Suicide Prevention Plan Research Articles

Debate

In this debate the focus is on suicide which is a complex maze, wherein multiple parameters intersect. The first part of the paper questions many basic premises which have been taken as given in the discourse of suicide and currently form the substrate of conversations around suicide. The basic premise is that this societal problem has been expropriated by health professionals. They have assumed ownership without having the wherewithal to address the many contributory factors to suicide – social, economic, cultural, and moral. Suicide prevention plans are ritually rolled out despite a consistent record of repeated failures. There is a need to move against the tide and reimagine the subject in light of macrolevel evidence. The second part posits that for an issue as complex as suicide, it is important to think inclusively rather than looking for simplistic answers in either/or way, and the larger societal, economic and even political issues will need to be factored in.

Regional suicide prevention planning: a dynamic simulation modelling analysis

Background Regional planning may help to ensure that the specific measures implemented as part of a national suicide prevention strategy are aligned with the varying needs of local services and communities; however, there are concerns that the reliability of local programme development may be limited in practice. Aims The potential impacts of independent regional planning on the effectiveness of suicide prevention programmes in the Australian state of New South Wales were quantified using a system dynamics model of mental health services provision and suicidal behaviour in each of the state's ten Primary Health Network (PHN) catchments. Method Reductions in projected suicide mortality over the period 2021–2031 were calculated for scenarios in which combinations of four and five suicide prevention and mental health services interventions (selected from 13 possible interventions) are implemented separately in each PHN catchment. State-level impacts were estimated by summing reductions in projected suicide mortality for each intervention combination across PHN catchments. Results The most effective state-level combinations of four and five interventions prevent, respectively, 20.3% and 22.9% of 10 312 suicides projected under a business-as-usual scenario (i.e. no new policies or programmes, constant services capacity growth). Projected numbers of suicides under the optimal intervention scenarios for each PHN are up to 6% lower than corresponding numbers of suicides projected for the optimal state-level intervention combinations. Conclusions Regional suicide prevention planning may contribute to significant reductions in suicide mortality where local health authorities are provided with the necessary resources and tools to support reliable, evidence-based decision-making.

The impact of temporary contracts on suicide rates.

The number of suicides has increased in the last decades in several developed countries. For instance, Spain has experienced a gradual but steady increase in suicides since the 80’s and it is currently the leading external cause of death in the country. At the same time, the dualisation of the labor market, with a strong and persistent incidence of temporary contracts, has increased the instability of employment conditions. Both developments have a stronger incidence for individuals with lower levels of education. Therefore, in this paper we use rich administrative data in order to estimate the impact of the wide spread use of temporary contracts on suicides. In order to do that we exploit a reform that liberalised the use of fix-term contracts in Spain in 1984. Our results show strong long-term effects of the reform, which increased the suicide mortality rate of affected cohorts (those entering the labor market just after the liberalisation) by at least 25.3%. We believe that this result has important policy implications and should be taken into account in the design of the national suicide prevention plans.

Programming to Address Suicidal Behaviour among Unaccompanied Refugee Minors in a Camp Setting: A Field Report from Ethiopia

In response to a perceived increase in suicidal ideation and behaviour among minors and especially unaccompanied and separated children (UASC) in camps for Eritrean refugees in Ethiopia, we developed a multilayered response programme. This programme included public awareness and stigma-reduction campaigns, psychoeducation aimed at both UASC and their caregivers, capacity building for humanitarian and community partners, group and individual counselling for UASC and crisis response and postvention. We offer learnings from the development and implementation of this programme, highlighting the importance of working with relevant constructs such as grief, guilt, attachment and identity. It is our hope that our learnings will be informative and helpful to practitioners working with displaced UASC in other contexts. Recognising the heightened risk factors experienced by young people with trauma histories currently in camp settings, we recommend the coordinated development of a suicide prevention and response plan as a core component of any humanitarian response.

