Suicide Research Articles

Inuit mental health service utilisation in Manitoba: results from the qanuinngitsiarutiksait study

ABSTRACT Despite decades of Inuit accessing services in Manitoba, Inuit-centric services remain scant and have only begun to emerge. This article reports on Inuit utilisation of mental health services in Manitoba. In this study, we focused on two interrelated cohorts: Inuit living in Manitoba and Inuit from the Kivalliq region who come to Winnipeg to access specialised services. We used administrative data routinely collected by Manitoban agencies. The study was conducted in partnership with the Manitoba Inuit Association, and Inuit Elders from Nunavut and Manitoba. Our results show that mental health-related consults represent between 1 in 5 and 1 in 3 of all consults made by Inuit in Manitoba. Rates of hospitalisation for mental health conditions are considerably lower than those of residents from the Manitoba northern health authority. Given that Nunavut has the highest rate of suicide in the world, our results suggest underserved needs rather than lower needs. Kivalliq and Manitoba Inuit utilise mental health services in Manitoba extensively, yet these services for the most part remain western-centric. Epistemological accommodations in the provision of mental health services have yet to be implemented. This is now the focus of our work.

Pathways to suicide for children and youth in Guyana: A life charts analysis

Background: Suicide is the third leading cause of death among youth aged 15 to 29 years old globally. Guyana has the highest rate of youth suicide in the world, yet only limited research exists. Aim: The aim of this study is to identify key features of the suicide pathway for Guyanese children and youth and to distinguish meaningful subgroups. Method: The psychological autopsy (PA) method was used to generate life charts for 15 Guyanese children and youth (10–29 years) who died by suicide. Nineteen close contacts of these individuals were interviewed about the life events of the decedent between 6 months and 5 years after their death. Semi-structured interviews lasting 30 to 150 min took place between November 2021 and January 2022. The interview data were converted into life charts and these were reviewed to uncover meaningful subgroups of suicide pathways. Results: Three groups with distinct suicide pathways were identified: hard life (46%), mental illness (20%) and interpersonal stress (20%). There were also two male youths for whom the suicidal antecedents and pathways were unclear. Interpersonal stress, alcohol, exposure to suicide and family history of suicide were common factors identified across groups. Conclusions: The findings emphasise the role of both acute and protracted interpersonal stress for child and youth suicide in Guyana. The structure and dynamics of Indo-Guyanese families are discussed. Interventions recommended include enhancing child and youth community engagement, improving mental health and suicide literacy, alcohol restriction, increasing access to support services, and reducing stigma.

First- and Second-Generation Psychological Theories of Suicidal Behaviour.

Suicidal behaviour is defined as taking actions with the intention of killing oneself and thinking of performing these actions. Suicide is a serious public health problem with complex biological, social and psychological risk factors and a multidimensional clinical appearance, occurring all over the world and ranking among the leading causes of death. In this study, psychological approaches explaining suicide were evaluated under the headings of first-generation and second-generation suicide theories, the different aspects of these theories were put forward, and previously published studies and recent evidence were reviewed. A literature review on the theoretical foundations of suicide is presented. First-generation suicide theories were developed before the 2000s and second-generation suicide theories were developed after the 2000s. While Psychodynamic Theory, Social Learning Theory, Hopelessness Theory, Shneidman's Suicide Theory and Escape Theory are included under the title of first-generation suicide theories, Interpersonal Psychological Suicide Theory, Three Stage Suicide Theory, Complementary Motivational-Demotivational Theory and Variable Predisposition Theory are examined as second-generation suicide theories. The approaches of the theories provide important evidence in understanding suicidal behaviour and recognising various risk factors in the transition from suicidal ideation to suicidal action. Controlling the risk factors may contribute both in terms of preventive community mental health and in the development of health policies.

