Successful Suicide Research Articles

Practitioners’ perspective: a mixed-methods study on dealing with suicidality from the perspective of oncological healthcare professionals

PurposeHealthcare professionals (HCPs) play a critical role in suicide prevention and clinical guidelines recommend inquiring about suicidality as part of medical history and diagnosis. Emerging evidence indicates a lack of implementation of such policies in clinical practice. However, to date, no comprehensive mixed-methods study has examined this issue in the field of oncology.MethodsA preregistered mixed-methods study was conducted with oncological HCPs (N = 20) from various professions, using semi-structured interviews and validated questionnaires. Employing an explorative theory-generating approach, qualitative content analysis was applied to the interviews. The different data sources are integrated and contrasted. Comparisons according to sociodemographic variables (profession, age, and gender) and frequency distributions were used to examine the questionnaire data.ResultsMost HCPs reported direct or indirect experiences with suicidality in cancer patients. Nineteen HCPs did not routinely explore suicidality, of whom five reported not inquiring about it at all. Those who explored suicidality were more confident, less emotionally overwhelmed and reported higher subjective knowledge. HCPs also differed regarding their endorsement of suicide myths.ConclusionThe study highlights difficulties with active suicide exploration and differences among HCPs. Integrating these findings into education and training could improve HCPs’ skills and reduce disparities, supporting successful suicide prevention.

Evidence for Public Policies to Prevent Suicide Death in the United States.

Suicide rates have increased in the United States in recent years. Public policies have great potential to prevent suicide death, and well-designed quasi-experimental studies have identified policies that are effective at reducing suicide rates; however, evidence about these policies has not been synthesized. This review summarizes evidence across three domains of public policies: (a) policies that affect structural determinants of suicide risk (e.g., policies that improve economic security), (b) policies that promote access to clinical services (e.g., Medicaid expansion), and (c) policies that limit access to lethal means for completing suicide (e.g., policies that restrict access to firearms). The historical context of suicide prevention in US public policy is provided, considerations for successful suicide prevention policy implementation are discussed-such as policy awareness among key groups, enforcement, and sufficient funding-and priority areas for future research are enumerated.

Autopsy-Based Study of Suicidal Deaths Among the Elderly Conducted at Victoria Hospital Mortuary.

Background: Suicide is the act of deliberately killing oneself and it is a significant cause of death in all age groups (1). When comparing the number of attempted and completed suicides, older people have a more significant number of successful suicide than any other age group worldwide (2). 'National Policy on Older Persons'- 1999 defines 'elderly' or ‘senior citizen’ as a person of age 60 years or above (3). NCRB 2020 reported that around 13,126 older people per 100,000 population committed suicide in India (4). Objectives: This study aims to investigate the demographic characteristics, psychological, and etiological factors associated with elderly suicides, and evaluate the methods used by individuals in this age group to end their lives. Methods: A cross-sectional study was conducted at Victoria Hospital Mortuary over 18 months (February 2021 to July 2022). Out of 397 autopsies in the study age group, 67 cases of suicide were included based on the inclusion criteria. Information was collected from police reports, family members, and suicide notes, followed by a detailed analysis of autopsy findings. Results: The study revealed that 77.6% of the victims were male, with the majority falling within the 60-64 age group (40.3%). Hanging was the most common method of suicide (50.7%), followed by poisoning (34.3%). Key contributing factors included psychiatric disorders, predominantly depression (53.73%), chronic physical illness (46.27%), and social isolation or loneliness (32.84%). Conclusion: Elderly suicide is a multifactorial issue, with psychological distress, chronic illness, and social isolation being the primary contributors. Effective prevention strategies should include early mental health interventions and social support systems tailored to the needs of the elderly.

