Suicide Prevention Measures Research Articles

Changes in the epidemiological profile of suicide in Hong Kong: a 40-year retrospective decomposition analysis.

The suicide rate in Hong Kong has increased significantly over the past four decades. Population subgroups such as the elderly or economically-distressed are reported to be more vulnerable than others to suicidal behaviors, while changing suicide methods (such as charcoal burning which emerged in 1998), has also contributed significantly to increasing suicide rates. However, the extent of the contribution of different factors to changes in suicide rate remains unclear. This paper reported on a decomposition analysis of the epidemiological profile of suicide in Hong Kong between 1976 and 2015, specifically considering factors underlying the increasing suicide rate over this period. Completed death registry information was available from the Census and Statistics Department of the Hong Kong SAR for this investigation. We compared absolute and relative contributions of gender, age and suicide method to rate changes over time. Changes in suicide rate were generally underpinned by more than one factor. Population aging in a rapidly-aging city contributed significantly to suicide rate increases, whilst jumping from a height had the greatest influence on rate changes throughout the study period. Suicides by male aged 25–34 years and 45–54 years were more likely to be triggered by economic factors, compared with the other gender-age subgroups. The decomposition approach provided a comprehensive understanding about how socioeconomic factors and suicide methods interacted to influence over-time suicide patterns. This research supports development of more focused suicide prevention measures to reduce suicide rate.Supplementary InformationThe online version contains supplementary material available at 10.1007/s42379-021-00087-5.

Railway Suicide in The Netherlands Lower Than Expected.

. Background: Increasing rail transportation requires appropriate railway suicide preventive measures. Aims: The investigation of trends in railway suicide during 2008–2018, a period in which preventive measures were taken by Dutch railway infrastructure manager ProRail. Methods: Generalized linear regression models for railway suicide were developed for the period 1970–2007 with general suicide rate, railway traffic intensity, and a combination of these variables as regressors. Subsequently, the best-fitting model was used to investigate trends in railway suicide after 2007 by comparing in retrospect observed values with the expected outcomes of the regression model. Results: An adequate regression model for railway suicide was obtained using both general suicide rate and railway traffic intensity as regressors. Based on this model, while national suicide mortality and railway traffic increased, a distinct relative decline in railway suicides was found from 2012 onward. Conclusions: This decline of railway suicides in the Netherlands may indicate that preventive measures taken by ProRail were effective and prevented around 85 railway suicides annually, a reduction of 30%.

Improvement of Medication Adherence in Psychiatry and Mental Health Literacy Education

In Japan, the number of patients with mental illness is increasing; therefore, the need for national measures, such as suicide prevention measures and measures against alcohol health disorders, and multiple social concerns and needs, such as depression and dementia problems, are increasing. As such, measures for mental health are emphasized. Mental health is a common issue; however, there is still prejudice regarding mental illness, and its understanding and awareness by local residents and medical staff need to be improved. The author introduced a medication self-management module in the psychiatric ward to improve medication adherence, and constructed a program for mental health literacy education in the faculty of pharmacy. This paper outlines these studies.

Suicidal behaviour and the coronavirus (COVID-19) pandemic: Insights from Durkheim's sociology of suicide.

Whilst suicide is well established as a critical global public health burden causing around 800,000 deaths annually along with many more attempts, there is a concern that the impact of the coronavirus (COVID‐19) pandemic might intensify suicidality. The purpose of this study is to draw attention to the budding correlation between the COVID‐19 pandemic and suicidality from the theoretical perspective of Emile Durkheim's sociology of suicide. A review of online newspaper databases (1 January to 30 April 2020) that reported suicide cases and attempts triggered as a result of the disruptions caused by the COVID‐19 pandemic were included and analysed. Out of the 28 identified cases, there were three suicide attempts, one homicide‐suicide/pact‐suicide, and 24 suicides spanning 10 countries. Durkheim explained the social causation of suicide and provided a four‐fold suicide typology. The cases were analysed according to their appropriate typology, and classified as egoistic (9), altruistic (3), anomic (8), and fatalistic (8). Durkheim suggests that the rise and fall of suicide rates will depend on the nature of social change. As society is undergoing massive social disruption resulting from the COVID‐19 pandemic, suicide rates may increase unless suicide prevention measures align with the current social reconstruction process.

