Suicide Deaths Research Articles

The effectiveness of a suicide prevention program in primary care clinics supported by community public health resources: A difference-in-differences analysis

The importance of appropriate and intensive follow-up management for individuals identified with suicide risk through screening is highlighted. The Link between Primary Care Clinic and Public Health Resources Intervention(LinkPC-PH), a suicide prevention program in primary care clinics supported by community public health resources, was implemented at the district level in 2017. The purpose of the present study is to evaluate the effectiveness of the LinkPC-PH intervention by comparing suicide rates before(2014-2016) and after(2017-2019) implementation of the intervention using a difference-in-differences design. The LinkPC-PH comprises several dimensions of intervention including screening, risk assessment of suicidality, and referral in primary care clinics and crisis contact within 24 hours, case management, and safety planning led by public health professionals. After adjustment for district-level confounders, an intervention-implemented district had 2.87 fewer suicide deaths per 100,000 people in a population sample at post-intervention than would have been expected from the same trend in suicide rates as non-implemented intervention districts. In other words, the suicide rate in the intervention area decreased by 25% following the intervention. These results empirically substantiate suicide prevention programs in primary care clinics by community public health resources for reduced suicide rates to support effective community-based suicide prevention interventions.

Association of chronic pain with suicide attempt and death by suicide: a two-sample Mendelian randomization.

Prior studies have suggested an association between chronic pain and suicidal behavior. However, evidence supporting the causal nature of this association, and the role played by depression, remain difficult to establish due to confounding. We investigated associations of chronic pain with suicide attempt and death by suicide as well as the mediating role of depression in this association using a genetically informed method strengthening causal inference. We conducted a two-sample Mendelian randomization. Independent SNPs (N = 97) from the multisite chronic pain GWAS (NGWAS = 387,649) were used as instrumental variables to test associations of chronic pain with suicide attempt (measured from hospital records; NGWAS = 50,264) and death by suicide (measured from official death causes; NGWAS = 18,085). Indirect associations of chronic pain with suicide attempt and death by suicide via major depressive disorder (NGWAS = 173,005) were estimated. Primary analyses were supported by a range of sensitivity and outlier analyses. We found evidence supporting the contribution of chronic pain to increasing the risk of suicide attempt (OR = 1.67, CI = 1.21-2.35) and death by suicide (OR = 2.00, CI = 1.10-3.62). Associations were consistent across sensitivity analysis methods, and no evidence for outliers driving these associations was found. Through mediation analyses, we found that major depressive disorder explained a substantial proportion of the association between chronic pain and suicide attempt (proportion mediated = 39%; ORindirect association = 1.32, CI = 1.09-1.61) and death by suicide (proportion mediated = 34%; ORindirect association = 1.40, CI = 1.13-1.73). Our findings suggest that both pain management interventions and prevention of depression are likely to be effective strategies to reduce suicide risk in individuals with chronic pain.

State expansion of Supplemental Nutrition Assistance Program eligibility and rates of firearm-involved deaths in the United States

IntroductionPoverty is a consistent correlate of firearm-involved mortality, yet little work has considered the effects of social and economic policies on these deaths. This study examined associations of state elimination...

Facets of Suicidal Ideation

According to SAMHSA (2023), approximately 16,600,000 American adults and teens reported having serious thoughts of suicide in 2022. While suicide prevention has primarily focused on suicide deaths and attempts, we contend that suicidal ideation (SI) deserves more in-depth investigation and should be an essential intervention target on its own. In support of this point, we provide three examples of ways to improve specificity in understanding of SI through the study of controllability of SI, the language used to assess SI, and measuring SI in real time. We also consider qualitative work on the content of SI, its treatment, and definitional considerations. We thus call for an increased general focus on SI within research, clinical care, and policy.

Travel Distance to Hospital Is Associated With Self-Harm Hospital Presentation But Not Suicide.

