instructed by mental health professionals to restrict their child's access to lethal means in managing suicidal behaviours. Twelve Israeli parents of youth aged 12-21 years participated in in-depth interviews. Using interpretative phenomenological analysis, the study investigated the emotional, psychological and relational challenges parents face when implementing LMR. Findings indicate that parents struggle to understand and implement LMR guidance, experience emotional strain from their role as protectors, and face pervasive anxiety about their child's safety. The study also highlights feelings of helplessness and the erosion of trust between parents and children. Many parents criticise LMR, viewing it as potentially harmful to their relationship with their child or ineffective at keeping their child safe. This study underscores the emotional and practical challenges parents face when implementing LMR. To improve its effectiveness, guidance should be re-evaluated and communicated more flexibly, emphasising shared responsibility between the parent and child, and address the emotional toll on parents during this critical period.

Adolescent weight status, perceived closeness to others, and past year suicide consideration and attempts.

PurposeThe present research leveraged a nationally representative dataset to examine between-group differences in adolescent suicide consideration and attempts by weight status and perceived closeness to others.FindingsAdolescents with overweight and obesity were more likely to report past year suicide consideration (1.54x and 1.43x as likely) and attempts (1.74x and 1.59x as likely) compared to adolescents with healthy weight. A significantly smaller proportion of adolescents with obesity endorsed closeness to others at school compared to adolescents with healthy weight. Adolescents who felt close to others were less likely to report either suicidal ideation or attempts, regardless of weight status. Compared to the healthy weight group, significantly higher proportions of adolescents with overweight or obesity endorsed attempting suicide, both among adolescents who felt close to others, X2(2) = 14.76, p = .001, n = 4773, and those who did not, X2(2) = 18.58, p < .001, n = 2859.ConclusionsAdolescents with overweight and obesity were more likely to consider and attempt suicide relative to those with healthy weight, regardless of perceived closeness to others. Perceived closeness was associated with lower likelihood of suicide consideration and attempts among all weight groups. Further investigation may clarify the prospective utility of social closeness for adolescent suicide risk reduction, especially among those with overweight/obesity.

Geospatial estimates of suicidal ideation and suicide attempt prevalence in the U.S. veteran population (2022)

BackgroundVeteran suicide remains a major public health concern; rates increased 64.3% from 2001 to 2022 and substantial geospatial variation exists, with state-level rates ranging from 15.4/100,000 (Maryland) to 87.1/100,000 (Montana). Surveillance of suicidal ideation (SI) and suicide attempts (SA) can provide insights to reduce suicide risk within communities.MethodsA population-based, cross-sectional survey of 17,949 Veterans residing in all 50 U.S. states, the District of Columbia, Puerto Rico, and U.S. Pacific Island (PI) Territories, was conducted in 2022 to assess SI and SA prevalence. Lifetime and post-military SI and SA and past-year SI prevalence were estimated by Census region, division, and state. Prevalence ratios were calculated for post-military SI and SA to assess differences by division, accounting for demographic covariates (i.e., age, race, gender, rurality, and time since military separation). Methods used in lifetime SA and considered in past-year SI were also examined by region.ResultsThe West had the highest prevalence of lifetime (36.94%; 95%CI = 34.65–39.23) and post-military SI (28.73%; 95%CI = 26.51–30.96), significantly higher than all other regions except for PI Territories and Puerto Rico. PI Territories had the highest prevalence of past-year SI (15.68%; 95%CI = 10.91–20.44) and lifetime (9.86%; 95%CI = 6.36–13.37) and post-military SA (5.67%; 95%CI = 3.21–8.14). At the divisional level, the Pacific West (29.12%; 95%CI = 26.01–32.23) and West South Central (29.09%; 95%CI = 26.18-32.00) divisions had the highest prevalence of post-military SI, while West South Central had the highest prevalence of post-military SA (6.89%; 95%CI = 5.07–8.70), and the PI Territories remained highest for lifetime SA. After adjusting for covariates, numerous significant differences across divisions were observed. Differences in suicide methods considered and used were also observed across regions.ConclusionsVariability in SI and SA prevalence among Veterans at state, divisional and regional levels supports the need for nuanced surveillance efforts, along with targeted prevention efforts in areas at greatest risk.