Barriers to suicide prevention in primary care: A qualitative study among general practitioners in Germany

BackgroundSuicide is a global public health issue and general practitioners (GPs) are important frontline responders to ensure treatment for persons experiencing suicidality. Although valid assessment tools and guidelines for managing suicidality in primary care are available, previous studies suggest that these are not yet sufficiently adhered to. Knowledge about the challenges experienced by GPs in identifying and managing suicidality among their patients is needed for the development of interventions to improve suicide prevention within primary care. AimThe current study seeks to examine the challenges GPs in Germany encounter when managing suicidality among patients in primary care. MethodsWe conducted qualitative online interviews with 15 GPs practising in Germany. Data were analysed using qualitative content analysis. ResultsWe included a diverse sample of mainly early-practise GPs (mean age: 42 years; w = 9, m = 6). GPs in our study reported 1) difficulties in identifying suicidality, 2) uncertainty and insufficient knowledge, 3) responsibility and discomfort and 4) challenges due to the health care system. ConclusionsOur findings suggest that GPs in Germany would benefit from specialised trainings to increase their knowledge and reduce uncertainties in handling suicidality among their patients. Reported challenges could be an important focus of successful suicide prevention.

Using Implementation Outcomes to Inform Implementation of Suicide Risk Screening with Juvenile Legal-Involved Youth: Considerations for Task-Shifting Suicide Screening to Juvenile Legal Staff

ABSTRACT Youth in the juvenile legal system (JLS) are at increased risk for suicidal thoughts and behaviors. Examine the acceptability, feasibility, and appropriateness of imbedding suicide screening and intervention in the JLS. The current study involved formative semi-structured interviews with key JLS stakeholders (n = 37) from two states, one in the Northeast and one in the Midwest, to determine whether suicide screening and intervention could be integrated into the role of juvenile probation officers. Stakeholders discussed perspectives on the acceptability (perceived JLS staff comfort with suicide screening and a brief intervention), feasibility (improving comfort of staff, youth, and families), and appropriateness (perceived impact on youth and families). Qualitative data suggested acceptability of suicide screening was mitigated by staff comfort and perceived support of available clinical resources. Feasibility of improving staff comfort to conduct suicide screening and a brief intervention revolved around logistical, training, and supervisory support. Barriers to the appropriateness of suicide screening and intervention with youth in the JLS suggest concerns about how youth’s distrust of the JLS and mental health stigma might impact engagement in suicide screening and intervention efforts. We conclude with implementation strategy considerations to enhance successful suicide screening and intervention by JLS staff.

Mental Health and Suicide Decriminalization: Connecting the Dots

Suicide is a current public health crisis as every year, more than 800,000 individuals die by suicide worldwide. According to World Health Organization (WHO) estimates, 77% of these deaths occur in low- and middle-income countries (LMICs). In context of mental illness only, the reported percentage of completed suicides varies from 60% to 98% of all suicides.2,3 Many of the remaining episodes have to do with interpersonal or financial issues, and the crises that follow. Nonetheless, prejudice, violence, and armed conflicts can be some of the other reasons.3 At the start of the twenty-first century, depression accounted for thirty percent of deaths worldwide from unnatural causes. Substance-use disorders came in second with eighteen percent, schizophrenia with fourteen percent, and personality disorders with thirteen percent.2 In June 2022, twenty nations had suicide attempts criminalized and subject to penalties.4 One prominent defense of criminalization of suicide was that it deters people from trying to die by suicide and thus may be a successful suicide prevention strategy but according to the literature, this idea is at best false and at worst deceptive. According to a recent study, there is no conclusive evidence that nations with criminalized suicide have lower suicide rates than the worldwide average.4.In fact, the suicide rates in five of the seven nations where it is illegal were higher than the global average.4 A recent ecological study of 171 countries has shown that suicide laws are linked to increased national suicide rates particularly among women in non-Muslim nations with low Human Development Index scores.5 Women may be more susceptible to suicidal thoughts due to the patriarchal culture's lack of support and the laws that criminalize suicide. This clearly shows that there is no positive benefit of criminalizing suicide while on the other hand research has shown that suicide rates are decreased by laws that restrict access to fatal suicide methods (pesticides, weapons, and so forth).6 While many countries do not prosecute people who attempt suicide rigorously ,7criminalization of suicide discourages people from seeking help, stigmatizes those who try suicide, and makes it difficult to accurately quantify suicide rates due to misclassification of the event because of law. The care process for people who attempt suicide is complicated by the criminalization of suicide attempts.8 Treatment can be considerably delayed by the criminal justice system.