Impact of COVID-19 lockdown on suicide attempts : Aretrospective analysis of the springtime admissions to the trauma resuscitation room at the Medical University of Vienna from 2015-2020.

BackgroundIn response to the current coronavirus disease 2019 (COVID-19) pandemic the Austrian government issued a lockdown from 16 March to 15 May 2020. As periods of economic and emotional burden have proven to detrimentally affect people’s psychological health, healthcare officials warned that the strict measures could have a serious impact on psychological health, leading to an increase in suicide attempts. Thus, the objective was to provide evidence for this assumption.MethodsAll adult patients admitted to the trauma resuscitation room of the Medical University of Vienna during the lockdown period following a suicide attempt were included in this analysis, forming the study group. Suicidal patients treated during the same period in 2015, 2016, 2018, and 2019 were pooled to create the control group. The year 2017 was excluded because another major hospital in Vienna was partially closed due to a change in infrastructure, resulting in an increased number of severely injured patients treated at our department. As the lockdown caused a markedly decreased number of patients admitted due to other reasons than suicide the actual number was replaced with the average number of patients admitted in the relevant previous 4 years.ResultsBy comparing the study and the control group based on this realistic estimate we revealed an increase in attempted suicides during the lockdown period (p = 0.001). Demographic, mental health-related, and injury specific patient data did not differ between the groups.ConclusionThe results strongly urge for an improvement in crisis intervention and suicide prevention measures in the event of a future lockdown.

Suicide prevention in Japan: Government and community measures, and high-risk interventions.

Suicide is one of the most critical issues worldwide. In Japan, more than 30 000 people died by suicide every year between 1998 and 2011, and the Japanese government, local governments, and various other agencies have been working on suicide prevention programs to reduce the suicide rate. While the number of suicides is still high (more than 20 000 per year), many specialists are striving to further reduce the number of suicides in Japan. The Japanese government has played a central role in suicide prevention through the enactment of several laws, and in recent years, suicide prevention has shifted from government to community-specific measures. This review discusses the suicide prevention measures that have been taken so far: (1) policy strategies for suicide prevention by the Japanese government, (2) community suicide prevention, and (3) strategic studies for suicide prevention. Finally, as shown in the ACTION-J study, we conclude that cooperation among related organizations in the community, not just one institution, is important for future suicide prevention, especially youth suicide prevention.

The role of the construction project manager in developing a culture of suicide prevention

The construction industry is the most significant occupational contributor to suicide rates worldwide. This is credited to strenuous working conditions, lack of awareness in mental health culture, but more so, that help-seeking is seen as a weakness. This study aims to investigate the role of the construction project manager in creating a culture of suicide prevention on-site. This is achieved through delving into the principles of culture creation within differing industries, with adaptations for construction managers, through a comparative analysis of culture creation literature. Twenty-two interviews with employees are undertaken. Representative data gathered are analysed and presented, to highlight the levels of knowledge, barriers and proposed solutions, for construction project managers. Results are broken down into ‘awareness of and openness to discussing suicide prevention’, ‘barriers to the adoption of suicide-prevention measures’ and ‘proposed solutions to the adoption of suicide-prevention measures’. The interviews give an insight into the acceptance of the need for stronger mental health support structures, without necessarily any regard for the method of their implementation. The originality and subsequent value in the research are the proposed use of construction project managers as the conduit in beginning to address and, as a result, develop a culture of suicide prevention on-site.

Assessing the Quality of Suicide Reporting in Online Newspapers in Uttar Pradesh, India, According to World Health Organization Guidelines.

Background: Sensitive media reporting has an important role in suicide prevention. However, there is no research on the quality of media reporting of suicide in newspapers of Uttar Pradesh (UP), India. Aim: The present study aimed to assess the quality of newspaper reports of suicide against the World Health Organization (WHO) reporting guidelines. Method: Suicide news content of four purposively selected newspapers published between March 1, 2019 and February 29, 2020, were scrutinized. A total of 501 news reports from UP were included. Results: The most commonly reported attribute was the gender of the deceased and the method of suicide. Almost half of the newspapers reported the occupation of the deceased in the title. Mental illness was attributed as a cause of suicide among 23.75% of the news reports. Less than 2% of the news reports referred to expert opinion, research evidence, national or global statistics on suicide, suicide prevention measures, or information about suicide helpline. There was a significant difference in the quality of reporting between the vernacular newspapers and English dailies. Limitations: Only four online newspapers were analyzed retrospectively. Conclusion: The quality of media reporting of suicide in UP is found to be poor despite its negative effect on suicide.