Nature and drivers of suicide in a rural community of Western Maharashtra

Context: The National Crime Records Bureau reports that 134,516 deaths result from suicide in India every year. Maharashtra accounts for 13.4% of the total reported suicides. Aims: This documentation study in the framework of a community mental health program (CMHP) aimed to identify local features of suicide in a rural community, namely sociodemographics and drivers of suicide. Settings and Design: The study was conducted in a community of rural Purandhar block in Western Maharashtra from January 2014 to March 2016 where a CMHP was ongoing since 2013. Data were collected as a part of process documentation through its local community health workers (CHWs). Subjects and Methods: CHWs involved in the program were interviewed, and data were analyzed manually. Results: Seventeen completed and seven attempted suicides who were not a part of the ongoing CMHP among the population were documented. Majority were men under 30 years of age. Pesticide consumption was the most common method of self-harm, and domestic strains were the major driver for suicides. Conclusions: The local pattern of suicidal behavior and its context are relevant for consideration in suicide prevention plans responsive to culture-specific features of suicide.

Development of a Self-Harm Monitoring System for Victoria.

The prevention of suicide and suicide-related behaviour are key policy priorities in Australia and internationally. The World Health Organization has recommended that member states develop self-harm surveillance systems as part of their suicide prevention efforts. This is also a priority under Australia’s Fifth National Mental Health and Suicide Prevention Plan. The aim of this paper is to describe the development of a state-based self-harm monitoring system in Victoria, Australia. In this system, data on all self-harm presentations are collected from eight hospital emergency departments in Victoria. A natural language processing classifier that uses machine learning to identify episodes of self-harm is currently being developed. This uses the free-text triage case notes, together with certain structured data fields, contained within the metadata of the incoming records. Post-processing is undertaken to identify primary mechanism of injury, substances consumed (including alcohol, illicit drugs and pharmaceutical preparations) and presence of psychiatric disorders. This system will ultimately leverage routinely collected data in combination with advanced artificial intelligence methods to support robust community-wide monitoring of self-harm. Once fully operational, this system will provide accurate and timely information on all presentations to participating emergency departments for self-harm, thereby providing a useful indicator for Australia’s suicide prevention efforts.

Critical Overview of Adolescent Suicides in India; A Public Health Concern

Suicide is the second most leading cause of death among the 15-29 age group (adolescent). The World HealthOrganization statistics indicate that 8, 00,000 people suicide annually. The National Crime Records Bureaurecords indicates that suicidal deaths in 2014 is 15.8% more than 2004, 17% of the suicides worldwidehappens in India. Suicides is a contingency that affects the victim’s family community and nation at largeand has a long lasting effect on the people left behind. The adolescents often don’t get help when neededwhich leads to suicides. Sustainable Development Goals 3 intents to promote healthy lives and promotewellbeing for all.Aim: To understand; 1) the percentage increase of suicide in India, difference between male and femalesuicides, 2) identify states with maximum number of suicides, 3) identify states with maximum number ofstudent suicides, 4) Major Causes for suicide among adolescent male, female and trans gender and to study5) Major means adopted for suicides in India, 6) Understand the significance promoting wellness addressingadolescent suicides.Results: there is significant increase in number of suicides form 2013 to 2016 and it affects the nation’seconomy. The states with maximum number of adolescent suicides are 1) Maharastra, 2) Tamil Nadu, 3)West Bengal, 4) Madhya Pradesh and 5) Karnataka. The major Causes for suicides among adolescents male,female and trans gender were identified. The most common means adopted for suicide among adolescentshave been identified and listed.Conclusion: The adolescent and student suicides in the nation are increasing rapidly causing serious economicburden to the nation. Hence a comprehensive suicide prevention plan must be developed, the policy shouldindividually target the states with highest number of adolescent and student suicides, access to the mostprominent means of suicides must be limited. A national suicide prevention help line and community basedaccess points could be created to provide mental health first aid to the vulnerable adolescents and students.

Constant observation of pediatric patients at risk for self-harm and suicide: An evidence-based practice inquiry

Suicide is a leading cause of death for pediatric patients in the United States. The utilization of protective observation strategies, namely constant observation, is a regulatory recommendation as part of a comprehensive suicide prevention plan for hospitalized behavioral health patients. Constant observation is the increased level of observation and supervision with continuous one-to-one monitoring techniques, taken to assure the safety and well-being of a patient and others in the patient care environment (Moore et al., 1995). This evidence-based practice inquiry describes a search for the best evidence on constant observation practices ensuring the safe care of pediatric patients at risk for self-harm or suicide. The findings included no high-level evidence, however four literary themes related to the challenges of constant observation emerged: confusing language and definitions, untested models of care, important privacy issues and lack of pediatric observation strategies for patients at risk for self-harm and suicide. Impaired communication underscored each of the themes.