Dying with the enemy: Interrogating the roles of religion in social support for suicide terrorism

Suicide terrorism seemingly employed to settled conflicts between the Shiite and the Sunnis, mixed with the Salafis ideology of violence is also seen used for demand for State of Islam, national liberation, and propagation against democracies, mis-governance, and secularism amongst others. Terror cells groups could be seen aggravating suicide terrorism by substituting suicide for martyrdom. It was against this background that this study engage religious belief hypothesis to interrogate the roles of religion in garnering social support for suicide terrorism. The study decomposes roles of religion in suicide terrorism into crises between the Shiites and the Sunnis, substitution of suicide with martyrdom. The study employed desktop research design with reliance historical and secondary data from extant literature. The study concludes that the manipulation of the religious injunctions, extremist interpretation of religious teachings, as well as advancement of religion facade for economic gains stronger motivation for people who support suicide terrorism. Finding from the study showed that there would be no successful suicide terror campaign without the support of the society where the suicide terrorists reside and whose interest they claim to be defending. The study recommends that distorted ideology driven by religion can only be countered by respected Islamic clerics and leaders, especially from the Arab world with covert Western support to circumvent the perverted narrative of martyrdom as sacrifice for the good of the land, people or God, and rather brand it as common suicide and an honourless venture.

A Retrospective Analysis of Familicide in Latium (Italy): A Criminological Profile of the Victims and Offenders Involved in 29 Cases and a Comparison with the Literature.

Familicide, an extreme form of domestic violence where one family member kills another, is a complex criminological issue. We analyzed autopsy files from the Institute of Legal Medicine, University of Rome Tor Vergata (1995-2022), to understand familicide better. The study focused on victim profiles, offender characteristics, and case dynamics. From 29 analyzed cases, 31 victims emerged, with 2 instances of double homicide. The perpetrators were mostly male (79.31%) and the victims were primarily female (54.84%). The familial ties ranged from parent-child to siblings and spouses. A significant number of crimes happened at private residences (70.97%) using bladed weapons (48.39%), with the injuries being concentrated on the head and chest. Half of the cases showed struggle signs, and 24.14% of the perpetrators had identifiable psychiatric disorders, which often served as the motive. Post-crime actions included self-reporting, suicide attempts, and successful suicides. A comparison with literature confirmed the typical familicide offender as a middle-aged male with potential social stressors and a history of domestic violence, with the victims often being female family members. Mental health conditions including depression, bipolar disorder, and schizophrenia significantly impacted these events. These findings underline the need for customized approaches to comprehending and preventing familicide.

Xenophobia amidst and post-COVID-19 pandemic.

Xenophobia amidst and post-COVID-19 pandemic.

Prevalence of and Factors Influencing Suicide Ideation, Attempt, and Completion in Heroin Users: A Systematic Review and Meta-Analysis.

Suicide is considered a fundamental problem in discussions on public and global health. Thus, the current study aimed to review the prevalence of and reasons for successful suicide attempts in heroin users. This study was conducted by systematically searching the electronic databases of PubMed, Scopus, Web of Science, and PsycINFO from 1960/1/1 to 2021/11/1 based on the PRISMA checklist and using MeSH keywords with no temporal or linguistic limitations. The primary and secondary impacts of suicide were identified, and all studies following an observational design (cohort, case-control, and cross-sectional studies) were included in the research. Data analysis was performed using Stata version 13. Finally, 17 studies were included in the work process for systematic review and meta-analysis. The results showed the most frequent reasons for suicide among the studied individuals were gender (being female), youngness, heroin overdose, multi-drug abuse, history of repeated suicide attempts, history of psychiatric disorder (especially depression), joblessness, homelessness, distorted family relationships, etc. Moreover, the results of synthesizing the studies revealed the prevalence of suicide attempts equaled the effect size (95% CI=0.3 [0.23-0.37]) among these individuals, and the prevalence of successful suicides approached the effect size (95% CI=0.03 [0.01-0.05]). The results of the present study showed the high prevalence of suicidal thoughts and suicide attempts among the heroin-abusing population. Furthermore, according to the findings, the prevalence of unsuccessful suicide attempts was ten times more than that of successful ones in the target population.