Association of Selected Area-Level Indicators With Suicide Mortality in Slovenian Municipalities.

Background: With an average suicide rate of 20 per 100,000 in the last decade, Slovenia is above the EU average. There are considerable regional differences in suicide mortality within the country. Aim: We aimed to investigate the relationship between selected indicators at area level and the suicide rate in Slovenian municipalities. Method: Sociodemographic, socioeconomic, and (mental) health data in the years 2012-2016 were analyzed for 212 municipalities. Robust correlation and regression analyses were performed to determine the relationship between different variables and the suicide rate. Results: The suicide rate was positively associated with the percentage of male inhabitants, the high social cohesion in the neighborhood, and the number of sick leave days per capita. It was negatively related to the net income per capita, the marriage rate, the divorce rate, and the availability of professional mental healthcare services. Limitations: The small suicide frequencies within municipalities constitute a limitation of the study. Conclusion: Factors at local, municipal level can be linked to the risk of suicide. In Slovenia, neighborhood cohesion is one of the factors that should be considered when designing suicide prevention measures in a community.

Do online media adhere to the responsible suicide reporting guidelines? A cross sectional study from India.

The content and nature of media reports could influence suicide prevention measures. To evaluate contemporary online media reports' compliance with guidelines for responsible reporting of suicidal acts from Indian resources. We included English and Hindi articles for reports concerning suicide, published by local and national media sources for 30 consecutive days from the day of death of a celebrity by alleged suicide. The search was performed in Google News with predefined search queries and selection criteria. Two independent investigators did data extraction. Subsequently, each news report was assessed against guidelines for the responsible reporting of suicide by the WHO and the Press Council of India. We identified 295 articles (Hindi n = 172, English n = 123). Results showed more than 80% of the media reports deviated from at least one criterion of the recommendations. A maximum breach was seen in the news article's headlines, sensational reportage and detailed suicide methods description. Significant differences were seen in the quality of English and Hindi reporting and reporting celebrity and noncelebrity suicide. Additional items revealed were reporting suicide pacts, linking multiple suicides in a single news report, allowing user-generated threads and linking Religion and suicide. Measures are required to implement reporting recommendations in the framework of a national suicide prevention strategy.

The indicators associated with increasing suicide trends: Need for harmony in discussing suicide in legal medicine and other fields.

Each year in Japan from 1990 to 1997, approx. 21,000-24,000 individuals committed suicide. In 1998, the number of suicides increased to >30,000, and a trend of high suicide numbers then persisted for >10 years. Although Japan's annual number of suicides has recently been decreasing, it remains among the highest worldwide. Herein, we assessed the annual suicide data (numbers and rates) related to three economic and life indicators: (1) the difference between actual income and consumer spending of one average month per year in one household, (2) the annual difference between exports and imports, and (3) the annual total debt determined by statistical analyses for both sexes/males/females during the 40-year period from 1979 to 2018 in Japan. Our findings indicated that [1] total debt may be associated with both the number of suicides and the suicide rate for both sexes, for males, and for females, and [2] the difference between actual income and consumer spending may be associated with both the number of suicides and the suicide rate only in females. These findings revealed factors that are clearly suicide-related, and it is necessary to design suicide prevention strategies based on the factors. Relevant public and private entities should become aware of the involvement of both debt and the difference between income and spending in suicide trends as they plan suicide prevention measures. Further analyses of suicide data should be performed in a wide range of fields including legal medicine, toward a greater understanding of suicide risk factors.