Background: Travel distance to hospital emergency departments (EDs) may be a more influential factor in the spatial variation in hospital-presenting self-harm than for suicide deaths. Aims: We investigated the associations of travel distance to the nearest ED with self-harm hospital presentations and suicides in a large city in Taiwan. Method: Data for self-harm and suicide were extracted from Taiwan's National Suicide Surveillance System (2012-2016). Results: Adjusted analyses using Bayesian hierarchical models showed that a longer travel distance to the nearest hospital ED was associated with lower self-harm hospital presentation rates but not suicide rates. Limitations: This is an ecological study; the area-level associations could not be directly implied at the individual level. Conclusion: Living in remote neighborhoods could be a barrier to seeking medical help after self-harm, and this has implications for suicide, surveillance, prevention and intervention strategies.

The Mental Health of First Nations Children in Manitoba: A Population-Based Retrospective Cohort Study Using Linked Administrative Data: La santé mentale des enfants des Premières Nations au Manitoba : une étude de cohorte rétrospective dans la population, à l'aide de données administratives liées.

First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study compares diagnosed mental disorders and suicidal behaviours of First Nations children living on-reserve and off-reserve to all other children living in Manitoba. The research team, which included First Nations and non-First Nations researchers, utilized population-based administrative data that linked de-identified individual-level records from the 2016 First Nations Research File to health and social information for children living in Manitoba. Adjusted rates and rate ratios of mental disorders and suicide behaviours were calculated using a generalized linear modelling approach to compare First Nations children (n = 40,574) and all other children (n = 197,109) and comparing First Nations children living on- and off-reserve. Compared with all other children, First Nations children had a higher prevalence of schizophrenia (adjusted rate ratio (aRR): 4.42, 95% confidence interval (CI), 3.36 to 5.82), attention-deficit hyperactivity disorder (ADHD; aRR: 1.21, 95% CI, 1.09 to 1.33), substance use disorders (aRR: 5.19; 95% CI, 4.25 to 6.33), hospitalizations for suicide attempts (aRR: 6.96; 95% CI, 4.36 to 11.13) and suicide deaths (aRR: 10.63; 95% CI, 7.08 to 15.95). The prevalence of ADHD and mood/anxiety disorders was significantly higher for First Nations children living off-reserve compared with on-reserve; in contrast, hospitalization rates for suicide attempts were twice as high on-reserve than off-reserve. When the comparison cohort was restricted to only other children in low-income areas, a higher prevalence of almost all disorders remained for First Nations children. Large disparities were found in mental health indicators between First Nations children and other children in Manitoba, demonstrating that considerable work is required to improve the mental well-being of First Nations children. Equitable access to culturally safe services is urgently needed and these services should be self-determined, planned, and implemented by First Nations people.

A Study among Chemical Suicidal Victims: Situation Analysis

Background: Suicide by poisoning is the act of intentionally killing oneself by using various chemical substances and it is the most common and widely used method in developing countries like Bangladesh. Objective: The objectives of this study were to find out the socio-demographic characteristics and possible reasons among the chemical suicidal victims. Materials and method: This was a descriptive type of cross-sectional study, held in the Morgue of department of Forensic Medicine of Dhaka Medical College (DMC), Dhaka, Bangladesh, from July 2016 to June 2018. Victims were selected purposively according to the availability in the morgue of Dhaka MedicalCollege. Data were collected from the relatives of the victims and the verbal consent of the doctors who performed autopsy at DMC morgue. Results: A total of 50 victims of suicide using chemical substances as revealed by autopsy findings from the DMC morgue were enlisted in this study. Victims of suicide not using chemicals were excluded from this study. Half (50.0%) of the suicidal deaths by poisoning cases were aged 20 or below. Majority (66.0%) of the victims was male. Organophosphorus compound was found in 58.0% cases, followed by diazepam (8.0%) and barbiturates (4.0%), after receiving chemical analysis report. Conclusion: Pesticides are the most commonly used suicidal agent particularly in low and middle-income countries like ours. So, social awareness regarding this issue is very much needed. Delta Med Col J. Jan 2021;9(1):23-27

Smoking is associated with increased eryptosis, suicidal erythrocyte death, in a large population-based cohort

