This study examines mental health services among college students at risk of suicide within Chinese collectivist culture, focusing on the subgroup heterogeneity of help-seeking willingness as outlined by Andersen's model. By incorporating social learning theory, it highlights the significant role of informal social networks in help-seeking decisions in this cultural context, thereby expanding Andersen's model applicability in suicide prevention and providing evidence for targeted campus psychological intervention strategies. A survey of 2,447 Chinese students applied Andersen's Model, using latent profile analysis to identify help-seeking patterns shaped by suicide risk, depression, suicide stigma, social support, and mental health service availability and accessibility. ANCOVA and PROCESS were used to analyze group differences in intentions and the role of others' positive experiences. Four help-seeking groups were identified: Moderate Risk-Resource Limited (19.2%), High-Risk Isolated (4.9%), Low Risk-Stable (55.4%), and Resource Advantage (20.6%). Help-seeking intentions varied significantly (F = 79.16, p < 0.001, partial η² = 0.089), increasing progressively from the High-Risk Isolated to the Resource Advantage Group (ps < 0.01). The perception of others' positive help-seeking experiences significantly boosted intentions, with varying effects across groups. The High-Risk Isolated Group had the lowest intentions, while the Resource Advantage Group had the highest. Under low exposure to positive experiences, the Moderate Risk-Resource Limited Group showed significantly higher intentions than the Low Risk-Stable Group; however, no significant difference was found between these groups in high exposure. Suicidal college students show diverse traits in predisposing, enabling, and need factors under Andersen's model, with help-seeking intentions varying significantly across groups and affected by others' positive experiences. The findings underscore the necessity for targeted, layered interventions to improve campus mental health services while also highlighting the importance of fostering a supportive environment and encouraging colleges to facilitate the sharing of help-seeking experiences to enhance students' willingness to seek help. Not applicable.

Recently, inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury, highlighting a promising biological dimension of suicide risk assessment. Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce. Mental health nurses are frequently the most accessible professionals in schools, communities, and low-resource settings and are prime candidates to bridge this gap. By integrating psychosocial evaluation with emerging biomarker data, they can deliver systematic risk assessment, continuous monitoring, and timely intervention. This role would not replace psychiatric expertise; it would extend the reach of psychiatric services, embedding suicide prevention across the continuum of care. For health systems, nurse-led integration may enhance capacity, equity, and resilience in responding to adolescent suicide risk. This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.

Love, loss and despair: the role of romantic relationships in suicidal ideation and prevention

The link between ageism, mental health, and suicide has been highlighted in previous research. This article examines the possible impact of ageism on to the enduring cross-switches observed by older adults' population from different Western countries. We reviewed existing literature in the field to understand how ageism manifests across cultures. Furthermore, we explored to what extent the concept is recognized in different countries and what initiatives are currently being taken. In Latin-origin countries, many older people live alone, with children who have moved away or emigrated, and have less active social networks. By comparison, Anglo-Saxon countries provide more community services to support older adults, including programs against loneliness. The stigma attached to mental health is counteracted by active public campaigns and more accessible services. Moreover, many people in Latin countries live with low pensions and economic uncertainty, especially if alone or widowed. In Canada, Australia and New Zealand, more robust pension systems and forms of social assistance exist, reducing financial stress. Based on the available literature, it doesn't seem that ageism may justify the higher number of suicides in old age in countries such as Italy, Spain, and Portugal. At most, it can partly explain the higher rates observed by contributing to creating a climate of invisibility, exclusion and mistrust that can be fertile ground for psychological suffering. Thus, intervening against ageism could not only be seen as an ethical act, but also a concrete form of suicide prevention.