Public Policies for making the right to life effective: The problem of suicide at ‘Third Bridge'

Abstract The World Health Organization (WHO) recognizes suicide as a public health priority. According to the same, between 2010 and 2016 the suicide rate in Brazil increased about 7%, in contrast to the world index, wich fell 9,8%. In the state of Espírito Santo - ES (estimated population of 4 million people), the number of suicide events reached 233 in 2018, the highest rate ever recorded by Datasus Mortality Monitoring Panel to the state. Suicides on public venues are noteworthy. According to data from the Rodovia do Sol Concessionaire (Rodosol), in 2018 about 41% of suicides in this state occured in metropolitan region of Vitória (estimated population of 2 million people). In Deputado Darcy Castello de Mendonça bridge, popularly known as Third Bridge, 71 attemps were counted, of wich 7 culminated in suicide. As a point of concern, this bridge, main link between the cities of Vitória and Vila Velha, has a contingency plan for emergency and crisis situations since 2016, in addition to cameras monitored by a prepared team that work together with a firefighter's team allocated near the bridge to intervene at any time of the day. The monitoring of the situation makes it possible to verify that, since 1999, the suicides that have occurred add up to lower rates in relation to the attempts. However, there was an increase of approximately 44% in the number of people who attempted suicide in the period from 2015 to 2018. Knowing that interventions to prevent suicide include reducing access to lethal means, it stands out that in 2019 a plan to build a protection net in Third Bridge was approved by the government. These strategies, combined to provided health care from the State Hospital of Clinical Attention and suicide preventive measures from public healthcare system SUS, are in accordance with Brazilian's public health policies. It is a recognition, by the state, that the life of the individual has a public significance, and should be protected even from the individual itself. Key messages Interventions to prevent suicide must include reducing access to lethal means, that is knowingly a highly effective preventive practice and is responsibility of public policies of a country/state. Knowing that life has a public and political dimension, the suicide barrier implementation is necessary for the State to fulfill its duty to protect the life of the citizen.

#UsapTayo: Utilizing Tweetchat for Mental Health Advocacy in the Philippines

Abstract Mental health remains a public health concern across countries. It is estimated that 1 in 4 people will be affected by mental or neurological disorders at some point in their lives. In the Philippines, about 3 million Filipinos live with depression. Mortality rate for suicide is 3.2 per 100,000 population. Meanwhile, social media use remains high in the country with 76 million users in 2019. It is thus important to explore potential ways in maximizing social media for mental health advocacy. From January 1 to December 31, 2019, a mental health tweetchat “#UsapTayo” (direct Filipino translation of WHO's #LetsTalk) was observed every 10th, 20th, 30th of the month from 7:00 to 8:00 PM. #UsapTayo aimed to answer how effective social media platforms like Twitter in promoting mental health awareness and education among Filipino Twitter users. Engagements and impressions from users were measured using Symplur, a healthcare hashtag analytics platform. From January to December 2019, a total of 4,626 users participated in the tweetchat. Impressions for the year reached 52 million with an average of 4.75 million impressions per month. Engagements and impressions were recorded highest in the month of September with 1,169 users and 8.74 million, respectively. Overall, the tweetchat #UsapTayo was able to generate 14,385 tweets for the complete calendar year with suicide prevention identified as the most discussed topic among Filipino Twitter users. Given the country's high social media penetration rate at 71% with Twitter ranking as the second most frequently used social media, leveraging this platform improves access to information and helps in normalizing conversations on mental health. #UsapTayo then partnered with #ThereIsHelp, a project initiated by Twitter to create safer spaces online through integration of suicide prevention measures. It was also recommended convening a multistakeholder consultation to develop a national mental health promotion and communication plan. Key messages Innovative platforms in social media like tweetchat can be leveraged to promote safer digital space for mental health and to strengthen online effort for suicide prevention especially among youth. It is important to maximize the use of social media platforms for mental health advocacy particularly suicide prevention given the Philippines’ high penetration rate and access to social media.

Does Suicide Prevention Work

To address the question of whether suicide prevention measures help to ameliorate the dramatic rise in the U.S. suicide rate (NEJM JW Psychiatry Jun