Smoking has multiple detrimental effects on health, and is a major preventable cause of premature death and chronic disease. Despite the well-described effect of inhaled substances from tobacco smoke on cell toxicity, the association between smoking and suicidal erythrocyte death, termed eryptosis, is virtually unknown. Therefore, the blood samples of 2023 participants of the German National Cohort Study (NAKO) were analyzed using flow cytometry analysis to determine eryptosis from fluorescent annexin V-FITC-binding to phosphatidylserine-exposing erythrocytes. Blood analyses were complemented by the measurement of hematologic parameters including red blood cell count, hematocrit, hemoglobin, mean corpuscular cell volume (MCV) and mean corpuscular hemoglobin (MCH). Eryptosis was higher in smokers than in non- and ex-smokers, and positively associated with the number of cigarettes smoked daily (r = 0.08, 95% CI [0.03, 0.12]). Interestingly, despite increased eryptosis, smokers had higher red blood cell indices than non-smokers. To conclude, smokers were characterized by higher eryptosis than non-smokers, without showing any obvious detrimental effect on classic hematological parameters.

Predicting Sensationalism in Suicide Story Headlines.

Objective: Suicide is a leading cause of death in the United States, and media publicity plays a role in suicide rates. The United States offers guidelines for the reporting of suicide. This study evaluated guideline adherence in newspaper and newswire publications covering celebrity suicide deaths. The research also assessed whether the sensationalism of article headlines could be predicted by variables reflecting nonadherent reporting. Method: Publications from 2013 to 2018 reporting on nine celebrity suicides were evaluated via content analysis. Adherence was assessed in a two-step hierarchical linear regression to determine which variables predicted sensationalism in headlines. Results: Overall adherence to reporting guidelines was moderate. Newspaper disclosure of suicide method only, suicide method and location, and note contents significantly predicted headline sensationalism in the first regression model, R2 = 22%. The sensationalism in the body of the article and other variables additionally predicted headline sensationalism in the second regression model, R2 = 55%. Limitations: This study is limited to celebrity suicide reporting and may not reflect media reporting trends of noncelebrity suicide deaths. Conclusion: Findings reveal that sensationalism in the body of the article and other variables uniquely contributed to sensationalism in newspaper headlines. This suggests that the public could be at risk for reading harmful content not consistent with reporting recommendations about suicide because of the initial attraction to sensational headlines.

(365) Understanding Suicide Trends Among Floridian Males; An Essential Component of a Men’s Health Initiative

Abstract Introduction Collecting regional health data is imperative to guide the planning and implementation of programs and policies that will ultimately improve men’s health. Suicide is a leading cause of mortality among males of all age groups within the United States. Understanding the demographics of male suicide, as well as age, racial, and ethnic disparities is critical in developing targeted solutions to this devastating problem. Objective The objectives were to identify the magnitude of male suicide within the State of Florida in terms of overall incidence. Additionally, we sought to identify age, racial, and ethnic disparities within the state, as well as any potential trends in these variables. A description of the various disparities of the modality used to commit suicide was of interest, as well. Methods Data was obtained from the United States Census Bureau, the State Department of Health, and the Center for Disease Control and Prevention. Included within a number of reports prepared by these organizations were demographic data on population size, age, race, and ethnicity within our state. The Florida Department of Health provided health indicator data from several different sources, which included death certificates and results from the 2015 and 2019 Behavioral Risk Factor Surveillance Survey (BRFSS). The BRFSS is an annual random sample, state-based, telephone survey used to collect data from Florida residents regarding individual health practices and risk behaviors. Finally, we used the Centers for Disease Control and Preventions’ National Center for Health Statistics Mortality in the United States Report to obtain life expectancy at birth data in Florida and in the US by both race and sex. Causes of death for suicide were coded based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Comparative data was developed in the context of age, race/ethnicity, and mechanism of suicide. Results Suicide is the 4th leading cause of death in Floridian men ages 18-54, accounting for 1,700 deaths annually. Floridian males have more than three times the rate of suicide deaths compared to females. In 2021, non-Hispanic and White men had the highest suicide death rate per 100,000 individuals at 24.3 and 24 respectively compared to Black men at 10.3. (see Figure 1). In 2021, firearms were used in the majority of suicide deaths across the state and all age groups, accounting for 63%. Suffocation accounted for 21%, followed by poisoning at 8%. Conclusions This study corroborates national data suggesting that suicide is a major health problem that preferentially impacts males. Racial, ethnic, and geographic health disparities among Floridian males exist as demonstrated by accumulated data on suicide death rates. This data is extremely important for Men’s Health experts to recognize and understand. A continued focus on strengthening data and research on suicide is needed to provide prevention initiatives and strategies targeted towards these vulnerable populations. Disclosure No.

