Suicidal Threats Research Articles

Performance Appraisal of Tehran Firefighting Stations in Attempted and Threating Suicide with National and Global Standards (The First 6 Months of 2018)

Background: We aimed to compare the performance of Tehran firefighting stations in the incidents of suicide attempt and threats among Tehran citizens using international standards.
 Methods: A research method was a descriptive-analytical study based on library studies. The data were analyzed by descriptive and inferential methods such as single group t-test and independent t-test. The statistical population of this study included all citizens in 22 districts of Tehran City that committed or threated to commit suicide in the 2018 year. They were selected in a targeted manner. All data were extracted and analyzed through the fire department in the first half of 2018 in the action and threat of suicide.
 Results: Men commit suicide more than women do. Moreover, the average time of exit from station and the average travel time are shorter than Iranian and world standards. The people saved by firefighters outnumber the people who died in suicide, which indicates the satisfactory performance of firefighters in relief and rescue operations. In suicide operations, according to the general results obtained from statistical calculations of departure time from the station and the average travel time, which are the two main factors in evaluating the performance of firefighters in suicide accidents, which in comparison with international standards. It was significantly lower and the performance of firefighters was positive.
 Conclusion: The average duration of exit from station and the average travel time, are significantly lower than international standards, which demonstrates the good performance of firefighters.

Распространенность и варианты суицидального поведения детей и подростков Краснодарского края

Background: according to the World Health Organization (WHO), every year about 700,000 people die as a result of suicide. In the age group of 15–19 years, suicide is the fourth leading cause of death. In 2011 UNICEF released the report based on the Federal Service for State Statistics (Rosstat) data, according to which every twelfth teenager aged 13–17 years is trying to commit suicide in Russia. Aim: to study the frequency and case structure of suicidal activity in children and adolescents in the Krasnodar Territory for further improvement of measures to reduce the risk of autoaggressive behavior. Patients and Methods: the article presents the analysis of indicators concerning suicidal activity in children and adolescents of the Krasnodar Territory for the period 2020–2021. The data were obtained from specialists of the psychiatric and pediatric service of the Krasnodar Territory, the Directorate of the Federal Service for State Statistics of the Krasnodar Territory and the Republic of Adygea (Krasnodarstat), and the Directorate for Registry Offices of the Krasnodar Territory with the support of Medical Information and Analytical Center. Results: in 2020, 98 cases of autoaggressive behavior were registered. Of these, 70 (71.4%) cases of incomplete suicide attempts, 25 (25.5%) cases of suicidal statements and 3 (3.1%) completed suicides. In 2021, there were 138 cases of suicidal behavior of minor residents registered in the Krasnodar Territory, of which 91 (65.9%) cases of incomplete suicide attempts, 40 (29%) cases of suicidal statements, intentions and threats without committing a suicide attempt, and 7 (5.1%) cases of completed suicides. In the contingent of persons with incomplete suicidal attempts (90 minors), there was a significant predominance of females 79 (85.9%) and 75 (83.3%) people in 2020 and 2021, respectively, as well as the predominance of the age group of 15–17 years old 48 (69.6%) and 68 (75.6%) people in 2020 and 2021, respectively. In the structure of the methods concerning committing incomplete suicidal attempts, the administration of medications and other substances, as well as self-harm, were most commonly recorded. Conclusion: incomplete suicide attempts and the number of suicide deaths among children and adolescents of the Krasnodar Territory were analyzed by age and sex. The main ways of implementing auto-aggressive behavior, representation in various regions of the Krasnodar Territory, as well as the measures conducted by outpatient and inpatient psychiatric services in order to prevent suicidal behavior in the study cohort were identified. KEYWORDS: suicidal activity, autoaggressive activity, completed suicide, suicidal attempt, children, adolescents. FOR CITATION: Boyko E.O., Vasyanina Yu.Sh., Mylnikova Yu.A., Aleksanyan E.K. Prevalence of suicidal behavior in children and adolescents of the Krasnodar Territory. Russian Journal of Woman and Child Health. 2022;5(3):223–227 (in Russ.). DOI: 10.32364/2618- 8430-2022-5-3-223-227.