Self-esteem and Frustration of Youth Impact on Suicidal Ideation

이 연구는 자아존중감과 좌절감이 청소년들의 자살생각에 미치는 요인 탐색하기 위해 연구가 진행되었다. 본 연구대상은 G시 소재 청소년 689명이었다. 조사도구로는 자아존중감척도, 좌절인내력척도, 자살생각척도를 사용하였고, 분석방법으로는 t-검증, 상관분석, 중다회귀분석을 실시하였다. 본 연구의 결과를 살펴보면 첫째, 성별에 따라 자아존중감, 좌절감, 자살생각 등이 유의미한 차이가 있는 것으로 나타났다. 둘째, 자아존중감이 청소년의 자살생각에 유의미한 영향을 미치고 있었다. 셋째, 좌절감이 청소년들의 자살생각에 유의미한 영향을 미치는 것으로 나타났다. 끝으로 본 연구를 통해 청소년들의 자살요인과 자살 예방대책을 마련하는 데 시사점을 논의하였다.In this study, a study was conducted to explore the factors that affect Self-esteem and Frustration on Youth s Suicidal Ideation. The subjects in this study were 689 Youth s in G city. The Self-esteem scale, the Frustration endurance scale, and the Suicidal Ideation scale were used as the survey tools, and t-test, correlation analysis, and multiple regression analysis were used as the analysis method. Looking at the results of this study, first, according to the gender. Self-esteem and Frustration were found to have a significant correlation with Youth s Suicidal Ideation. Second, Self-esteem was found to have a significant effect on Youth s Suicidal Ideation. Third, it was found that Frustration had a significant effect on Youth s Suicidal Ideation. Through this study, the implications of Youth s Suicide factors and Suicide prevention measures were discussed.

Análise epidemiológica do suicídio na Região Nordeste do Brasil no período de 2014 a 2018

Realizar uma análise epidemiológica do suicídio na região nordeste do Brasil no período entre 2014 e 2018. Trata-se de uma pesquisa epidemiológica, documental, retrospectiva, de caráter descritivo, com abordagem quantitativa sobre taxas de suicídios encontradas na região nordeste do Brasil no período entre 2014 e 2018. Os dados foram obtidos no Sistema de Informações no banco de dados oficial do SINAN, do Departamento de Informática do Sistema Único de Saúde (DATASUS). Observou-se que a prevalência de óbitos registrados por suicídio segundo a faixa etária ocorre em indivíduos de 30 a 39 anos, havendo um incremento significativo nas idades de 15 a 19 anos. Ficou evidenciado que o sexo masculino cometem mais atos autolesivos do que o sexo feminino e quanto ao estado civil, o indivíduo solteiro e de baixa escolaridade se destaca como maior número de óbitos por esta causa. Evidenciou-se a necessidade urgente de medidas de prevenção do suicídio, pois como há uma tendência de aumento a cada ano, a intervenção precoce surge com o intuito de proteção da vida e dos danos por ele causados.

Two-day assertive-case-management educational program for medical personnel to prevent suicide attempts: A multicenter pre-post observational study.

Suicide attempters have a high risk of repeated suicide attempts and completed suicide. There is evidence that assertive case management can reduce the incidence of recurrent suicidal behavior among suicide attempters. This study evaluated the effect of an assertive-case-management training program. This multicenter, before-and-after study was conducted at 10 centers in Japan. Participants were 274 medical personnel. We used Japanese versions of the Attitudes to Suicide Prevention Scale, the Gatekeeper Self-Efficacy Scale, the Suicide Intervention Response Inventory (SIRI), and the Attitudes Toward Suicide Questionnaire. We evaluated the effects with one-sample t-tests, and examined prognosis factors with multivariable analysis. There were significant improvements between pre-training and post-training in the Attitudes to Suicide Prevention Scale (mean: -3.07, 95% confidence interval [CI]: -3.57 to -2.57, P < 0.001), the Gatekeeper Self-Efficacy Scale (mean: 10.40, 95%CI: 9.48 to 11.32, P < 0.001), SIRI-1 (appropriate responses; mean: 1.15, 95%CI: 0.89 to 1.42, P < 0.001), and SIRI-2 (different to the expert responses; mean: -4.78, 95%CI: -6.18 to -3.38, P < 0.001). Significant improvements were found on all Attitudes Toward Suicide Questionnaire subscale scores, except Unjustified Behavior. The effect of training was influenced by experience of suicide-prevention training and experience of working with suicidal patients. The training program (which was developed to implement and disseminate evidence-based suicide-prevention measures) improved attitudes, self-efficacy, and skills for suicide prevention among medical personnel. Specialized suicide-prevention training and experience with suicidal patients are valuable for enhancing positive attitudes and self-efficacy; furthermore, age and clinical experience alone are insufficient for these purposes.