Cost-effectiveness of system-level mental health strategies for young people in the Australian Capital Territory: a dynamic simulation modelling study

Regional mental health planning is a key challenge for decision makers because mental health care is a complex, dynamic system. Economic evaluation using a system dynamics modelling approach presents an opportunity for more sophisticated planning and important evidence on the value of alternative investments. We aimed to investigate the cost-effectiveness of eight systems-based interventions targeted at improving the mental health and wellbeing of children, adolescents, and young adults in the Australian Capital Territory (ACT). We assessed eight interventions for children and young people (aged ≤25 years) with low, moderate, and high-to-very-high psychological distress: technology-enabled integrated care, emergency department-based suicide prevention, crisis response service, family education programme, online parenting programme, school-based suicide prevention programme, trauma service for youths, and multicultural-informed care. We developed a system dynamics model for the ACT through a participatory process and calibrated the model with historical data, including population demographics, the prevalence of psychological distress, and mental health services provision. We calculated incremental cost-effectiveness ratios compared with business as usual for cost (AU$) per: quality-adjusted life-year (QALY), suicide death avoided, self-harm related hospital admissions avoided, and mental health-related emergency department presentation, using a 10-year time horizon for health-care and societal perspectives. We investigated uncertainty through probabilistic sensitivity analysis and deterministic sensitivity analysis, including using a 30-year timeframe. From a societal perspective, increased investment in technology-enabled integrated care, family education, an online parenting programme, and multicultural-informed care were expected to improve health outcomes (incremental QALYs 4517 [95% UI -3135 to 14 507] for technology-enabled integrated care; 339 [91 to 661] for family education; 724 [114 to 1149] for the online parenting programme; and 137 [88 to 194] for multicultural-informed care) and reduce costs ($-91·4 million [-382·7 to 100·7]; $-12·8 million [-21·0 to -6·6]; $-3·6 million [-6·3 to 0·2]; and $-3·1 million [-4·5 to -1·8], respectively) compared with business as usual using a 10-year time horizon. The incremental net monetary benefit for the societal perspective for these four interventions was $452 million (-351 to 1555), $40 million (14 to 74), $61 million (9 to 98), and $14 million (9 to 20), respectively, compared with business as usual, when QALYs were monetised using a willingness to pay of $79 930 per QALY. Synergistic effects are anticipated if these interventions were to be implemented concurrently. The univariate and probabilistic sensitivity analyses indicated a high level of certainty in the results. Although emergency department-based suicide prevention and school-based suicide prevention were not cost effective in the base case (41 QALYs [0 to 48], incremental cost $4·1 million [1·2 to 8·2] for emergency department-based suicide prevention; -234 QALYs [-764 to 12], incremental cost $90·3 million [72·2 to 111·0] for school-based suicide prevention) compared with business as usual, there were scenarios for which these interventions could be considered cost effective. A dedicated trauma service for young people (9 QALYs gained [4 to 16], incremental cost $8·3 million [6·8 to 10·0]) and a crisis response service (-11 QALYs gained [-12 to -10], incremental cost $7·8 million [5·1 to 11·0]) were unlikely to be cost effective in terms of QALYs. Synergistic effects were identified, supporting the combined implementation of technology-enabled integrated care, family education, an online parenting programme, and multicultural-informed care. Synergistic effects, emergent outcomes in the form of unintended consequences, the capability to account for service capacity constraints, and ease of use by stakeholders are unique attributes of a system dynamics modelling approach to economic evaluation. BHP Foundation.