Domestic Violence Current Legal Status: Psychiatric Evaluation of Victims and Offenders.

Domestic Violence Current Legal Status: Psychiatric Evaluation of Victims and Offenders.

Multi-center nationwide study on pediatric psychiatric inpatients 2000–2018: length of stay, recurrent hospitalization, functioning level, suicidality, violence and diagnostic profiles

Inpatient treatment is an important part of child and adolescent psychiatric (CAP) care. This nationwide study explores the changes in length of stay, recurrent hospitalization, functioning level, suicidality, violence and diagnoses of CAP inpatients in Finland in 2000, 2011 and 2018. We obtained comprehensive questionnaire data on each study year from 93 to 95% of all CAP wards in Finland. We split the 1276 inpatients into two age groups in each study year: under 13 and 13–18. The median length of stay in inpatient treatment decreased from 82.0 days in 2000 to 20.5 days in 2018 (p < 0.001) and recurrent hospitalization increased from 38 to 46%. General functioning, which was evaluated by the Children’s Global Assessment Scale, deteriorated by an average of six points between 2000 and 2018. Violent threats decreased from 21.5 to 16.6% and violent acts decreased from 26.9 to 20.3%. Suicidal threats decreased from 42.6 to 23.3% in those aged under 13 and remained stable among those aged 13–18. In the 13–18 group, there was an increase in the diagnoses of ADHD, from 5.0 to 16.9% and depression, from 25.1 to 41.7%. However, psychosis decreased from 23.2 to 12.6% in the older age group. In the whole cohort, anxiety disorders increased from 7.6 to 15.6%. The overall picture does not show that CAP inpatients have become more disturbed. While the general functioning of CAP inpatients deteriorated somewhat over the 2000–2018 study period, symptoms of suicidality and violence remained stable or decreased. There was also a continuous increase in short-term treatment.

Risk of Suicidal Behavior in Children and Adolescents Exposed to Maltreatment: The Mediating Role of Borderline Personality Traits and Recent Stressful Life Events.

Childhood maltreatment (CM) is associated with increased non-suicidal self-injury (NSSI) and suicidal behavior (SB), independently of demographic and mental health conditions. Self-Trauma Theory and Linehan’s Biopsychosocial Model might explain the emergence of Borderline Personality Disorder (BPD) symptoms as mediators of the association between CM and the risk of SB. However, little is known regarding such relationships when the exposure is recent for young persons. Here, we study 187 youths aged 7–17, with or without mental disorders. We explore CM experiences (considering the severity and frequency of different forms of neglect and abuse), recent stressful life events (SLEs), some BPD traits (emotion dysregulation, intense anger and impulsivity), and the risk of SB (including NSSI, suicide threat, suicide ideation, suicide plan and suicide attempt). We study the direct and mediating relationships between these variables via a structural equation analysis using the statistical software package EQS. Our findings suggest that youths exposed to more severe/frequent CM have more prominent BPD traits, and are more likely to have experienced recent SLEs. In turn, BPD traits increase the risk of SLEs. However, only emotion dysregulation and recent SLEs were found to be correlated with SB. Therefore, targeted interventions on emotion dysregulation are necessary to prevent NSSI or SB in children and adolescents exposed to CM, as is the minimization of further SLEs.