Suicide, Psychoactive Substances, and Homelessness: A Scoping Review.

The homeless population (HP) is a heterogeneous group characterized by the absence of stable and conventional housing, often relying on public spaces and deteriorated environments for shelter and survival, either temporarily or permanently. This group is exposed to multiple health vulnerabilities, with substance use disorder (SUD) identified as a significant risk factor for suicidal behavior. The aim of this study was to conduct a scoping review of the relationship between PAS use and suicide among homeless individuals. A comprehensive literature search was performed using five databases: PubMed, Scopus, SciELO, LILACS, and Google Scholar. Studies were selected based on their relevance to the topic, and data were extracted regarding substance use, suicide-related outcomes, and associated sociodemographic and clinical factors. The findings indicated a strong association between PAS use and increased suicidal ideation and behavior among homeless individuals, particularly among youth, men, and women. Opioids and alcohol were the most frequently reported substances in this context. Additional factors such as unemployment, exposure to violence, social inequalities, and mental health disorders further exacerbated the risk of suicide in this population Conclusions: The reviewed literature underscores the urgent need for integrated, context-sensitive interventions addressing both substance use and mental health among the homeless. Tailored public health strategies focused on prevention, harm reduction, and psychosocial support are essential to reducing suicide risk and promoting overall well-being in this highly vulnerable group.

Maladaptive Thinking Styles and Suicide Cognitions: Serial Mediation of Difficulties in Emotion Regulation and Loneliness.

There are many social, cultural, biological, and environmental factors that influence suicidal cognitions. Research aimed at understanding suicidal cognitions among university students may provide theoretical evidence for preventive studies on suicide. Accordingly, the present study aims to investigate how maladaptive thinking styles contribute to suicide cognitions through the serial mediating roles of difficulties in emotion regulation and loneliness. The sample consists of 617 university students (77.6% of the participants are female, Mage = 20.511, SD = 2.307). The correlation analysis revealed that maladaptive thinking styles were positively associated with difficulties in emotion regulation, loneliness, and suicide cognitions. Serial mediation analysis was conducted using the PROCESS macro (Model 6), which revealed that difficulties in emotion regulation and loneliness have a serial mediating role in the relationship between maladaptive thinking styles and suicide cognitions. The results have practical implications for developing intervention strategies targeting emotion regulation and loneliness to reduce suicide risk among university students. The research results are discussed and interpreted in the light of the literature.

Emotional memory biases in bipolar depressed patients with high suicide risk.

Emotional memory biases in bipolar depressed patients with high suicide risk.

Higher gender role stress and depressive severity increase suicide risk among male military service members and veterans.

Higher gender role stress and depressive severity increase suicide risk among male military service members and veterans.

Enhancing adolescent suicide prevention through the implementation of trauma-informed care models in school-based mental health programs