Problem gambling and suicidality in England: secondary analysis of a representative cross-sectional survey

ObjectivesProblem gamblers in treatment are known to be at high risk for suicidality, but few studies have examined if this is evident in community samples. Evidence is mixed on the extent to which an association between problem gambling and suicidality may be explained by psychiatric comorbidity. We tested whether they are associated after adjustment for co-occurring mental disorders and other factors. Study designSecondary analysis of the Adult Psychiatric Morbidity Survey 2007, a cross-sectional national probability sample survey of 7403 adults living in households in England. MethodsRates of suicidality in problem gamblers and the rest of the population were compared. A series of logistic regression models assessed the impact of adjustment on the relationship between problem gambling and suicidality. ResultsPast year suicidality was reported in 19.2% of problem gamblers, compared with 4.4% in the rest of the population. Their unadjusted odds ratios (OR) of suicidality were 5.3 times higher. Odds attenuated but remained significant when depression and anxiety disorders, substance dependences, attention-deficit/hyperactivity disorder, and other factors were accounted for (adjusted OR = 2.9, 95% confidence interval = 1. 1, 8.1 P = 0.023). ConclusionsProblem gamblers are a high-risk group for suicidality. This should be recognised in individual suicide prevention plans and local and national suicide prevention strategies. While some of this relationship is explained by other factors, a significant and substantial association between problem gambling and suicidality remains.

Report finds suicide leading cause of death for Oregon youth

Suicide has reemerged as the leading cause of death for Oregon young people ages 10 to 24, Willamette Week reported March 5. The Oregon Health Authority released its annual report on its Youth Suicide Intervention and Prevention Plan at the beginning of the month. The report reflects data from 2018, the most recent figures released to the organization. In 2017, the leading cause of death for Oregon youth was unintentional injury. But unintentional injury rates have decreased, while the rate of death has significantly increased. Oregon now has the 11th‐highest suicide rate in the country for young people. Across demographics, Oregon's suicide rate has been on the rise since 2000 and is more than 30% above the national average. Last year, Senate Bill 52, or Adi's Act, was signed into law, requiring Oregon schools to develop suicide prevention plans. Before Adi's Act, Oregon was one of only three states that went without suicide prevention regulations for schools.

Last Bastion Nevermore! A Qualitative Exploration of the Australian Government’s Fifth National Mental Health and Suicide Prevention Plan from the Perspective of Lessening Mental Stigma and Sanism in the Workplace

The need to advance mental health through greater levels of social and economic inclusion represents a pressing policy issue. Within Australia, this policy focus has been progressed at a national level. This exploratory study aims to critically investigate The Fifth National Mental Health and Suicide Prevention Plan in terms of its potential to help reduce mental stigma and discrimination within Australian workplaces. Qualitative content analysis was applied to the national policy document as well as to 12 academic texts retrieved from a Google Scholar search and meeting inclusion criteria. Stage one of the content analysis process revealed themes of representation, education, research, and activism, while stage two added those of language, legal, and media. This study posits that workplace anti-mental stigma and sanism measures as identified within the Plan are limited in the sense that they represent only a subset of those currently available. This research also supports the prospect of these measures operating in a collaborative manner. Finally, it is proposed that potential exists throughout Australian workplaces to implement stigma and sanism reduction measures that specifically target the health and peer workforce.

Estudio de 130 años de defunciones por Suicidio en el Uruguay.1887- 2017.

El suicidio es una de las expresiones de violencia autoinfligidas, que causa un gran impacto y daño en la familia, en la comunidad y en la sociedad. A nivel mundial se suicidan aproximadamente 800 mil personas por año y Uruguay es uno de los países con tasas de suicidio más elevadas. El objetivo de este estudio es determinar la tendencia de las muertes por suicidio en el Uruguay en el período comprendido entre 1887 y 2017. Se trata de un estudio de tipo descriptivo, del total de personas fallecidas por suicidio en el Uruguay, en el período de estudio. Para el análisis de tendencias se utilizó un modelo de regresión joinpoint, también se calcularon medias móviles y tendencia polinómica. Se observa que en estos 130 años, permanece un aumento significativo de la tasa (p< 0,05). Siendo el sexo masculino quien continúa presentando los valores más altos, conservando el aumento significativo de la tasa (p<0.05) durante todo el período. Uruguay continúa presentando una tasa estandarizada ubicada en el primer tercio de Países con las tasas más altas del mundo y de América. Se recomienda analizar, profundizar y realizar el permanente seguimiento del Plan Nacional de Prevención de Suicidio aprobado por la Autoridad Sanitaria.