Safety Planning for Youth With Suicide Risk: A Clinical Audit

ABSTRACT This quality improvement activity examined Safety Planning Intervention (SPI) over two 3-monthly periods for presentations from 13–17-year-olds with suicidal risk to a regional hospital Emergency Department (ED). We collected patient demography, presentation characteristics, presentation rate, and clinician use of SPI, including those under Emergency Examination Authorities (EEAs). An education workshop was offered between the audits, aimed to increase clinician (social work, psychology, nursing, and psychiatry) knowledge of SPIs. The annual ED presentation rate for suicide risk for 15–17-year-olds was 1,520 per 100,000 persons. More presentations were female, non-Indigenous persons, and fewer than half presented voluntarily. Most presentations were for suicide attempt followed by suicide threat. In the first audit clinicians initiated SPIs in fewer than 50% of cases and completed SPIs in 15%. Whereas in the second audit where SPIs were initiated by clinicians in 69% of cases and fully completed in 49%, less than half the presentations with EEAs received a completed SPI. Indigenous persons, although a lower proportion of presentations, were overrepresented for the population. Following the education workshop, there was an improvement in SPI completion, reflecting the benefits of education and training to clinical staff. Lastly, this study highlights the benefit of conducting audits as quality improvement activities for patient care. IMPLICATIONS The international literature indicates an increase in child and youth suicide attempts. This increase requires preparedness from social workers and other clinicians (psychology, nursing, and psychiatry) who offer front-line healthcare for these presentations. Safety plans are best-practice and tailored strengths-based plans undertaken between a clinician and client so that the client feels confident knowing where to go and to whom to talk to avoid further suicide attempts. Social workers play an important role in undertaking safety plans with clients (especially those who are particularly vulnerable) in hospital and community settings to maximise client outcomes.

The role of context in understanding the use of tactical officers: A brief research note

A small body of research suggests that the use of police tactical officers has become normalized in that they now commonly respond to “routine” calls rather than being restricted to high-risk situations. However, this research has tended to rely on crude data (i.e., call type), which fails to account for the context of the calls (e.g., the presence of potential risk factors that might warrant tactical resources). In this brief research note, we sought to expand upon previous literature by examining the risk factors associated with tactical calls in a Canadian police service. We found that various risk factors were present in many of the calls that tactical officers responded to, some of which might be classified as “routine” (suicide threats, well-being checks, domestic disturbances, etc.). The presence of such risk factors highlights the need to consider context when attempting to understand the use (and consequences) of tactical officers. More rigorous tracking of these factors by police services will facilitate such research and inform policies around the use of tactical resources.

Traiettorie evolutive: una lezione dall’ADHD

A 12-year-old girl was urgently sent by her paediatrician to the Child and Adolescent Neuropsychi-atry ward for behavioural disorders and suicide threat. At the time of the visit the suicide risk was low. Nevertheless, considering a possible underlying psychopathology, a short Day Hospital admis-sion for appropriate diagnostic investigations was warranted. Developmental trajectory showed several symptoms of inattention, hyperactivity, impulsivity, poor tolerance to frustrations, emotional lability, irritability, emotional dysregulation, rule breaking be-haviours and impaired socialization with her coevals from early childhood. The diagnostic delay may have led to demoralization and then to depressive feelings. This led to the diagnoses of Attention - Deficit Hyperactivity Disorder and Oppositional-Defiant Disorder. Pharmacological therapy with Methylphenidate was prescribed as well as cognitive-behavioural therapy and parent training intervention.

Mental health symptoms and suicidality in Iranian gay men.

No published data is currently available on mental health symptoms and suicidality in Iranian gay men - a population facing serious legal threats including capital punishment. The present study provides initial data on this topic by assessing mental health symptoms (SCL-90) and suicidality (BSSI) in N = 213 gay men in Tehran, Iran. Last-week mental health symptoms were severe in 4.2% of gay men, moderate in 7.5%, minor in 27.7%, and absent in 61.6% of Iranian gay men. Regarding last-week suicidality: 1.9% were highly likely to attempt suicide, 7.5% reported having threatened to commit suicide, 19.7% reported suicidal ideation, and 80.28% revealed no suicidality. Last-week mental health symptoms and last-week suicidality were correlated in gay men to a high degree. When descriptively comparing the SCL-90 and BSSI scores with those in the general Iranian population reported in previous studies, gay men reported more serious mental health symptoms, and more suicidal ideation, threats, and attempts. The decriminalization of same-sex sexual encounters and accepting social attitudes towards gay men are needed in Iran to help improve this population's mental health and reduce their suicidality.