Suicide rates have increased notably in Spain, particularly among the migrant population, where mortality by suicide rose by 25% between 2018 and 2021. Migrants are exposed to cumulative stressors, including socioeconomic adversity, acculturative challenges, and adverse childhood experiences (ACEs) that may heighten the risk of suicidal behavior. This study aimed to examine and compare the risk factors associated with suicide attempts among foreign-born and native-born individuals in Spain, with particular emphasis on the role of ACEs. A sample of 754 patients assessed 15 days after a suicide attempt (73.1% female; M = 40.23, SD = 15.72) from the SURVIVE study was used. Sociodemographic, clinical, and psychological variables, including ACEs, were measured using validated instruments. Group comparisons and multigroup regression analyses were conducted to explore factors associated with suicidal outcomes based on migration status. Foreign-born patients were significantly younger and more likely to report emotional abuse, physical abuse, sexual abuse, and physical neglect during childhood than native-born individuals. They also exhibited higher psychological distress and greater acquired capability for suicide. In multivariate models, different predictors of suicidal ideation and behavior emerged across groups. In multivariate models, different predictors of suicidal ideation and behavior emerged across groups. For native-born individuals, suicidal ideation intensity was associated with greater psychopathology severity, more diagnosed mental disorders, higher acquired capability, and a history of suicide attempts. For migrants, higher acquired capability, lower impulsivity, and a history of suicide attempts were associated with greater ideation intensity. Migrant populations in Spain demonstrate a different profile of suicide risk, marked by increased ACEs and psychological burden. These findings highlight the need for culturally sensitive suicide prevention strategies that incorporate early trauma screening and address structural vulnerabilities. Prevention protocols should prioritize trauma-informed care and social integration to mitigate suicide risk in this vulnerable population.

Remote zero-burden sleep monitoring in veterans with PTSD and suicidal ideation: A longitudinal investigation of risk.

Primary care (PC) represents a widely accessed health care service for youths and families in the United States. In recent years, there has been an increase in youth presenting to PC with suicidal thoughts and behaviors. This study aims to better understand current suicide prevention practices and provider perspectives regarding suicide prevention practices in PC with pediatric populations. Two studies (one using focus groups, the other using individual interviews) were conducted with 40 PC staff (including physicians and physician assistants, integrated behavioral health staff, nurses and nurse practitioners, and clinic leaders) from pediatric PC clinics in Washington State. Focus groups/interviews elicited feedback on current suicide care practices, staff and clinic needs, barriers, facilitators, and suggestions for improvement. Focus groups/interviews were recorded, transcribed, and analyzed using thematic analysis. Results were similar across clinics and highlight challenges and needs for pediatric PC including time limitations, lack of resources for parents, need for additional provider training in suicide prevention, need for team-based approaches, need for standardized and streamlined pathways for patients at different risk levels, and need for integrating screening and intervention components into existing workflows. Overall, results suggest that suicide care is difficult to implement within PC contexts. Understanding PC staff needs, barriers, and facilitators is imperative to adapt feasible suicide care pathways for PC. Results highlight important needs and key components for implementation strategies to target. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Area-level socioeconomic deprivation and suicide by restrictable method of death: Trends in Japan, 1995-2022.

Artificial intelligence and machine learning (AI/ML) in prevention science may improve or perpetuate health inequities. Community engagement is one proposed strategy thought to empirically mitigate bias in AI/ML tools. We outline how to incorporate community engagement at every stage of the model development and implementation. Borrowing from a framework for phases of prevention research, we describe the value and application of engaging communities to help shape more rigorous and relevant applications of AI/ML for prevention science. We provide concrete examples from real-world applications, including efforts in suicide prevention with Indigenous communities, on chronic disease prevention for Hispanic and Latino populations, and a community-driven effort to leverage AI/ML to improve allocation of resources focused on social determinants of health for Native Hawaiians. This work aims to provide applied examples of how community-engagement has been incorporated into AI/ML development and implementation, with the goal of encouraging those in the prevention science field to consider the voices of the community as the use of such tools grows. Engaging with the community around AI/ML is critical to ensure these tools reach populations in need and advance health equity for all.