Suicide death, suicidal ideation and suicide attempt in patients with diabetes: A systematic review and meta-analysis.

Diabetes has been indicated to be a risk factor for suicide. We aim to estimate the prevalence of suicide in patients with diabetes. A meta-analysis using PRISMA methodology was adopted to examine the incidence of suicide in diabetic patients. From inception to October 2022, three online databases (PubMed, China National Knowledge Infrastructure and Web of Science) were used to search studies. We used random-effects model to analysis. And our primary outcome was the incidence of suicide death per 100 person-years, and other outcomes were prevalence of suicidal ideation and suicide attempt. To explore the sources of heterogeneity in our study, we performed subgroup and meta-regression analyses. The suicide death rate in diabetic patients was 0.027 per 100 person-years, with a higher rate for Type 1 Diabetes Mellitus compared to Type 2 Diabetes Mellitus. The prevalence of suicidal ideation in diabetes patients was 0.175, with a higher prevalence in Type 1 Diabetes Mellitus compared to Type 2 Diabetes Mellitus. The prevalence of suicide attempts in diabetes patients was 0.033, indicating a higher rate for Type 2 Diabetes Mellitus compared to Type 1 Diabetes Mellitus. The results indicate a high rate of suicide among people with diabetes, and this study identifies populations and regions at high risk for suicide. Our review emphasizes interventions in mental health and the improvement of suicide prevention programmes. The study investigated suicide death, suicidal ideation and suicide attempt in diabetic individuals. Suicide rates are elevated among diabetic patients, and various patient groups face distinct suicide risks. It is important to prioritize the mental well-being of diabetic individuals and enhance interventions, including personalized approaches, to inform public health efforts aimed at preventing and addressing suicide among diabetic patients. No patient or public involvement.

Kala Pathar (Paraphenylenediamine): the Frequent and fatal poisoning

Pakistan doesn't keep exact records of deaths or suicides because it doesn't have any vital records. The world's average suicide death rate for both men and women in 2017 was 9.98 per 100,000 people. In Pakistan, the projected age-adjusted suicide rate is 4.4 per 100,000 people. Three countries that are close by have suicide death rates of 13.33, 5.73, and 7.55 per 100,000 people, respectively. Recent statistics show that self-harm is becoming a major public health issue in Pakistan, even though the estimated rate is still low1. About 96% of the people who live in Pakistan are Muslims. Like most major faiths, Islam says that suicide is a sin that can't be forgiven. This could be a big reason why people don't commit suicide, as shown by the fact that rates are usually much lower in Muslim countries than in non-Muslim countries. Because of religious beliefs,

Lethal means counseling can help prevent suicide by firearms

Pointing to the need for effective suicide risk screenings by health care professionals, especially given that more than half of suicide deaths in 2022 involved firearms, a new article published Jan. 23 by The Pew Charitable Trust addresses the need for lethal means counseling for people at risk of suicide and with access to guns.

Research, practice, and data informed investigations of child and youth suicide: A science to service and service to science approach

Background: Suicide rates for children and adolescents have been increasing over the past 2 decades. In April 2023, the National Institute of Mental Health (NIMH) convened a two-day workshop to address child and youth suicide. Purpose: The workshop focus was to discuss the state of the science and stimulate a collaborative response between researchers, death investigators, and data collection teams to build a science to service and service to science approach toward understanding - and ultimately preventing – this growing problem of child and youth suicide. Highlights: Topics that meeting participants highlighted as worthy of further consideration for research and practice were: increasing awareness among death investigators, medical examiners, and coroners that child suicide deaths under age 10 years do occur and should be investigated and documented accordingly; emphasizing the value of science based protocols for child and youth death investigations to enhance consistency of approaches; and articulating needs for postvention services to suicide loss survivors. Outcomes: The importance of collecting an accurate and complete cause and manner of death (i.e., unintentional, suicide, homicide, undetermined) among all child decedents, and demographic information such as race, ethnicity, and sexual/gender minority status was underscored as critical for enhanced surveillance. For prevention efforts, approaches to assessing and understanding suicidal thoughts and behaviors among diverse groups of children, and the variability in proximal and distal risk factors are needed to inform opportunities for preventive interventions for diverse communities. The need for consistent measures and processes to improve death investigations, fatality review committees, and coordination between data collection systems and agencies was also raised. Practical applications: Collaborations among researchers, death investigators, and data collection teams can help to fully describe the child and youth suicide crisis and provide actionable information for new research, and prevention and response efforts.