Why Do More People Commit Suicide after the Economic Bubble

This paper examines the relationship between the economic recession and the high suicidal rates in Japan during the post-economic bubble in the late 1990s and early 2000s. The aim of the study is to explore the relationship between the economic recession, mental health, suicide prevalence and sociocultural dynamics. The literature review and empirical analysis show compelling evidence linking economic instability, financial distress, and unemployment to increased suicide rates. In addition, this paper explores the interplay of cultural factors for instance, stigma surrounding mental health and collective norms, in explaining the vulnerability experienced by individuals during economic recessions and hard times. Key findings emphasize the role of economic stability in increasing vulnerabilities as well as the effects of unemployment, familial relationships and self-esteem. The findings also show that the societal pressure to adhere to traditional roles, especially in times of economic uncertainty, is a key stressor affecting mental well-being. The study advocates for detailed research strategies such as interviews and surveys to further investigate causal relationships. This research provides key insights into the varying factors that contribute to suicide during economic crises, suggesting the need for holistic interventions that address both sociocultural and economic dimensions.

Occurrence and characteristics of suicidal ideation in psychiatrically healthy individuals based on ecological momentary assessment.

Decedents with no known mental disorder comprise 5-40% of suicides, suggesting that suicide ideation (SI) and behavior may occur in the psychiatrically healthy with important implications for suicide risk screening. Healthy Volunteers (HV) and patients with Major Depressive Disorder (MDD) provided 7 days of Ecological Momentary Assessment (EMA) data about SI and stressors. Longitudinal mixed effects logistic regression models compared HV and patient SI and stressors. Mixed effects linear regression models compared HVs' and patients' SI score change from the previous epoch's SI score when each stressor occurred. HVs (n = 42) reported less frequent (p < 0.001) and less intense SI (p < 0.003) than patients (n = 80), yet did endorse SI and/or SI-related items in 44% of EMA epochs, endorsing SI items in 25% of epochs with non-zero SI scores. For 7 of 8 stressors, patients reported stressors more often than HVs (all p < 0.001) responding to them with increased SI (0.0001 < p < 0.0472). HVs were relatively resilient to stressors, reporting SI increases only in response to neglect (p < 0.0147). Although SI and SAs are documented among psychiatrically healthy individuals, scientific attention to these observations has been scant. Real-time SI measurement showed that HVs' SI was less pronounced than MDD patients', but was endorsed, nonetheless. Patients were more likely to report stressors than HVs, perhaps due to greater sensitivity to the environment, and reported SI in response to stressors, which was less common in HVs. Both MDD patients and HVs most often manifested passive SI (viz, "decreased wish to live"). However, passive SI (viz, "desire for death"), may predict suicide, even absent SI per se (thinking about killing yourself). This study validates the utility of real-time SI assessment, showing that HVs endorse SI items in 11% of epochs, which implies that suicide risk screening focused on those with mental disorders may be too narrow an approach.

Acceptability and content validity of suicidality screening items: a qualitative study with perinatal women.

Suicide is a leading cause of death for perinatal women. It is estimated that up to 50% of women with mental health issues during pregnancy and/or after birth are not identified, despite regular contact with healthcare services. Screening items are one way in which perinatal women needing support could be identified. However, research examining the content validity and acceptability of suicide-related screening items with perinatal women is limited. This study sought to: (i) assess the acceptability and content validity of 16 suicide-related items that have been administered and/or validated in perinatal populations; and (ii) explore the potential barriers and facilitators that may affect how women respond to these items when administered during pregnancy and after birth. Twenty-one cognitive and semi-structured interviews were conducted with pregnant and postnatal women in the UK. The sample included women who had experienced self-reported mental health problems and/or suicidality during the perinatal period, and those who had not. Interviews were transcribed verbatim, and a coding framework based on the Theoretical Framework of Acceptability was applied to explore the data using deductive and inductive approaches. Findings indicated that the acceptability and content validity of suicide-related items were largely unacceptable to perinatal women in their current form. Women found terms such as 'better off dead' or 'killing myself' uncomfortable. Most women preferred the phrase 'ending your life' as this felt less confronting. Comprehensibility was also problematic. Many women did not interpret 'harming myself' to include suicidality, nor did they feel that abstract language such as 'leave this world' was direct enough in relation to suicide. Stigma, fear, and shame was central to non-disclosure. Response options and recall periods further affected the content validity of items, which created additional barriers for identifying those needing support. Existing suicide-related screening items may not be acceptable to perinatal women. Maternity practitioners and researchers should consider the phrasing, clarity, context, and framing of screening items when discussing suicidality with perinatal women to ensure potential barriers are not being reinforced. The development of specific suicidality screening measures that are acceptable, appropriate, and relevant to perinatal women are warranted.