Using data from the HBSC study for evidence-based suicide prevention in Luxembourg

Abstract Issue As suicide is the second leading cause of death for young people, WHO aims to reduce the suicide rate with 10% by 2020 worldwide. In Luxembourg, organization D’Ligue coordinates suicide prevention. Since suicide research has been carried out in the country for a few years only, data on adolescent suicidal ideation is lacking. Therefore, D’Ligue has contacted the Luxembourg team of the international Health Behaviour in School-aged Children (HBSC) study, to identify risk factors for suicide behaviour and derive recommendations from them. Description of the problem First, our practice partner wanted us to provide them with basic data on the suicidal ideation of adolescents: How many adolescents are suicidal and what are risk factors? Second, recommendations for practice should be derived from the results. To this end, the HBSC data (2014) of 5262 pupils aged 12-18 were analysed. Results 15.1% of adolescents thought about suicide last year and 7% attempted suicide. Of the 24 risk factors examined, 12 were found to be significant, with three being particularly important: multiple health complaints (OR: 1.3 for each health complaint, p < 0.001, CI: 1.18 - 1.33), lower life satisfaction (OR: 1.3 for the loss of each life satisfaction point, p < 0.001, CI: 1.17 - 1.33) and frequent physical fighting (OR: 2.4, p < 0.001, CI: 1.57 - 3.74). Lessons Risk factors for suicide behaviour known from research have been confirmed for Luxembourg. What is new is that the number of health complaints is the most important risk factor for Luxembourgish adolescents. Therefore, a list of 8 health complaints was validated as a screening tool for suicidal thoughts. In a further step, this tool could be used, for example, by school nurses. The HBSC data can be used to update the national suicide prevention plan. Main messages HBSC data are used to: update the Luxembourgish national plan for suicide prevention.investigate a screening tool for adolescents at risk for suicide.

Are the Prescriptions of Psychiatric Patients Who Repeatedly Attempt Suicide Distinctive? A Study Based on a Survey of Prescription Drug Overdose Patients Admitted for Emergency Medical Care

Objectives: Examining the pharmacotherapy of patients who have attempted suicide by overdose could be useful in developing treatment and suicide prevention plans. We surveyed the drugs taken by psychiatric prescription overdose patients who received inpatient treatment and sought to determine the characteristics of patients who repeatedly attempt suicide. Methods: Subjects were 116 patients who attempted suicide by overdose with prescription psychiatric drugs and received inpatient treatment at the Intensive Care Unit of the Emergency and Critical Care Center of Teikyo University Hospital from August 2009 to July 2010. We retrospectively surveyed clinical characteristics, including prescriptions prior to hospitalization and psychiatric diagnosis, divided subjects into a first-admission (FA) and repeatadmission (RA) groups, and compared their clinical characteristics. Results: All subjects were prescribed benzodiazepine-receptor agonists (BZDRAs), whereas antidepressants and antipsychotics were prescribed to 58.6% and 49.1% of subjects, respectively. Emotionally unstable personality disorder, borderline-type (EUPD-B) was found to be significantly more common in the RA group. Comparing prescriptions in the FA and RA groups indicated that the prescribed dosage and prescription rate for antipsychotics were significantly higher for RA group patients. Conclusion: This study revealed that repeat-admission attempted suicide patients had a significantly higher rate of EUPD-B and were more frequently using antipsychotic prescription drugs. Further, in these patients, more frequent use of antipsychotics is believed to correspond to patient impulsivity. The excessive prescription of BZDRAs is a serious problem requiring urgent measures. Research on the prescriptions for overdose patients may lead to clinically significant findings and should be promoted in the future.