Zachowania suicydalne wśród osób starszych

In Polish society, the very word “suicide” evokes many extreme emotions in people, such as fear, uncertainty, but also hostility, and even reluctance and embarrassment. Sometimes it is sadness and regret. Most people prefer to avoid this topic and live under the illusion that this problem affects only a small part of the population. However, this phenomenon exists and affects all social and age groups to an increasing extent, including the elderly, who theoretically should enjoy life to the fullest. Suicidal behavior among seniors in recent years has become a growing problem, which systematically grows stronger every year, which is clearly confirmed by the increasing number of attempts and successful suicide attacks carried out by the elderly. The aim of this article is to present the scale of the suicide phenomenon among representatives of the age group over 65, with particular emphasis on the general outline of the issue, its etiology and symptomatology. The conclusion presents in detail the models of preventive interventions that take into account social, psychological, psychiatric, criminological and victimological factors that can effectively reduce the occurrence of the phenomenon in the discussed social group.

Development of a suicidal tendency model in borderline personality disorder patients based on perceived burden and suicidal acquisition capacity through pessimistic attribution style

Background and Aim: Borderline personality disorder is specifically separated from other mental disorders by its emphasis on successful suicide, non-suicidal self-injurious behaviors, and suicidal behavior as a diagnostic criterion. Therefore, the present study aimed to develop a model for suicide tendency in individuals with borderline personality disorder based on perceived burdensomeness and acquired capability for suicide through the use of deceitful documents. Methods: The research method was of correlation type with structural relationship path analysis plan, or modeling. The statistical population of the current study included all female and male adults aged 18 to 40 who referred to the psychiatric department of hospitals and psychiatric offices in Tehran during the year 2021, who received a diagnosis of borderline personality disorder and had a history of attempted suicide, suicidal tendencies, and There were suicidal thoughts. Sample get the method It was done purposefully through the screening of patients. The sample size was equal to 500 people, which was chosen according to Kline's theory to design structural equations. In this research, Beck's (1961) suicidal ideation questionnaires, suicidal behavior capacity (revised) by Osman et al. (2001), and Patterson et al.'s (1981) documentary styles and perceived burden with Interpersonal Needs Questionnaire (INQ) were measured. Data analysis in SPSS software AMOS It was done using the structural equation modeling method. Results: The results showed that the proposed research model had an acceptable fit. Therefore, the research model based on modeling the relationship between perceived burden and the acquired capacity of suicide with the desire to commit suicide through pessimistic attribution style was confirmed by using structural equation analysis. Also, the secondary results showed that there is a significant correlation between the predictor variables of the research with the tendency to commit suicide. In this way, the effect of perceived burden and acquired capacity of suicide with pessimistic attribution style was 0.25 and 0.30 respectively, which increased to 0.46 due to the facilitating role of pessimistic attribution style. Conclusion: Based on this, it can be concluded that the positive effect of the perceived burden and the acquired capacity of suicide on the desire to commit suicide is increased and facilitated by the style of pessimistic attributions. According to this result, the mediating role of pessimistic attributional style to facilitate the positive effect of predictor variables (perceived burden, and acquired suicidal capacity) on suicidal tendency in patients with borderline personality disorder was confirmed. This result indicates the possibility of combining Abramson's cognitive theory and Joyner's interpersonal relationships in explaining suicidal tendencies.

Social Media Sentiments on Suicides at the New York City Landmark, Vessel: A Twitter Study.

Vessel is a landmark created by Heatherwick Studio where visitors can enjoy views of New York City from different heights and perspectives. However, between February 2020 and July 2021, four individuals jumped to their deaths from the landmark. Effective preventive solutions have yet to be identified, and the site is currently closed. In this study, we examined the trajectory of public sentiment on the suicide-related activity at Vessel on Twitter by investigating the engagement patterns and identifying themes about the four suicides from February 2020 to August 2021 (n = 3058 tweets). The results show increased levels of discussion about each successive suicide case in the first 14 days following each incident (from 6 daily tweets for the first case to 104 for the fourth case). It also took longer for relevant discussions to dissipate (4 days for the first and 14 days for the fourth case, KS statistic = 0.71, p < 0.001). Thematic analysis shows a shift from expressions of emotion to urging suicide prevention actions in the third and fourth cases; additionally, we detected growing support for restricting means. We suggest that, prior to the reopening of Vessel, collective efforts should be made to install safety protections and reduce further suicide risks.

Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents.