Subsistence via Jala-Samadhi (Sacred Suicide): An Enigmatic Activism of Yogmaya

Collective jal-samadhi (killing oneself by plunging in the river) is one of the rare evidences in the resistance history that Yogmaya led from the Eastern part of Nepal at the verge of Rana regime. This paper examines her three different aspects - her life story, her Sarwartha Yogbani, and her collective jala-samadhi - to argue Yogmaya as an enigmatic social activist. The main purpose is to foreground her life struggle with reference to her Sarwartha Yogbani from the perspective of subaltern studies. The notions of ‘hegemony’ and ‘subaltern’ as Antonio Gramsci and Gayatri Chakravorty Spivak point out when ‘agency’ of the oppressed is concerned have been applied as theoretical parameters to foreground her story. The finding of the study shows subsistence of her resistance via jal-samadhi that helps engage intellectuals in academic activism and critical discourse in the history form below perspective.

How to eliminate pathogen without killing oneself? Immunometabolism of encapsulation and melanization in Drosophila.

Cellular encapsulation associated with melanization is a crucial component of the immune response in insects, particularly against larger pathogens. The infection of a Drosophila larva by parasitoid wasps, like Leptopilina boulardi, is the most extensively studied example. In this case, the encapsulation and melanization of the parasitoid embryo is linked to the activation of plasmatocytes that attach to the surface of the parasitoid. Additionally, the differentiation of lamellocytes that encapsulate the parasitoid, along with crystal cells, is accountable for the melanization process. Encapsulation and melanization lead to the production of toxic molecules that are concentrated in the capsule around the parasitoid and, at the same time, protect the host from this toxic immune response. Thus, cellular encapsulation and melanization represent primarily a metabolic process involving the metabolism of immune cell activation and differentiation, the production of toxic radicals, but also the production of melanin and antioxidants. As such, it has significant implications for host physiology and systemic metabolism. Proper regulation of metabolism within immune cells, as well as at the level of the entire organism, is therefore essential for an efficient immune response and also impacts the health and overall fitness of the organism that survives. The purpose of this "perspective" article is to map what we know about the metabolism of this type of immune response, place it in the context of possible implications for host physiology, and highlight open questions related to the metabolism of this important insect immune response.

Does Suicide Risk Screening Improve the Identification of Primary Care Patients Who Will Attempt Suicide Versus Depression Screening Alone?

The effectiveness of suicide risk screening relative to depression screening alone among primary care patients has not been tested rigorously. This study compared the performance of multiple depression screening methods (Patient Health Questionnaire [PHQ]-2, PHQ-8, and PHQ-9) and multiple suicide risk screening methods (PHQ-9 item 9 and suicide-focused screening of "thoughts of killing yourself" during the entire lifespan, within the past month, and within the past week) in a convenience sample of primary care patients. A total of 2,744 patients (military personnel, family members, and retirees) from six military primary care clinics completed the PHQ-9 and screening for suicidal ideation (SI) during routine clinic visits. Follow-up phone interviews were conducted for one year post-baseline to assess the incidence of suicide attempts, the study's primary outcome. Sensitivity, specificity, accuracy, and F1 statistics were calculated for each screening method for identifying patients who attempted suicide. More than 65% of patients who screened positive for SI also screened positive for depression on the PHQ-9. Depression screening with the PHQ-9 correctly identified more patients who attempted suicide during follow-up than the PHQ-2, past week SI, and past month SI. The PHQ-9 correctly identified more patients who attempted suicide within 3 months than lifetime SI, but lifetime SI correctly identified more patients who attempted suicide within 6 and 12 months. Depression screening with the PHQ-9 was the most effective strategy for identifying patients who attempted suicide in the near term. Universal suicide risk screening is unlikely to meaningfully improve identification of higher-risk patients beyond PHQ-9 depression screening.