Adolescent suicide presents a critical public health crisis, exacerbated by cumulative trauma exposure and insufficiently trauma-responsive mental health systems in schools. This study investigates the efficacy of trauma-informed care (TIC) models integrated into school-based mental health programs for reducing suicide risk among adolescents aged 12–18. Utilizing a quasi-experimental mixed-methods design, the research deployed a multi-tiered TIC framework across 20 public schools, involving 600 participants stratified by gender and adverse childhood experiences (ACEs). Quantitative data were collected using the Columbia-Suicide Severity Rating Scale (C-SSRS) and ACE Questionnaire, while qualitative insights were gathered through semi-structured interviews analyzed using thematic analysis. Results demonstrated statistically significant reductions in suicidal ideation (mean difference = ?1.4, Cohen’s d = 0.85), psychological distress (mean difference = ?2.1, d = 0.78), and increased school engagement (mean difference = +1.5, d = 0.65) over a 16-week period. Subgroup analysis revealed greater responsiveness among female students and those with moderate ACE scores, while higher dropout and fidelity variability among certain cohorts exposed implementation limitations. The Generalized Linear Mixed Model (GLMM) confirmed the robustness of outcome predictions across clusters. The study concludes that TIC integration in educational settings yields multidimensional improvements in adolescent mental health and school functioning. Recommendations include gender-responsive program design, trauma-tiered intervention delivery, continuous fidelity monitoring, and policy-level integration through Multi-Tiered Systems of Support (MTSS). These findings support the systemic transformation of school environments into trauma-informed ecosystems that preemptively disrupt suicide trajectories and promote sustainable mental resilience. Keywords: Adolescent, Suicide Prevention, Trauma-Informed Care, School-Based, Mental Health Programs.

Differential directional effects between insomnia symptoms and suicidal ideation across trait depression levels: a cross-lagged network analysis among Chinese medical undergraduates.

Suicidal ideation (SI) is intricately linked with insomnia and trait depression, yet the directional relationships and the role of trait depression remain unclear. This study sought to investigate the dynamic interplay between insomnia symptoms, SI, and trait depression (including trait anhedonia (TAN) and trait dysthymia (TDY)), aiming to clarify the role of trait depression in the relationship between insomnia and SI. A longitudinal design was employed to assess 566 undergraduate students (aged 18-25) recruited from a medical university in China. Participants underwent comprehensive assessments with a one-month interval between baseline and follow-up, applying the Athens Insomnia Scale (AIS), the Self-rating Idea of Suicide Scale (SIOSS), and the Trait Depression Scale (TDS). Cross-lagged panel network (CLPN) models were implemented to examine temporal associations, centrality metrics, and network differences between high/low TAN and TDY subgroups. Network stability was evaluated using bootstrap methods. Insomnia symptoms, particularly AIS6 (sense of well-being during the day) and AIS7 (functioning), emerged as pivotal nodes significantly predicting SI factors, including despair (DSP) and suicide (SUI), with bidirectional feedback observed. TAN emerged as a central node, strongly influenced by insomnia and SI. TDY primarily influenced TAN and optimism (OPT). In the high-TAN group, OPT was a mediator among the nodes, OPT, AIS2 (awakening during the night), and AIS7 were key bridging nodes, whereas AIS3 (final awakening earlier than desired), AIS8 (sleepiness during the day), and DSP bridged in the low-TAN group. High/low TDY networks exhibited structural congruence but significant differences in bridge centrality rankings. Insomnia symptoms exacerbate SI by impairing daytime functioning and emotional regulation, with trait anhedonia serving as a critical node. Personalized interventions targeting specific insomnia symptoms (e.g., AIS6, AIS7 or AIS8) and suicidal emotional factors (e.g., OPT or DSP) are crucial disrupting feedback loops or critical connections to reduce suicide risk, particularly in individuals with varying levels of trait anhedonia. Although medical undergraduates represent a population commonly affected by mental health problems, the specialized nature of our sample may limit the generalizability of our findings. Future research and validation should be conducted in more diverse populations.