This study investigated the short-term (in 2020) and long-term (in 2021) impacts of the COVID-19 pandemic on suicide-related characteristics in Korean adolescents in comparison with the pre-pandemic period (in 2019) and examined the factors associated with those impacts. Secondary data of the cross-sectional 15th–17th (2019–2021) Korea Youth Risk Behavior Web-based Survey targeting adolescents in school were utilized. The proportions of adolescents with depression, suicidal ideation, suicide planning, and suicide attempts were 26.5%, 12.2%, 3.7%, and 2.4%, respectively. Following an adjustment, depression, suicidal ideation, and suicide attempts significantly improved in the short term and depression and suicide attempts improved significantly in the long term (i.e., 2021), albeit to a lesser degree. The associated variables in the short-term analysis (i.e., 2020) reflected the socioeconomic vulnerabilities (e.g., lower household socioeconomic status [SES], unhealthy status, and unhealthy behaviors), as well as the socioeconomically favorable indicators (e.g., high household SES and high academic achievement). In the long-term, suicidal ideation was no longer associated with a lack of engagement in hand washing, and suicide attempts were no longer associated with the amount of internet time used for studying. For a successful suicide prevention, it is necessary to develop in-school interventions that address the relevant factors identified in this study and the community-based interventions that target out-of-school adolescents.

Time-series analysis of trends in the incidence rates of successful and attempted suicides in Thailand in 2013–2019 and their predictors

BackgroundSuicide rates are of increasing concern worldwide. There are approximately 4000–5000 deaths by suicide each year in Thailand. This study examined trends in annual incidence rates and predictors of successful and attempted suicides in Thailand (2013–2019).MethodsSecondary data analysis was conducted on data from two national-level databases: The National Health Security Office and the National Death Certification Registry System. Time-related trends and predictors of successful and attempted suicides were calculated using joinpoint regression and multivariable logistic regression analyses, respectively.ResultsOf all successful suicide cases from 2013 to 2019, about 80% involved men, with an average age of 45.37 (± 16.43) years. Predictors of successful suicide included male sex, older age, using highly lethal methods, and no prior psychiatric treatment. Among individuals admitted to hospitals following a suicide attempt from 2013– to 2019, the average age at first admission was 38.83 ± 22.47 years, with women more heavily represented than men. Only 2.3% of these patients received psychiatric treatment in the hospital. Predictors of attempted suicide included female sex; adolescent or adult; and mental, alcohol, or substance-related disorder(s). Age-standardized annual rates per 100,000 people showed that, through 2019, suicide incidence increased slightly, and attempts decreased.ConclusionsThere was a significantly increasing trend in successful suicide during the 7 years; the increase was more notable among men. The study highlights sex-related gaps in public health owing to an identified higher incidence of suicide among men, and a higher incidence of suicide attempts in women adolescents, emphasizing the need to consider sex-sensitive issues in individual as well as societal contexts.

Suicide risk assessments: Why are we still relying on these a decade after the evidence showed they perform poorly?

Suicide deaths have a profound impact on whānau and community and are a tragic loss. However, from a statistical point of view, suicide is a relatively rare event. Predicting rare events is difficult, and the implications for suicide prevention were highlighted in an important editorial in this journal more than a decade ago, yet little seems to have changed. Risk assessment that focuses on accurate prediction of suicide in real-world contexts is given a great deal of attention in mental health services, despite the fact that current scientific knowledge and best practice guidelines in this area highlight that it is unlikely to be a good basis on which to provide access to treatment. It is our view that we have a good enough understanding of the common conditions people who struggle with suicidal distress experience and energy is better directed at acting to reduce exposure to these conditions and providing treatment for those who seek it. Blueprints for successful suicide prevention exist. If we lessen the focus on prediction, we will have greater resources to focus on treatment and prevention.