Association between hearing loss and suicidal ideation: Discrepancy between pure tone audiometry and subjective hearing level

BackgroundThis study aimed to evaluate hearing loss by combining pure tone audiometry (PTA) with subjective hearing level concerning suicidal ideation. MethodsA total of 23,215 individuals from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2009 and 2013 were included. PTA was categorized according to average audiometric threshold levels: normal (≤25 dB), mild (26–40 dB), and moderate-severe (>40 dB). The subjective hearing level was categorized as “no discomfort,” “mild discomfort,” and “considerable discomfort” for hearing without a hearing aid. Next, we classified hearing loss into nine groups by combining PTA and subjective hearing levels. Suicidal ideation was defined as answering yes to the following question: “Have you ever seriously thought about killing yourself in the past 1 year?” We conducted chi-square tests and multiple logistic regression analyses. ResultsAmong the 23,215 participants aged ≥19 years (mean age 46.52 years), 3,214 (13%) reported having suicidal ideation. According to PTA, moderate to severe hearing loss was related to suicidal ideation (OR = 1.19, 95 % CI = 1.01–1.41). Subjective hearing loss was associated with suicidal ideation (mild: OR = 1.41, 95 % CI = 1.21–1.65; considerable: OR = 1.57, 95 % CI = 1.20–2.05). Moreover, as the subjective hearing level increased, the ORs of suicidal ideation increased in individuals with moderate to severe hearing loss (mild: OR = 1.52, 95 % CI = 1.24–1.88; considerable: OR = 1.81, 95 % CI = 1.39–2.36). LimitationsThe cross-sectional study limits the interpretation of causal relationships. ConclusionsSubjective hearing loss was more strongly associated with suicidal ideation than hearing loss as measured by PTA.

A Study on Factors Influencing Youth to Commit Suicide in Kashmir

Suicide is one of the burning issues worldwide as its rate is increasing continuously. This paper examines the status of suicide in the world and factors influencing youth of Kashmir to commit suicide. The study was carried out in Kashmir region in the year 2023 to trace the various socio-economic, political and cultural factors which are responsible for high suicide rates within the Kashmir valley. The results of present study revealed that social implications like unemployment, social isolation, family issues, failures in examination, relationship failures, increase in cultural change due to modernization are some of the notable contributors to the growing menace of suicide in Kashmir. Moreover, widespread socio-economic and cultural changes are highly stressful. This paper also aims to focus on the biological and neurological factors of people committing suicide. The study recognizes the hopelessness and helplessness associated with persistent insecurity, statelessness and poverty is triggering the mental wellbeing of the citizens of the valley and resulting in suicides. Finally, the researchers propose some preventive measures which would lessen depression, mental illnesses and frustration among the youth in Kashmir.

Ketamine: Mechanisms and Relevance to Treatment of Depression.

Major depressive disorder (MDD) is a leading cause of suicide in the world. Monoamine-based antidepressant drugs are a primary line of treatment for this mental disorder, although the delayed response and incomplete efficacy in some patients highlight the need for improved therapeutic approaches. Over the past two decades, ketamine has shown rapid onset with sustained (up to several days) antidepressant effects in patients whose MDD has not responded to conventional antidepressant drugs. Recent preclinical studies have started to elucidate the underlying mechanisms of ketamine's antidepressant properties. Herein, we describe and compare recent clinical and preclinical findings to provide a broad perspective of the relevant mechanisms for the antidepressant action of ketamine.