BackgroundArtificial intelligence (AI) offers potential solutions to address the challenges faced by a strained mental health care system, such as increasing demand for care, staff shortages, and pressured accessibility. While developing AI-based tools for clinical practice is technically feasible and has the potential to produce real-world impact, only a few are actually implemented into clinical practice. Implementation starts at the algorithm development phase, as this phase bridges theoretical innovation and practical application. The design and the way the AI tool is developed may either facilitate or hinder later implementation and use.ObjectiveThis study aims to examine the development process of a suicide risk prediction algorithm using real-world electronic health record (EHR) data through a qualitative case study approach for clinical use in mental health care. It explores which challenges the development team encountered in creating the algorithm and how they addressed these challenges. This study identifies key considerations for the integration of technical and clinical perspectives in algorithms, facilitating the evolution of mental health organizations toward data-driven practice. The studied algorithm remains exploratory and has not yet been implemented in clinical practice.MethodsAn exploratory, multimethod qualitative case study was conducted, using a hybrid approach with both inductive and deductive analysis. Data were collected through desk research, reflective team meetings, and iterative feedback sessions with the development team. Thematic analysis was used to identify development challenges and the team’s responses. Based on these findings, key considerations for future algorithm development were derived.ResultsKey challenges included defining, operationalizing, and measuring suicide incidents within EHRs due to issues such as missing data, underreporting, and differences between data sources. Predicting factors were identified by consulting clinical experts; however, psychosocial variables had to be constructed as they could not directly be extracted from EHR data. Risk of bias occurred when traditional suicide prevention questionnaires, unequally distributed across patients, were used as input. Analyzing unstructured data by natural language processing was challenging due to data noise, but ultimately enabled successful sentiment analysis, which provided dynamic, clinically relevant information for the algorithm. A complex model enhanced predictive accuracy but posed challenges regarding understandability, which was highly valued by clinicians.ConclusionsTo advance mental health care as a data-driven field, several critical considerations must be addressed: ensuring robust data governance and quality, fostering cultural shifts in data documentation practices, establishing mechanisms for continuous monitoring of AI tool usage, mitigating risks of bias, balancing predictive performance with explainability, and maintaining a clinician “in-the-loop” approach. Future research should prioritize sociotechnical aspects related to the development, implementation, and daily use of AI in mental health care practice.

An abridged version of this paper was presented at the International Association for Suicide Prevention’s 33rd World Congress (Austria, June 2025). In this paper, I pose and respond from several angles to the following question: Is it possible to kill oneself? The purpose is twofold: first, to elaborate on psychoanalytic theory pertaining to suicide; second, albeit a primary concern, to promote interdisciplinary dialogue with wider suicide prevention research and practice. The question is used to orient a critique of the current mainstream suicide prevention paradigm that is dominated by positivist, risk-based models. I address the difficulties this presents for both patient and clinician and plea for a deeper theoretical engagement with the clinical phenomenon of suicide, one that resists reducing the act to a symptom of mental illness. I use the question to offer a clinical contribution to working in the aftermath of a non-fatal suicide attempt; specifically, using a Freudian and Lacanian framework, I examine the disjunction between the individual’s act and her purported intent (or lack thereof), arguing that psychoanalysis is in a unique position to engage with such instances.

Transgender, nonbinary, and gender-expansive (TNGE) Black, Indigenous, and other people of color (BIPOC) communities tend to experience alarmingly disparate levels of suicidal ideation and attempts. Such levels of suicidal thoughts and behaviors are exacerbated by systemic exclusion within medical systems and a limited interest within scientific research to center community narratives. To better understand potential avenues of effective crisis intervention and suicide prevention, the present study surveyed 110 TNGE BIPOC participants about their advice to mental health professionals who work with community members experiencing suicidal ideation. Given that much of the extant suicidology literature about TNGE BIPOC tends to be deficit-based, the overarching motive of this study was to recenter information regarding suicide prevention to include the perspectives of TNGE BIPOC community members. A conventional content analysis approach resulted in four major themes and 16 subthemes to guide mental health professionals in the work of self-education, systemic change, clinical intervention, and community. Contributions to counseling in suicide prevention include (a) engaging with self-education as an ongoing process, (b) conceptualizing the clinical role as one of systemic change with therapeutic support that is contextualized within resistance to oppressive systems, and (c) valuing community connection as an integral psychological resource. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Suicide stigma is a pervasive barrier to suicide prevention efforts. Although several suicide stigma measures are available, a suicide stigma assessment tool that is specific to religious communities has yet to be created. This research was conducted to evaluate the psychometric properties of a scale that measures religiously themed suicide stigma. The sample consisted of 378 adult participants from across the USA who attend a religious community, with over 40% of the sample identifying as "faith leaders." The Religious Suicide Stigma Measure (RSSM) items were conceptualized based on statements made by congregants experiencing suicidal behaviors (CESB) and operationalized into twenty-four items. After removing items based on low item-total correlations, low factor loadings, and to increase both internal consistency and a good fit in structural equation modeling, nine items remained. Exploratory factor analysis was conducted, and two factors were found: Community Hostility and Religious Stereotypes. Confirmatory factor analysis was conducted, and the model with nine items exhibited good fit, and all items showed strong factor loadings. The RSSM is a nine-item measure that shows high reliability, content and construct validity, as well as convergent and discriminant validity with a public stigma measure. Future research can also utilize this measure to assess religious suicide stigma and its relationship to mental health symptoms and help-seeking behaviors.

