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This paper critically analyses deaths in prison in England and Wales. It focuses on how the state's 'truth' about the nature and extent of these deaths has been challenged and develops an alternative perspective which situates these deaths in the context of a system built on violence and systemic indifference and where state agents are protected by a culture of immunity and impunity. It also illustrates the often-abysmal treatment of the families of dead prisoners and the struggles they have engaged in, alongside the charity INQUEST1, to establish the actual truth about the deaths of their relatives and to hold to account those responsible for these deaths, many of which were preventable. The paper concludes by outlining a range of radical alternatives to the current baleful situation including humanising prisoners and removing the stigma of less eligibility which has prevailed for 200 years and has legitimated the pain and punishment inflicted on them by the state. [ABSTRACT FROM AUTHOR]

Objective: We investigated recent trends in youth suicide and their associations with societal and psychological factors in Taiwan. Methods: Suicide data (1971–2019) for 10–24 year olds were extracted from Taiwan's national cause-of-death data files. We investigated changes in trends in youth suicide rates, societal factors (gross domestic product per capita, Gini index, overall and youth unemployment rates, divorce rates in people aged 40–59 years [i.e. the age of most 15–24 year olds' parents] and Internet use rates) and psychological distress indicators (youth self-harm rates and the prevalence of worry-related insomnia, and suicide ideation, plan and attempt) using joinpoint regression and graphic examinations. The associations of these factors with youth suicide rates were examined using Prais–Winsten regression. Results: Suicide rates in Taiwan's 10–24 year olds changed from a downward trend (2005–2014) to an upward trend in 2014 and increased 11.5% (95% confidence interval = [5.2%, 18.1%]) annually between 2014 and 2019. There was also an upturn in divorce rates among females aged 40–59 years in 2014 and self-harm rates among 15- to 24-year-old youth in 2013. The prevalence of self-reported insomnia and suicide ideation, plan and attempt in youth started to increase from 2013 to 2016. In the regression analysis, Internet use, female divorce rates and youth self-harm rates were positively associated with youth suicide rates. Conclusion: Suicide rates and the prevalence of suicidal behaviors began to increase in Taiwanese youth in the 2010s. These increases may be associated with concurrent rises in parental divorce rates, Internet use and poor sleep. Further research is needed to examine the mechanisms underlying recent increases in youth suicide risk. [ABSTRACT FROM AUTHOR]

This study examined suicide stigma in relation to Korean cultural characteristics, such as Collectivism, Chemyon sensitivity (concern about losing a socially acceptable face), the tendency toward conformity, and the emphasis on the interdependent self. We found that these characteristics were connected to suicide stigma in Korea. Those with high Chemyon sensitivity tended to perceive that suicidal people were incompetent, immoral, selfish, and deviated from society. Conformity tendency was positively associated with five stigma factors: incompetence, glorification, immorality, selfishness, and social exclusion. Those who perceived themselves as interdependent tended to consider suicidal people incompetent, lacking morality, self-centered, and deviant. [ABSTRACT FROM AUTHOR]

This qualitative study analyzed suicide notes left by 591 decedents in Shanghai and Wuhan, in China. General guidelines and detailed requests with regard to funeral service were coded. In general, suicide decedents preferred untraditional funerals, which were simple and speedy rather than grand and costly funeral arrangements. These choices suggested that suicide decedents could fear stigmatization and discrimination. Some suicide decedents regarded suicides as vicious deaths, and thus wished their families to dispose of the cursed bodily remains and tombs as swiftly as possible. [ABSTRACT FROM AUTHOR]

Objectives: There have been numerous qualitative studies into the impact of the death of a patient by suicide on clinicians, but the majority of studies have focussed on psychiatrists and psychologists, primarily in inpatient or secondary care settings. To date, little has been done to explore the impact of such deaths on other mental health practitioners working in primary care, such as those working in Improving Access to Psychological Therapies (IAPT) services. Design: This qualitative study used purposive sampling and adopted an interpretative phenomenological analysis (IPA) methodology. Method: All participants had experienced the death of a patient in their role as a practitioner in an IAPT service. Seven practitioners were recruited from services across the North of England. Semi‐structured, one‐hour telephone interviews were audio recorded and then transcribed verbatim. Results: Analysis of the transcripts identified a number of themes, which were represented in the majority of cases. Specifically, the analyses yielded four superordinate themes: (1) feeling shocked and upset about the death of a patient; (2) attempting to understand the causes of the suicide; (3) learning from the tragic event; and (4) reflections on what helped in coping with the tragic event. The emotional responses of shock, upset, guilt and fear of blame by IAPT practitioners following the death of a patient through suicide is consistent with that found in studies of other mental health practitioners. Conclusions: It is hoped that the current study will help raise awareness amongst primary care mental health practitioners, services and training centres, of the impact of losing a patient to suicide and will encourage them to consider how best to prepare and support practitioners in this eventuality. Recommendations include raising awareness of the potential for patient suicide in primary care services, providing clarity on the individualised support available and on the requirements of investigations. [ABSTRACT FROM AUTHOR]