1311 Time of Day and Suicide Risk Screening Outcomes in Veterans Health Administration Emergency Departments

Abstract Introduction Nocturnal wakefulness is a risk factor for suicide. After adjusting for the proportion of the population awake at each given hour, Veterans are most likely to die by suicide between 12-3 am. It is unclear if self-reported suicidal thoughts and behaviors also follow such a daily rhythm in healthcare settings. The present study examined the relationship between time of day and positive suicide risk screens in emergency departments within the Veterans Health Administration (VHA). Methods This was an analysis of VHA medical record data from calendar year 2023. Responses on the Columbia-Suicide Severity Rating Scale (C-SSRS) screener were extracted for all veterans who completed their first screen of the year in a VHA emergency department. Risk of a positive suicide screen was modeled using Poisson regression with robust errors. Time of day was modeled using either cyclic b-splines and cosinor harmonic terms, with the model fit of the different approaches compared using the Bayesian Information Criterion. Results Data were available for 708,256 veterans, of whom 4,630 (0.7%) had a positive C-SSRS screen. Modeling time-of-day with cosinor harmonic terms (24-, 12-, and 8-hour harmonics) demonstrated better model fit than with cyclic b-splines (ΔBIC = -13.03). Risk of a positive C-SSRS screen was strongly associated with the time of day (χ2 = 429.4, df = 6, p &amp;lt;.001), with the lowest risk observed at 7:48 am (0.28%) and the highest risk observed at 1:30 am (1.02%; relative risk = 3.60). Conclusion Consistent with suicide rate data, risk of a positive suicide screen demonstrated a clear daily rhythm, with a nadir in the morning and a peak in the late nighttime. A steady rise in positive screening risk was observed from morning through night. These findings provide further support that nocturnal wakefulness is a risk factor for suicidal thoughts and behaviors. Addressing sleep difficulties among veterans may therefore help reduce suicide risk. Support (if any) This study is based on work supported by the US Department of Veterans Affairs and the Rocky Mountain Mental Illness Research, Education, and Clinical Center

1250 Nightmares and Self-Injurious Thoughts Among High-Risk Adolescents: Examining Negative Affect as a Potential Mechanism

Abstract Introduction Self-injurious thoughts and behaviors (SITBs) are a critical public health concern among adolescents. Emerging research identifies nightmares—a sleep problem characterized by vivid, dysphoric dreams—as a promising proximal and modifiable risk factor for SITBs. However, little is known about the mechanisms through which nightmares may confer risk for SITBs among youth. This study aimed to address this gap by investigating whether negative affect intensity mediates the relationship between nightmares and SITBs in a sample of clinically high-risk adolescents. Methods Adolescents (N=86; ages 12–18) were recruited after discharge from acute psychiatric care settings (e.g., psychiatric inpatient hospitalization) and assessed using a 28-day ecological momentary assessment (EMA) design. Nightmare presence and intensity were assessed each morning, while negative affect (NA), suicidal thoughts, and non-suicidal self-injurious (NSSI) thoughts were measured multiple times per day. Multilevel structural equation modeling was employed to examine within- and between-person effects. Results Results revealed significant between-person mediation effects: adolescents who experienced more frequent or intense nightmares reported greater NA intensity, which in turn was associated with greater suicidal and NSSI thought intensity. Notably, these associations were observed at the between-person level but not within-person level, suggesting that the risk associated with nightmares and NA may be more reflective of stable individual differences rather than short-term, dynamic fluctuations. Conclusion These findings represent one of the first attempts to examine a mechanistic pathway linking nightmares to SITBs in adolescents, using temporally sensitive data collected during the critical period following discharge from acute psychiatric care—a time of heightened risk for SITBs. The findings have important clinical implications. Targeted interventions to reduce nightmare frequency and intensity may hold promise for mitigating SITB risk among high-risk adolescents. In sum, this study advances the understanding of how nightmares and NA intensity contribute to SITBs, providing a foundation for targeted, evidence-based interventions aimed at reducing suicide risk among vulnerable youth. Support (if any) This research was supported by a grant from the National Institute of Mental Health (R01MH124899 to EMK/CRG/RTL).

Anti-Suicidal Effects of Lithium, Ketamine, and Clozapine-A 10-Year Systematic Review.