BackgroundThe safety planning intervention (SPI) is a suicide prevention intervention that results in a written plan to help patients reduce suicide risk. High-quality safety plans—that is, those that are the most complete, personalized, and specific—are more effective in reducing suicide risk. Measuring SPI quality is labor-intensive, which means that clinicians rarely get specific, actionable feedback on their use of the SPI.ObjectiveThis study aimed to develop the Safety Plan Fidelity Rater, an automated tool that assesses the quality of written safety plans leveraging 3 large language models (LLMs)—GPT-4, LLaMA 3, and o3-mini.MethodsUsing 266 deidentified safety plans from outpatient mental health settings in New York, LLMs analyzed four key steps: warning signs, internal coping strategies, making the environment safe, and reasons for living. We compared the predictive performance of the three LLMs, optimizing scoring systems, prompts, and parameters.ResultsFindings showed that LLaMA 3 and o3-mini outperformed GPT-4, with different step-specific scoring systems recommended based on weighted F1-scores.ConclusionsThese findings highlight LLMs’ potential to provide clinicians with timely and accurate feedback on safety plan quality, which could greatly improve its implementation in community practice.

Background: Signage designed to encourage help-seeking is a suicide prevention intervention used at public sites where suicides occur. Aims: We aimed to investigate the perspectives of people with lived experience of suicide on signs that are designed to encourage help-seeking. Method: We conducted a qualitative study using semistructured interviews undertaken in Melbourne, Australia, during April 2021. We showed participants photos of existing Lifeline (Australia's largest national crisis support line) signage used at public sites that are known for suicide and asked for their feedback. We used a deductive coding approach, guided by the interview topics and study aims. Results: We interviewed 12 participants, and most had previously seen such signs and could recollect elements of these. Participants considered that empathetic and uncomplicated messaging was important and viewed Lifeline branding favorably. Signs that participants perceived as unhelpful were those that contain multiple or unclear messaging, or messaging considered patronizing. The use of the word crisis was also viewed unfavorably by some. Limitations: Study limitations include our small sample size and our broad definition of lived experience. Conclusion: Our results may be of use to organizations looking to create or update signs. Future signs should be codesigned with people with lived experience of suicide.

According to the World Health Organization, over 700,000 people die by suicide each year, accounting for 1.3% of global deaths. As neuroscience and neurotechnology increasingly shape suicide research and prevention, East Asian societies such as Japan, South Korea, and Taiwan-historically more permissive toward suicide-have enacted laws emphasizing multi-level psychosocial interventions. Despite advances in neuroscientific inquiry, neuroethical reflection on suicide prevention remains limited. This paper proposes a culturally grounded neuroethical framework that integrates neurorights, disability rights, and cultural perspectives. Rejecting reductionist views of suicide as mere brain dysfunction, it examines how direct and indirect brain interventions, cognitive liberty, and cultural mediation interact in shaping moral and policy responses. It argues that the suicidal brain and culture are co-produced phenomena, dynamically evolving within complex neuroethical structures that shape contemporary suicide prevention.