School Dropout and Suicide Intention of Students: A Study at Khyber Pakhtunkhwa Level

The pressure on the students for high marks creates exam phobia, which in turn causes school drop-out and suicide intention of the students. With the help of examination phobia (EPH), this study looked into the effects of parental pressure for high grades (PPHM) on students' intention to commit suicide (SI) and drop out (SD). It was also discovered that the socioeconomic status and education of the parents were moderate. There were 49 items on the survey. SPSS and AMOS were used to analyse the data gathered from 384 respondents. According to this study's substantial correlation between the factors, parental pressure for high grades may still have an impact on kids' intentions to commit suicide and their likelihood of dropping out of school. The socioeconomic situation and educational level of the parents were found to be moderators of the connection between PPHM and SI and SD. The school heads, the parents and the society might not ignore the factors causing students' suicide intention leads to their suicide. This study makes a substantial contribution to the literature in the field in a developing nation.

“Following your dreams, and not killing yourself to do so”: Black PharmDstudent perceptions of pharmacy residency

ObjectiveResidency training is a key element of advancing the roles of pharmacists in patient care. Diversifying the healthcare workforce is also crucial in reducing health disparities and improving health equity.1 The objective of this study was to investigate Black Doctor of Pharmacy students’ perceptions of pursuing pharmacy residency training to aid pharmacy educators in creating and improving structures to support the professional advancement of Black student pharmacists. MethodsA qualitative study employing focus groups was conducted at one of the top 20 colleges of pharmacy. Four focus groups consisting of Black students in years 2 through 4 of the Doctor of Pharmacy program were organized. A constructivist grounded theory approach2 was utilized to collect and analyze the data, which was organized into a conceptual framework. ResultsThe elements of the framework developed showcase Black students’ consistent negotiation between personal well-being and pursuit of professional advancement. This framework also highlights how the experience of navigating personal wellness is unique for Black students, rather than simply a work/life balance concern. ConclusionThe concepts in this framework may be valuable for colleges of pharmacy seeking to increase diversity in their residency pipeline. Targeted interventions to ensure adequate mentorship, mental health resources, diversity and inclusion efforts, and financial support will be necessary if the profession truly desires to expand increased diversity in clinical pharmacy.

“At Least, at the Border, I Am Killing Myself by My Own Will”: Migration Aspirations and Risk Perceptions among Syrian and Afghan Communities

It is well-documented that border controls make migration journeys riskier for people on the move. Policymakers construe deaths in migration journeys as resulting from the individual risk-taking attitudes of migrants. However, risks involved in migration journeys are not only related to border control measures. Based on the analysis of 30 semi-structured interviews conducted with Syrian and Afghan migrants in Turkey, we embrace a social constructionist approach to unpack how migrants form their aspirations based on their risk perceptions. Our findings explain why some migrants would still move onwards despite violent borders while others stay or search for “safer” ways for onward migration.

Socio-demographic Correlation among Patients with Deliberate Self-harm

Background: Deliberate self-harm is a complex behavior of maladaptive response to acute and chronic stress, and likely to be suffering from mental health problems as well as co-morbid general medical conditions, including several non-suicidal intentions to suicide. Deliberate self-harm was previously included in suicide. Sir Thomas Browne first used the word ‘Suicide’ in 1642 in his religion Medici. The word suicide originated from SUI (of oneself) CAEDES (murder). According to WHO ‘Suicide’ refers to the act of killing oneself intentionally, performed by the person with full knowledge or expectation of the fatal outcome. This study aimed to analyze the pattern of psychiatric disorders among patients with deliberate self-harm. This study aimed to analyze the socio-demographic correlation among patients with deliberate self-harm. Material Methods: This descriptive cross-sectional study was conducted at the Department of Medicine; emergency OPD, Rangpur Medical College, Rangpur, Bangladesh. The study duration was 1 year; July 2012- June 2013. A total of 116 deliberate self-harm cases were included in this study as per the inclusion criteria. A convenience sampling technique was undertaken in this study. Results: The correlation of age, sex, economic status, religion, educational status, occupation, marital status, family history of mental illness, previous H/O mental illness, previous H/O physical illness, nature of stress factors, and the total number of DSH was significant between psychiatric disorder and co-morbid general medical condition. Conclusion: There was a significant correlation between sociodemographic parameters among the patients with deliberate self-harm. Bangladesh is a country with a cultural heritage of thousands of years. Traditional values, and social and family bonding are the characteristics of the culture. Traditional value systems are being declined gradually due to the influence of western culture. The social structure is in a period of transition that is characterized by the waning of family ties and social support as well as an increase in urbanization and modernization. This factor together with psychiatric and co-morbid general medical conditions plays an important role in deliberate self-harm.