Suicide in India: a complex public health tragedy in need of a plan

Suicide in India: a complex public health tragedy in need of a plan

2017 Suicide Prevention Policies of Metropolitan Local Governments in Korea: Analysis of Core Components and Detailed Plans Based on the 3rd National Suicide Prevention Master Plan and the Local Government Suicide Prevention Plan

2017 Suicide Prevention Policies of Metropolitan Local Governments in Korea: Analysis of Core Components and Detailed Plans Based on the 3rd National Suicide Prevention Master Plan and the Local Government Suicide Prevention Plan

Suicide Deaths Climb Dramatically in U.S., Nearly Double for Women

Suicide Deaths Climb Dramatically in U.S., Nearly Double for Women

Characteristics of patients with mental disorders in a Slovene prison: A retrospective observational naturalistic study

Background and objectivesThe prevalence of mental disorders in EU prisons is high. Little is known about provision of care in Eastern and Central European countries, particularly in former Yugoslavian countries. The aim of this study was to assess diagnoses, characteristics and care provision of prisoners diagnosed with mental disorders in the psychiatric outpatient clinic in the biggest Slovene male prison Dob. MethodsPrison psychiatrist collected data on psychiatric diagnosis, suicide rates and care provision from patients’ medical records and charts. In addition, interviews were performed with leading representatives of service organization, members of staff working in psychiatric outpatient clinic, and prison guards. ResultsOut of 520 prisoners, 220 (42.3%) were involved in treatment in psychiatric outpatient clinic and all were included in this research. The data were gathered in 2016. The most prevalent diagnosis was addiction disorder in 82.7% (182) of all patients. Out of them only 24 (10.9%) were diagnosed with alcohol addiction. 94 prisoners (42.7%) were on substitution therapy because of drug addiction. The point prevalence of psychotic disorders was 7.3%, 10.0% for mood disorders and 15.9% for anxiety disorders. Personality disorders were diagnosed in 19.5% of all patients. Co-morbidity was diagnosed in 80 patients (36.4%). There were no suicides in the prison Dob in the period between 2012 and 2016. In this period strong and systematic anti-suicide measures have been already established and applied in the prison. The prison suicide prevention plan is described. ConclusionsThe prevalence of addiction disorders in Slovene prison is high. Absence of suicides in the four year period indicates that quality of suicide prevention measures in prison Dob.

Implementation and evaluation of the Victorian Suicide Register

ObjectiveThe Victorian Suicide Register (VSR) is a state‐based suicide surveillance system that contains detailed information on people who die by suicide and the circumstances surrounding their death. In this paper, we provide an overview of the VSR and then describe the evaluation, which used the Centres for Disease Control and Prevention guidelines for surveillance system evaluation as a framework. MethodsThe evaluation drew on three data sources to assess whether the VSR: i) embodies the attributes of a good public health surveillance system; and ii) can be used to inform community‐based suicide prevention efforts. ResultsThere was a high level of acceptability and enthusiasm for having an accessible data collection that can stimulate local action on suicide prevention planning. One of the key challenges identified was data quality, particularly around those data collected in the course of death investigations that are not designed for surveillance purposes. ConclusionThe VSR fills an important gap in the sustained and systematic collection of comprehensive information on suicide, with some key challenges identified. Implications for public healthFindings from the evaluation provide important strategic information for national and international jurisdictions seeking to establish their own suicide registers.

Suicide Prevention Training: Policies for Health Care Professionals Across the United States as of October 2017.

To identify and compare state policies for suicide prevention training among health care professionals across the United States and benchmark state plan updates against national recommendations set by the surgeon general and the National Action Alliance for Suicide Prevention in 2012. We searched state legislation databases to identify policies, which we described and characterized by date of adoption, target audience, and duration and frequency of the training. We used descriptive statistics to summarize state-by-state variation in suicide education policies. In the United States, as of October 9, 2017, 10 (20%) states had passed legislation mandating health care professionals complete suicide prevention training, and 7 (14%) had policies encouraging training. The content and scope of policies varied substantially. Most states (n = 43) had a state suicide prevention plan that had been revised since 2012, but 7 lacked an updated plan. Considerable variation in suicide prevention training for health care professionals exists across the United States. There is a need for consistent polices in suicide prevention training across the nation to better equip health care providers to address the needs of patients who may be at risk for suicide.