Background/Objectives: Suicide is a complex issue resulting in approximately 700,000 deaths annually. Individuals with mood disorders or schizophrenia are at an increased risk. Pharmacological interventions, such as lithium, clozapine, and ketamine, show promise in reducing suicidality. Methods: A systematic search was conducted across Google Scholar, Scopus, and PubMed to identify studies evaluating the effects of lithium, clozapine, and ketamine on suicidality. Peer-reviewed articles published between 2014 and 2024 that focused on adult populations were included. After screening 1297 records, 49 studies met the eligibility criteria: 14 on lithium, 23 on ketamine, and 12 on clozapine. Results: Multiple studies highlight lithium's significant anti-suicidal effects in patients with bipolar disorder, showing superior suicide risk reduction compared to valproate and other mood stabilizers. Ketamine has been shown to rapidly reduce suicidal ideation, with effects observable within hours and lasting up to a week. While most studies support its short-term efficacy, findings regarding its long-term benefits and the impact of repeated dosing remain inconsistent. Clozapine has consistently demonstrated a reduction in suicide risk for individuals with schizophrenia. Large-scale cohort studies report a significant decrease in suicide attempts and mortality when compared to other antipsychotics. Conclusions: Lithium, ketamine, and clozapine were proven to be effective in reducing suicidality. However, limited data, adherence challenges, and methodological differences across studies highlight the need for more robust, large-scale experimental research. Effective suicide prevention is an extremely complex topic and also requires consideration of healthcare and social system factors.

Suicidal Ideation and Suicide Completion in Benzodiazepine Users: A Systematic Review of Current Evidence.

Benzodiazepines (BZDs) are widely used anxiolytics for treating various psychiatric conditions and for procedures requiring conscious sedation. Despite their therapeutic benefits, there is concern about their paradoxical effects, particularly the potential increase in suicidal ideation and suicide completion. This systematic review examines the extent to which benzodiazepines contribute to, cause, or exacerbate suicidal ideation and suicidecompletion. Adhering to thePreferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) 2020 guidelines, we conducted a systematic review of literature from databases including PubMed, PubMed Central(PMC), and PubPsych. Search terms related to benzodiazepines and suicide were used, yielding 7,961 articles. After removing duplicates and applying inclusion and exclusion criteria, 587 articles were screened, leading to a final selection of six articles. These studies underwent rigorous quality assessment using various tools. The review highlighted several key findings. Moderate benzodiazepine usewith concomitant psychotherapy or antidepressants was associated with reduced suicide risk. Concurrent use of opioids and benzodiazepines significantly elevated the risk of suicide attempts and intentional self-harm. Benzodiazepine use was linked to increased suicide risk in vulnerable groups, including those with pre-existing mental health conditions. Benzodiazepines should be prescribed with caution, ideally for short-term use until antidepressant effects manifest. Close monitoring for addiction, withdrawal, and suicidal ideation is essential. Prescribers must be aware of the increased risks when benzodiazepines are used in conjunction with opioids or in patients with heightened vulnerability to suicide. Effective weaning programs and risk assessment tools are crucial to mitigate these risks and ensure patient safety.

Post-release behavioral healthcare utilization and suicide risk among formerly incarcerated individuals

IntroductionIndividuals who experience incarceration exhibit alarmingly high rates of suicide, particularly in the immediate post-release period. This study investigates the association between post-release behavioral healthcare utilization and suicide risk among individuals released from jail.MethodsIncarceration records for 61 438 individuals released from Philadelphia County jails between 2003 and 2016 were linked with administrative datasets, including the Medical Examiner's Office, involuntary commitment petitions, Medicaid enrollment and behavioral health claims, and emergency housing episodes. Using marginal structural Cox proportional hazards models, we examined the impact of post-release service engagement on suicide risk.ResultsSixty-five percent of formerly incarcerated individuals had behavioral health diagnoses. Only 27% used outpatient mental health services post-release, with 18% of these users engaging only once, and 28% used outpatient drug and alcohol services, with 21% of these users engaging only once. Low engagement in these services was associated with higher rates of suicide attempts and deaths.ConclusionThese results underscore the critical need for comprehensive systems that ensure smooth transitions from jail-based to community care to facilitate continuous service engagement. Implementing targeted interventions and policies to improve access to and sustained engagement with behavioral healthcare services is imperative to reduce suicide risk among individuals who experience incarceration.