Short and long term mortality following massive burn injury (>50% TBSA) in a UK burns centre

IntroductionDespite advances in burn care, large burn injuries carry significant mortality risk. Although studies examining immediate mortality are available, little data is available regarding risk after discharge from hospital. This study aimed to determine short and long term mortality rate at a UK burns centre for patients with massive burn injuries. We were particularly interested to determine whether mortality rate for self inflicted injuries was present and whether this was by suicide. MethodsThe International Burn Injury Database (iBID) was interrogated to identify patients admitted with> 50% TBSA (total body surface area) injuries from January 2009- September 2019. Documented cause of death on death certificates were viewed for patients who died. General Practitioners were contacted to determine if discharged patients were alive. Descriptive statistics were generated. Results96 patients were identified. Mean age was 45.6 years (range 16.4–93.7) with male to female ratio of 2:1. Mean TBSA was 71.8% (range 50–99). Mortality was 71.9% and was higher in females (75.7% vs 69.8%). Overall mean revised Baux score was 130 (range 68–184). Nearly half were self-inflicted (49.0%) with higher TBSA (74.4%). Of 69 patients who died only 1 was after discharge. Coroner inquiry determined that this was caused by acute alcohol intoxication. Most of those who died did so within 60 days (91.3%), usually within 48 h (71.0%). Burn futility accounted for most deaths (71.0%) followed by multi-organ failure (14.5%). ConclusionsLarge burns carry significant mortality risk. Self-inflicted large burns carry a higher mortality which may be attributed to larger TBSA. In patients surviving to discharge long term prognosis is good. Patients with self-inflicted burns seem to not make a subsequent successful suicide attempt after discharge from hospital.

Polycondensed Peptide Carriers Modified with Cyclic RGD Ligand for Targeted Suicide Gene Delivery to Uterine Fibroid Cells.

Suicide gene therapy was suggested as a possible strategy for the treatment of uterine fibroids (UFs), which are the most common benign tumors inwomen of reproductive age. For successful suicide gene therapy, DNAtherapeutics should be specifically delivered to UF cells. Peptide carriers are promising non-viral gene delivery systems that can be easily modified with ligands and other biomolecules to overcome DNA transfer barriers. Here we designed polycondensed peptide carriers modified with a cyclic RGD moiety for targeted DNA delivery to UF cells. Molecular weights of the resultant polymers were determined, and inclusion of the ligand was confirmed by MALDI-TOF. The physicochemical properties of the polyplexes, as well as cellular DNA transport, toxicity, and transfection efficiency were studied, and the specificity of αvβ3 integrin-expressing cell transfection was proved. The modification with the ligand resulted in a three-fold increase of transfection efficiency. Modeling of the suicide gene therapy by transferring the HSV-TK suicide gene to primary cells obtained from myomatous nodes of uterine leiomyoma patients was carried out. We observed up to a 2.3-fold decrease in proliferative activity after ganciclovir treatment of the transfected cells. Pro- and anti-apoptotic gene expression analysis confirmed our findings that the developed polyplexes stimulate UF cell death in a suicide-specific manner.

Psihološke teorije i modeli samoubistva i suicidalnog ponašanja

According to the World Health Organization every 40 seconds, someone somewhere in the world dies from suicide. The number of suicide attempts that do not end with death is twenty times larger than the number of suicide deaths. For decades researchers have been developing theories and models aiming to explain why people kill themselves. At the same time, they are trying to provide tools for successful suicide prediction and to emphasize different psychological, social, and economic factors that we should target when planning prevention. However, even though there is a significant number of theories of suicide, suicide prevalence is telling us that our theories are failing, suggesting that we should probably change the approach to this phenomenon. This study represents a review of selected psychological theories and models of suicide that are addressing psychological processes that underpin suicidal ideation and suicidal behavior. This paper covers psychoanalytic theories of suicide, diathesis-stress models of suicidal behavior, cognitive-behavioral models of suicide and suicidal behavior, complex (integrative) models and evolutionary theories of suicide and as such this paper represents a conceptual framework for understanding suicide from a psychological perspective.

Suicide and Suicidal Tendency in Primary Care Setting; Review Article

Suicide is critical public health problem that primary care physicians potentially can help address given that concerned patients frequently visit them in the weeks and months preceding the successful suicide. This article contemplates issues placing the patient at high risk for successful suicide and clinical valuation techniques available to the primary care physician. Patients identified as being at risk of attractive suicidal or those who have a equal of suicidal ideation or behavior judged apposite for management in the primary care setting should be monitored for risk at regular intervals. It is extremely significant to learn about and try to contextualize the patients' emotions that triggered the present crisis. Nurses can make sure that they have a thorough understanding of the present acuity, and all of the precipitating factors, and can exactly and collaboratively communicate with the caregivers and other involved medical teams.