Characteristics of Patients Who Complete Suicide and Suicide Attempts While Undergoing Treatment in Norway: Findings from Compensation Claims Records.

The aim of this study was to identify characteristics that differentiate patients who complete suicide (SC) from patients with suicide attempts (SA) while undergoing treatment in Norway. We examined data from the Norwegian System of Patient Injury Compensation (Norsk Pasientskade Erstatning-NPE). Data were extracted from NPE case records from a 10-year period (2009-2019) for 356 individuals who attempted (n = 78) or died by (n = 278) suicide. The two groups differed significantly in the types of medical errors identified by experts. Inadequate suicide risk assessment tended to be proportionally and significantly more prevalent among SC compared to SA. There was a weak but significant trend that SA had received medication only, whereas SC had received both medication and psychotherapy. There were no significant differences with respect to age group, gender, diagnostic category, number of previous suicide attempts, inpatient/outpatient status, or category of responsible clinic. We conclude that suicide attempters and suicide completers differed in terms of identified medical errors. Focusing on the prevention of these and other types of errors could help to reduce the number of suicides of patients in treatment.

Depression Detection using AI, ML and NLP

Suicide is one of the most serious social health issues that exist in today's culture. We can refer suicidal thoughts to act of killing yourself intentionally. It can be used as a suicide risk measure. India is among the top countries among in the world to have annual suicide rate. Social networks have been developed as a first-rate factor for its users to communicate with their interested friends and proportion their captions, photos, and videos reflecting their moods, emotions, and sentiments. To increase and put in force a version which takes a facial expression image as an enter and symptoms. Based on that, it predicts if the patient is suffering from anxiety, depression or not. We can train version using photographs of various emotions in it &amp; will use it for prediction. Image captioning can be accomplished after prediction for higher visualization of report. We will also use text mining (NLP) technique on various inputs taken in the form of audio and video to convert it into text. At final, we can make final choices based on above two techniques. And with this, we will be able to generate a detailed dashboard of user disease status and his history. With the help of all this data we can design webapp for above system. We will use CNN algorithm for speed up detection of depressed character instances and approach to become aware of high-quality answers of mental health troubles. We suggest system learning method as an efficient and scalable technique. We document an implementation of the proposed method. We have evaluated the efficiency of our proposed technique the usage of a set of various psycholinguistic features. We show that our proposed method can extensively improve the accuracy and category blunders price.

Confucianism and Gender Ratios of Suicide in the World: A WHO Data-Based Study.

This study explores how Confucianism affects suicide rates by gender. Data for the study come from the World Health Organization document "Suicide Worldwide in 2019", which provides frequency and gender ratios for suicide rates in 183 member countries. One-way ANOVA and multiple linear regression analysis were used to examine potential differences in suicide rates and male to female ratio of suicides. Independent variables include region, income level, culture, and Confucian values that may be related to suicide. Suicide rates for Confucian countries do not show significant differences from European countries. However, these countries have lower suicide gender ratios.

Death due to electrocution- A rare method of suicide

Suicide is defined as “the act of killing yourself deliberately”. Most common methods of committing suicide in India are hanging, followed by poisoning, drowning and self-immolation. While least common methods include consuming sleeping pills, electrocution, self-inflicting injuries and firearm injury. Considering deaths due to electrocutions, in India as well as globally, suicidal electrocutions are reported to be very rare compared to accidental ones. Existing literature also have scarcity of reports related to suicidal electrocutions. Hence, we hereby report a case of suicidal electrocution due to its rarity.