Use of extreme risk protection orders to reduce gun violence in Oregon

Research SummaryWe examined petition and respondent characteristics from extreme risk protection order (ERPO) cases in Oregon for the 15 months after implementation (n = 93). Most petitions were filed by law enforcement (65%) a were more likely to be granted than petitions filed by family/household members (p &lt; 0.001). Most ERPO respondents were reported by petitioners to have histories of suicidality (73%) or interpersonal violence (75%), with over half of death threats, suicide threats, or suicide attempts with known timing occurring within 1 week of the petition being filed.Policy ImplicationsERPO petitions and orders are overwhelmingly being used as intended, that is, specifically for cases of imminent risk of harm to self or others. Greater dissemination of public information about ERPOs may increase their appropriate use and the proportion of high‐risk individuals and families who may benefit. Legal aid assistance for family or household members in filling out petitions is advisable.

The limits of our knowledge: tracking the size and scope of police involvement with persons with mental illness

Significant public discourse has focused recently on police–civilian interactions involving with persons with mental illness (PMI). Despite increasing public attention, and growing demands for policy change, little is actually known about the myriad of ways in which Canadian police encounter PMI in the context of routine police work. To assist policymakers in developing evidence-informed policy, this paper attempts to shed light on present difficulties associated with addressing fundamental questions, such as the prevalence of mental health related issues in police calls for service. To do this, we attempt to map the size and scope of police calls for service involving PMI, drawing on both the available scientific data and the limited knowledge to be gleaned from available police reports. Our focus is on two broad categories of police interactions with citizens: public safety concerns (wellness checks, suicide threats, missing persons, mental health apprehensions) and crime prevention and response (encountering PMI as victims–complainants and (or) as potential suspects). We also explore the challenges policy-makers face in relying on police data and the importance of overcoming weaknesses in data collection and sharing in relation to the policing of uniquely vulnerable groups. This paper concludes with some key recommendations for addressing gaps highlighted.

SUICIDAL IDEATION AND SUICIDE THREATS AS ELEMENTS OF SUICIDAL BEHAVIOUR OF PEOPLE DEPRIVED OF LIBERTY

Suicidal ideation and suicide threats as elements of suicidal behaviour may occur in every social group, to a small extent though. Negative behaviour of this type increases among people in penal institutions. 112 prisoners took part in a study conducted in a detention center. The results of the study show that suicidal ideation is present among people in prison to a large extent and range. The length of the prison sentence causes a higher frequency of suicidal ideation. Suicide threats occur among prisoners, however, with a much lower frequency than suicidal ideation. They are manifested for the purpose of manipulating the prison staff and gaining better living conditions in penal institutions.

Suicidal Behaviors in the Ghana Police Service.

Background: Despite recent media reports showing disturbing trends of police suicides in Ghana, no published studies are available from the country. Aims: We sought to estimate the prevalence and describe some of the correlates of suicidal behaviors among police officers in the Greater Accra Region of Ghana. Method: We surveyed a convenience sample of 268 police officers, using the Suicide Behavior Questionnaire-Revised to assess suicidal ideation, planning, threat, and attempt. Results: Whereas lifetime suicidal ideation (28%), planning (3%), threat (21.6%), and 12-month suicidal ideation (26.9%) were reported, no participating police officer reported ever attempting suicide. Moonlighting showed the strongest statistically significant association with 12-month suicidal ideation, while age, marital status, and job satisfaction also emerged as statistically significant correlates of suicidal ideation. Limitations: The busy nature of police work precluded random selection. The criminalized and tabooed status of attempted suicide in Ghana might have led participants to provide guarded and socially desirable responses. Conclusion: Intervention efforts are needed to prevent the onset of suicidal ideation and possible transition to suicide among police officers in Ghana.

COVID-19 and Mental Health: An Examination of 911 Calls for Service

The purpose of this study was to explore the rate and geographic distribution of 911 calls for service related to mental health issues during the Coronavirus Disease 2019 (COVID-19) pandemic in the City of Detroit, MI, USA. The results suggest that the total number of calls for mental health issues was at the lowest level when compared with the same time period for the previous 3 years. Furthermore, as both the daily reported COVID-19 cases and related deaths increased over time, there was a significant decline in both suicide threats and suicides in progress. Significant hot spots were found for the total calls as well as for threats of suicide. These hot spots did not coincide with the spatial distribution of reported cases of COVID-19 by ZIP code. While higher and lower areas of reported cases were found, these differences by ZIP code were not found to be significant. When compared with the previous 3 years of data, the hot spot area was much smaller in 2020, implying that the mental health-related calls for service were more evenly spread throughout the city.