Supports for university counselors impacted by student suicide: A systematic review and thematic synthesis

The purpose of this systematic review and thematic synthesis was to identify and consolidate research on the support needs of impacted Higher Education (HE) counselors that have experienced a student suicide death. When exposed to a student suicide death, counselors are often extensively involved in a postvention response. This systematic review synthesized four qualitative papers that explored the experiences of staff impacted by student suicide. Thematic synthesis revealed three core themes: The unknown, responding, and the known, and six subthemes: Gaps in knowledge of individual experience, gaps in knowledge of organizational impact, extrospective responding, introspective responding, the needs of impacted counselors, the degree of impact, and the support processes that arise from needs. The results provide a summary of the current supports available to impacted HE counselors and considerations relevant to their postvention needs.

Predicting suicide death after emergency department visits with mental health or self-harm diagnoses

ObjectiveUse health records data to predict suicide death following emergency department visits. MethodsElectronic health records and insurance claims from seven health systems were used to: identify emergency department visits with mental health or self-harm diagnoses by members aged 11 or older; extract approximately 2500 potential predictors including demographic, historical, and baseline clinical characteristics; and ascertain subsequent deaths by self-harm. Logistic regression with lasso and random forest models predicted self-harm death over 90 days after each visit. ResultsRecords identified 2,069,170 eligible visits, 899 followed by suicide death within 90 days. The best-fitting logistic regression with lasso model yielded an area under the receiver operating curve of 0.823 (95% CI 0.810–0.836). Visits above the 95th percentile of predicted risk included 34.8% (95% CI 31.1–38.7) of subsequent suicide deaths and had a 0.303% (95% CI 0.261–0.346) suicide death rate over the following 90 days. Model performance was similar across subgroups defined by age, sex, race, and ethnicity. ConclusionsMachine learning models using coded data from health records have moderate performance in predicting suicide death following emergency department visits for mental health or self-harm diagnosis and could be used to identify patients needing more systematic follow-up.

Perceptions of Suicide among Pakistanis: Results of an Online Survey

Objective In Pakistan, a predominantly Muslim country, information on the patterning of suicidal thoughts and behaviors, as well as associated public perceptions and opinions, is limited. We sought to advance knowledge on suicide and self-harm in Pakistan with a large, online survey. Method Leveraging results from a twelve-item online survey (N = 5,157) circulated by the largest English language newspaper in Pakistan, we assessed personal experiences, opinions, and attitudes toward help-seeking in the context of suicide. We calculated proportions with 95% confidence intervals for endorsed responses and implemented binomial generalized linear models with odds ratios to assess differing response tendencies by age, gender, and urban/rural residence. Results Personal experiences related to suicide and self-harm as well as encounters in social circles were common. Mental illness tended to be recognized as a high likelihood contributor to suicide death over and above nonviolent interpersonal problems. Most considered suicide a way to escape pain, and few considered suicide to be immoral. Barriers to help-seeking included social deterrents, inaccessibility, and unaffordability. Women and youth emerged as higher risk groups, though the status of rural Pakistanis remained unclear. Conclusion The survey provides a preliminary basis for considering the unique experiences and perspectives of the public in shaping suicide prevention and intervention efforts in Pakistan.