Hardiness in aspects of suicidal prevention (Literature review)

The review is devoted to the hardiness of the individual as a factor of specifi c protection, potentially capable of reducing the risk of developing suicidal behavior. The development of the concept of “hardiness” and the features of its application in the subject field of suicidology are considered. ”Hardiness” is understood as a key personality variable that mediates the influence of stressful factors (including chronic ones) on somatic and mental health, as well as on the success of an activity. It is hardiness that allows a person to endure the fatal anxiety that accompanies the choice of the future (uncertainty), and not the past (immutability) in a situation of existential dilemma. The source base of the study was 38 publications. High agreement was noted between the authors that hardiness is an important protective factor for the emergence of suicidal ideations, performs a buffer (antisuicidal) role in a situation of distress, and is part of the normative functions of the human adaptation system. The significance of the contribution of certain parameters of hardiness to the protection of anti-vital and suicidal behavior can vary individually and socioculturally. The linear nature of the influence of the components of the phenomenon of hardiness on the likelihood of anti-vital and suicidal behavior seems relative. Significant for the development of suicide prevention measures are evidence that suicidal risk is associated with a weakening of reserves of hardiness, and a decrease in this risk is possible by strengthening the potential of hardiness through targeted psychosocial interventions. The potential variability of the parameter “hardiness” allows us to consider it as an important target for the prevention of suicide. Keywords: suicide, suicidal behavior, hardiness, suicide prevention

Quantifying the contributions of age, sex, methods, and urbanicity to the changing suicide rate trends in South Korea, 2001–2016

Suicide rates in South Korea have been one of the highest in the world. The aim of this study is to quantify the contributions of age, sex, method, and place of residence to the trends of the suicide rates between 2001 and 2016 in South Korea. Using the suicide data obtained from the South Korean National Death Registration data set for the years 2001-2016, a Joinpoint regression analysis was conducted to determine if there was a significant change in the trend of suicide rates. Next, a decomposition analysis method was used to quantify the contributions of age, sex, method, and places of residence to the changes in the suicide rates. Suicide rates increased between 2001 and 2010, and decreased between 2010 and 2016. Among all the age groups, the 65-79 age group contributed most to the rise (18% in men and 7% in women) and fall (-15% in men and -14% in women) of suicide rates. Men contributed much more than women to the increasing trend of suicide rate (63.0% vs. 37.0%). Hanging was the key method of suicide, dominating the ups and downs of the suicide rates. The rates of suicide by pesticide poisoning have been decreasing since 2005 and suicide by charcoal burning continued to increase against a decreasing trend of suicide rate during the period of 2010-2016. The gap of the metropolitan-city-rural suicide rates was narrowing during the period under study, although the rural areas remained to have the highest suicide rates. The ups and downs of suicide rates in South Korea were not uniform across different sociodemographic groups. Age, sex, method, and place of residence contributed differently to the changes in suicide rates. Suicide prevention measures can be more focused on certain age-sex-method-region subgroups.

Suicide in Rural Australia: Are Farming-Related Suicides Different?

Rural Australians experience a range of health inequities—including higher rates of suicide—when compared to the general population. This retrospective cohort study compares demographic characteristics and suicide death circumstances of farming- and non-farming-related suicides in rural Victoria with the aim of: (a) exploring the contributing factors to farming-related suicide in Australia’s largest agricultural producing state; and (b) examining whether farming-related suicides differ from suicide in rural communities. Farming-related suicide deaths were more likely to: (a) be employed at the time of death (52.6% vs. 37.7%, OR = 1.84, 95% CIs 1.28–2.64); and, (b) have died through use of a firearm (30.1% vs. 8.7%, OR = 4.51, 95% CIs 2.97–6.92). However, farming-related suicides were less likely to (a) have a diagnosed mental illness (36.1% vs. 46.1%, OR=0.66, 95% CIs 0.46–0.96) and, (b) have received mental health support more than six weeks prior to death (39.8% vs. 50.0%, OR = 0.66, 95% CIs 0.46–0.95). A range of suicide prevention strategies need adopting across all segments of the rural population irrespective of farming status. However, data from farming-related suicides highlight the need for targeted firearm-related suicide prevention measures and appropriate, tailored and accessible support services to support health, well-being and safety for members of farming communities.