Psychological Aposematism: An Evolutionary Analysis of Suicide

The evolutionary advantage of psychological phenomena can be gleaned by comparing them with physical traits that have proven adaptive in other organisms. The present article provides a novel evolutionary explanation of suicide in humans by comparing it with aposematism in insects. Aposematic insects are brightly colored, making them conspicuous to predators. However, such insects are equipped with toxins that cause a noxious reaction when eaten. Thus, the death of a few insects conditions predators to avoid other insects of similar coloration. Analogously, human suicides may increase the credibility of future suicide threats and attempts from others, conveying an evolutionary advantage to the phenotypic expression of suicidal behavior in low-fitness contexts.

Monitoring Social Media and Technology Use to Prevent Youth Suicide and School Violence

With suicide as the second leading cause of death for individuals between the ages of 10 and 34 and with mass school shootings averaging once per year, schools are exploring ways to prevent this seemingly increase in youth suicide and other forms of youth violence. School-based prevention initiatives such as social/emotional learning curricula, school-based mental health services, and internal threat assessment protocols are becoming more prevalent. Along with these prevention efforts, increases in youth use of technology and social media have created a market for social media monitoring companies that use algorithms to analyze youth social media posts for threats of harm toward themselves or others. School districts contract with these social media monitoring companies for assistance in identifying youth who may be at risk for violence. The purpose of this article is to describe one school district’s experience using social media monitoring programs as part of their comprehensive school violence prevention and mental health promotion effort. The school district was alerted to many students who made suicidal and homicidal threats on social media and after identifying those students, the students were able to receive referrals for mental health support.

Exploring the geography of suicide threats and suicide attempts: An application of Risk Terrain Modeling.

The purpose of this research is twofold: first, the spatial distribution of 911 emergency calls for service to the police for suicides in progress and threats of suicide in the City of Detroit, Michigan will be explored to determine whether these events exhibit different patterns of spatial clustering. Second, this research will explore the utility of Risk Terrain Modeling (RTM) to assist in our understanding of the locations of calls for service to the police related to suicide threats and suicides in progress. The results suggest that these events are different social phenomenon, both with respect to the spatial clustering of these events as well as qualitative differences in the environmental factors that may contribute to their occurrence.

Are pre-existing psychiatric disorders the only reason for involuntary holds in the emergency department?

ObjectivesTo determine the role of previous psychiatric disorders including substance use disorders on emergency department (ED) patients on involuntary holds and compare presentations, treatment, and outcomes based on cause.MethodsWe conducted a retrospective study of patients ≥ 18 years old on involuntary holds in the ED of a tertiary care center from January 1, 2013, to November 30, 2015. Demographic and clinical information were collected. Those with and without prior psychiatric disorder including substance use disorder were compared.ResultsWe identified 251 patients of which 129 (51.4%) had a psychiatric disorder, 23 (9.2%) had a substance use disorder, and 86 (34.3%) had both. Thirteen patients (5.2%) had no psychiatric disorder or substance use disorder and the majority 10 (76.9%) were on involuntary holds due to suicidal threats related to pain or another medical problem. Patients without a psychiatric or substance use disorder were older (55 years [17.8] vs 42 [19]; P = 0.01), more likely to be married (10 [76.9%] vs 64 [26.9%]; P < 0.001), and had more medical comorbidities (10 [76.9%] vs 114 [47.9%]; P = 0.049) compared with those without a psychiatric or substance use disorder.ConclusionPatients on involuntary holds most commonly have pre-existing psychiatric disorder including substance use disorder. Patients on involuntary holds without history of psychiatric disorder often have severe pain or other active medical conditions which may contribute to suicidal thoughts. Addressing these underlying medical issues may be crucial in preventing further psychiatric decompensation.