A Study on Pattern of Suicidal Deaths Brought for Medicolegal Autopsy at Mortuary of Siddhartha Medical College and Govt. General Hospital, Vijayawada, Andhra Pradesh

Background: The aim is to study the pattern of suicidal deaths, demographic profile including various contributary factors of victims and analyze the magnitude of deaths in and around Vijayawada part of Andhra Pradesh so that preventive measures can be set up to avoid such situation. A death by suicide is defined as the deliberate termination of life. For a death to be a suicide, it should be an un-natural death, the desire to die should originate within the person, and there should be a reason for ending their life, according to the National Crime Records Bureau. While India’s suicide rate of 14.04/lakh population in 2019 puts it at 49th rank globally, the grim reality of the highest numbers of suicides being reported annually from India cannot be overlooked. When you look at suicide deaths, the highest suicide rates are in the south. In central India, including Maharashtra, Madhya Pradesh and Rajasthan, you have “middling suicide rates”, and the rate falls up north, in Uttar Pradesh and Bihar.Material & Methods: A five years retrospective and cross-sectional study was conducted in Forensic Medicineand Toxicology Department, Siddhartha Medical College, Vijayawada, Andhra Pradesh. All the autopsiesconducted on victims of suicidal deaths during the period from Jan, 2016 to Dec, 2020 were studied from theavailable data. Inclusion criteria includes all the suicidal deaths due to poisoning, hanging and self-immolation by burns. Exclusion criteria includes suicidal deaths from causes other than poisoning, hanging and suicidal burns like drowning, electrocution, fall from height etc.Results: It is clear that committing suicide by consuming poison accounts for major number of deaths followed by committing suicide by hanging and least followed by committing suicide by self-immolation. It is also clear that committing suicides has increased year by year from 2016 to 2020 irrespective of committing suicide by hanging, poisoning. Coming to sex pattern, suicide by hanging was observed more in males. Sex pattern in suicidal deaths due to poisoning clearly showed that females outnumbered males. Sex pattern in suicidal deaths due to self-immolation clearly showed that females outnumbered males with high margin. Coming to the age pattern in committing suicidal deaths by hanging, 30 – 45 years age group showed highest incidence year by year followed by 45 – 60 years and least among 15 – 25 years age group. Where as in case of suicidal deaths by poisoning and self-immolation, incidence was highest in 30 – 45 age group followed by 15 – 30 years age group and least among 45 – 60 years group.
 Conclusion: According to the World Health Organization, in India, suicide is an emerging and serious publichealth issue. Suicide rates in India have been rising over the past five decades. India’s contribution to globalsuicide deaths increased from 25.3% in 1990 to 36.6% in 2016 among women, and from 18.7% to 24.3% among men. In 2016, suicide was the most common cause of death in both the age groups of 15–29 years and 15–39 years in India. Factors such as frustration, family problems, love affairs, poverty, harassment, sexual violence, social boycott, chronic diseases and bankruptcy were studied as the main reasons leading to committing of suicides in people.The need for a strategy which will raise awareness and help make suicide prevention a national priority has to be recognized. Such a national strategy will need a comprehensive approach that encompasses the promotion,coordination, and support of activities to be implemented across the country at national, regional, and local levels.The program would need to be tailored for populations at risk.

Institutional Failures as Structural Determinants of Suicide: The Opioid Epidemic and the Great Recession in the United States.

We investigate recent trends in U.S. suicide mortality using a "structural determinants of health" framework. We access restricted-use multiple cause of death files to track suicide rates among U.S. Black, White, American Indian/Alaska Native, and Latino/a men and women between 1990 and 2017. We examine suicide deaths separately by poisonings and nonpoisonings to illustrate that (1) women's suicide rates from poisonings track strongly with increases in prescription drug availability and (2) nonpoisoning suicide rates among all adult Americans track strongly with worsening economic conditions coinciding with the financial crash and Great Recession. These findings suggest that institutional failures elevated U.S. suicide risk between 1990 and 2017 by increasing access to more lethal means of self-harm and by increasing both exposure and vulnerability to economic downturns. Together, these results support calls to scale up to focus on the structural determinants of U.S. suicide.