Contributing to the growing need for adolescent school-based mental health interventions in Hong Kong, the "Suicide Help Intervention through Education and Leadership Development for Students" (S.H.I.E.L.D.S.) programme was developed to train secondary school students to become gatekeepers and lay leaders in mental health for their school communities. It involved both education - through mental health and suicide prevention training - and leadership development - through the design and implementation of student-led projects to encourage help-seeking behaviours and promote mental wellbeing to their peers. Using a mixed-methods approach, we examined the impact of two rounds of S.H.I.E.L.D.S. that ran between June 2022 and June 2023 on three groups of participants across eight participating schools: 89 student leaders (Mage = 15.2) who underwent training, 33 staff advisors who supported the student leaders, and 423 general students (Mage = 14.3) who participated in student-led project activities. Questionnaires were disseminated to each group of participants before and after relevant programme activities, while interviews were conducted after the conclusion of all programme activities. Quantitative analyses demonstrated that there were no significant changes in both student leaders' and general students' knowledge of and attitudes towards mental health. However, qualitative feedback revealed that leaders did feel that their mental health-related knowledge and ability to help their peers improved. This was supported by the staff advisors, who also developed a greater appreciation for the role of students' input in co-creating school-based mental health promotion initiatives. General students similarly appreciated the peer-led nature of project activities. General observations on the impact of S.H.I.E.L.D.S. on the schools' mental health culture are also discussed. This study highlights the importance of recognising student perspectives and integrating new mental health programmes with existing school efforts, which were instrumental in the successful implementation of S.H.I.E.L.D.S. in the intervention schools. Future implications for the continuity and scaling-up of S.H.I.E.L.D.S. and similar school-based mental health promotion initiatives are also given. Not applicable.

Over the time of the COVID-19 pandemic, many school systems started to utilize educational software to identify students actively planning suicide and other acts of violence. This study examines associations between county-level youth suicide rates and the implementation of GoGuardian Beacon, a school-based software using machine learning methods for identifying students at risk for suicide. Using difference-in-differences and event study methods, we analyzed 2018-2022 suicide data comparing 70 counties with sustained Beacon implementation to 1,215 matched comparison counties that never implemented Beacon. In our primary analysis, counties that maintained consistent Beacon use had 24.4% lower youth suicide rates during 2021–2022 (p < 0.05). In sensitivity analyses defining implementation based on initial adoption regardless of subsequent use, the association was attenuated and not statistically significant. Taken together, these findings indicate that counties with sustained use of Beacon had lower youth suicide rates in our primary analyses, while also highlighting the possibility that broader contextual factors (e.g., local mental health infrastructure and school system characteristics) contribute to the observed differences. Randomized trials with prospective follow-up, more information on school and community resources, and quality of Beacon response pathways after identification are needed to understand the effect of Beacon and clarify the independent contribution of digital monitoring tools within comprehensive youth suicide prevention strategies.

ABSTRACT This study explores how biblical narratives aid Catholic pastoral care for individuals with suicidal ideation in Oyo State, Nigeria. Using a constructivist grounded theory approach, I interviewed 20 Catholic priests, mostly chaplains in educational, parish and healthcare settings, experienced in suicide prevention. The 90-minute semi-structured interviews were analysed using NVivo 15, revealing seven themes: perseverance, hope, divine purpose, God's compassion, mercy, redemption, and avoiding judgment. Priests used stories of Joseph, Job, Elijah, Bartimaeus, and the Prodigal Son to reframe suffering, foster hope, and affirm life's value. These narratives served as spiritual and therapeutic tools, emphasizing God's presence. The study highlights biblical stories as vital for culturally sensitive suicide prevention in pastoral care, cautioning against judgmental attitudes. Findings suggest implications for pastoral training and mental health support in faith communities, promoting compassionate care strategies.

While prenatal exposure to tobacco has been associated with adolescent suicide attempt, little is known about the mechanisms explaining this association. This study aims to explore the mediating roles of internalizing symptoms, externalizing behaviors, and peer problems across childhood in the association between prenatal exposure to tobacco and adolescent suicide attempt. We analyzed data from N=8,861 participants from the Millennium Cohort Study followed from ages 9months to 17years. Binary logistic regression models were used to investigate the total association between exposure to tobacco in pregnancy and suicide attempt, and mediation analyses were conducted using structural equation models to investigate the direct and indirect associations. In models adjusted for key covariates, we found a significant association between prenatal tobacco exposure and increased risk of adolescent suicide attempts (odds ratio=2.08, 95% confidence interval = [1.68, 2.56]), partly mediated through internalizing problems, externalizing behaviors, and peer problems from ages 3 to 14 years (accounting for 37% of the total association, that is, 16%, 12%, and 9%, respectively). These findings suggest that interventions targeting mental health symptoms and peer problems may maximize suicide prevention efforts among children who were prenatally exposed to tobacco, thus potentially reducing the long-term risk of suicide attempt.