Detection and Prevention of Twitter Users with Suicidal Self-Harm Behavior

Recently, with the development of communication means such as 4G and the rapid growth of the use of mobile devices (smartphones and tablets) the number of twitter users has increased exponentially. By the end of 2018 Twitter had 321 million active users with over 600 million tweets every day. However, all this information will have no use if we cannot access the meaning it carries. The authors' idea is to identify Twitter users with suicidal or self-harm behaviors by analyzing their tweets using an algorithm inspired from the social life of Asian elephants. The objective is to prevent the situations of depressions, threats of suicide or any other form of self-destructive behavior that exists on Twitter.

Transport and logisitics workers face new challenges and adapt new trade union strategies

22 | International Union Rights | 27/3 FOCUS | IMPACTS OF COVID-19 ON WORK AND THE CHALLENGE FOR UNION RIGHTS Transport and logisitics workers face new challenges and adapt new trade union strategies During the early days of the crisis, before lock-down starts occurring and when globally there was uncertainty about the nature, duration and scale of Covid-19, it became clear that there were problems in supply chain resilience. From the outset, consumer panic buying and millions of workers relocating to work from home changed the already vast scale of e-commerce and left huge gaps on shelves in shops and warehouses. Throughout these supply chains are ITF affiliated members. From passenger services to air freight, from ships holding 10,000 containers of essential goods to the dockers unloading and moving to storage. The pickers in the warehouses who were getting consumers the essential goods that they needed. The vast road and rail networks that all these goods are transported along are all serviced by ITF affiliated members. Where transport workers usually are invisible except to a few, in these circumstances, they have arrived at the forefront of consciousness. However, beneath the global glory that transport workers were able to see more visibly than ever before, remain systemic problems that our members faced pre-Covid. Fragmentation of contracting systems throughout supply chains, dependant workers not able to access their ultimate employer, the knowledge and ability to form and join unions to bargain in the most basic sense has compromised union density. Articles are written elsewhere about the seafarers’ crisis, but with over 300,000 crew trapped at sea, even our most mature and exclusive model of global industrial relations is under strain. Everyday complaints about lack of access to PPE, unpaid and excessive hours of work and unachievable performance targets remain a constant threat to health and wellbeing. With workers reporting a lack of access to appropriate PPE, warehouses continue to be closed for deep cleaning following reports of clusters of infection and in some of the worst cases, deaths of our members. Some employers determined that it was more important to keep supply chains moving than take the time to perform proper risk assessments and check on access to toilets, handwashing facilities and sanitation stations to enable full compliance with WHO or governmental guidelines, in some cases avoiding their own corporate procedures. Within the ITF family, the spiking increase of ecommerce and just in time delivery to support the vast numbers of homeworkers, was exacerbated by the millions of workers furloughed by industries such as cruise and aviation, ITF affiliate members whose industries were decimated by travel restrictions and closed borders. Furthermore, we have many reports of our members being unable to leave warehouses until picks were completed, or trucks until deliveries were completed, airplanes where passengers were not following regulations on face coverings or other provisions. This has left our members struggling to combine increased domestic responsibilities with their work, some having to self-isolate from their own families without employer pay or support. The associated high volumes of stress are also unsurprising. ITF has had media coverage of the unacceptable conditions for our drivers hauling goods. We already had evidence of border crossing lorry drivers within the European Union identifying as victims of human trafficking. The inability of workers to be able to identify and negotiate with employers to achieve the life saving equipment needed, only contributed further to the detriment faced on the road by workers who were miles away from home for months on end, with no access to rest, toilet or sleeping facilities and receiving pay well below recognised minimums (see report on ITF website). Some of our seafarers are unable to even talk to their families. In some extreme cases we have received reports of the ships’ satellite being switched off to prevent them from accessing social media or other forms of contact with the outside world, and to stop them from complaining to their union or to the dedicated support systems within the ITF. The associated impact on mental health and wellbeing is real, including regularly receiving personal threats of suicide, leaving the ITF Inspectorate and unions representing our seafarers facing...