Background Lesbian, gay and bisexual (LGB) young people's increased risk of self-harm, suicidal attempts and suicide compared with heterosexual youth is well established. The current study sought to examine whether these findings also apply to the trans (T) population and which factors act as additional risk or protective factors. Methods In a national cross-sectional survey, 3713 LGBT adolescents, aged 11–19 years, reported on their own history of self-harm, suicidal ideation and suicide attempts, as well as their experiences of school and homophobic, biphobic and transphobic bullying. Logistic regressions tested the association between risk and protective factors on self-harm, suicidal ideation and suicide attempts. Results A high proportion of the sample reported self-harm (65.3%), suicidal ideation (73.8%) and suicide attempts (25.7%). Demographic risk factors included identifying as female, non-binary or trans and being from a low-income background. Bullying and online bullying were associated with an increased risk for each outcome, and positive school experience was associated with a reduced risk for each outcome. Conclusions Consistent with minority stress theory, the study found high rates of mental health problems within LGBT youth. Interventions focused on improving young people's experiences in schools appear useful targets to help improve mental health outcomes. [ABSTRACT FROM AUTHOR]

Background Imbalanced portrayal of suicide by the media can have adverse public health consequences. We aimed to evaluate the psychosocial context, as well as the quality of media reporting, of suicide among lesbian, gay, bisexual, transgender people, queer and intersex (LGBTQI+) population. Methods A cross-sectional study was conducted to evaluate online news reports discussing the suicide of LGBTQI+ persons published between January 2011 and January 2021. Psychosocial factors associated with suicide were extracted from the reports. Quality of suicide reporting was checked against international as well as locally relevant reporting guidelines. Results A total of 135 suicide reports from five newspapers were analyzed. Multiple psychosocial stressors were reported in 54.5% of the suicides. Social stigma was the most common factor associated with LGBTQI+ suicide. Several breaches of reporting were noted in relation to mentioning the identity (55.6%) and method of suicide (54.3%) in the title of report and inclusion of the deceased's photograph (20.4%). Potentially helpful reporting characteristics, such as including educational information (2.2%), mentioning warning signs (12.6%) and suicide support service details (3.7%), were rarely practiced. Local language news articles displayed more frequent and serious violations compared to English news reports. Conclusion Indian media reporting of suicide among LGBTQI+ persons is poorly adherent to reporting guidelines. [ABSTRACT FROM AUTHOR]

This study aims to investigate the phenomenon of suicide, which is a global health problem, by utilizing suicide notes. Our main concern in this article is to understand why a person leaves suicide notes before committing suicide; indeed, this question may shed light on particular personal characteristics of the note-leavers. 12 documents containing suicide notes, belonging to Turkish males, were obtained from Prosecutor office. By using an inductive and interpretative method, firstly, we conducted a semantic level analysis; and subsequently, we deeply analyzed the data by conducting latent level analyses from a Lacanian point of view. At the end of this cumulative process, we labelled the latent themes as 'ambivalence of emotions', 'issues associated with separation' and 'issues associated with the Law'. Within the scope of those findings, a diagnostic discussion was provided. This discussion designated a picture of narcissism in addition to a psychotic structure, specifically paranoia. [ABSTRACT FROM AUTHOR]

China accounts for an estimated third of the world's suicides, yet individuals experiencing suicidality typically do not seek out or receive treatment. This study examines community perceptions and public stigma toward suicide. In Shanghai, China 186 adults were recruited to participate in a survey with an experimental vignette describing a suicidal individual, manipulated on gender and age, followed by questions eliciting attitudes toward suicide. Most participants agreed that the suicidal subject had a serious problem, with seriousness of the problem decreasing with participant's age. Participants reported moderate levels of public stigma. More stigma was found toward adolescent subjects rather than adult. Male subjects were perceived as being more likely to change than females. The public's accurate view of suicide without biases could help prevent suicide from getting worse. Public perceptions regarding a suicidal individual's likelihood to change could lead to stigma reduction, which can subsequently help with effective crisis intervention. [ABSTRACT FROM AUTHOR]

Zeno the Stoic and the biblical Job react very differently to stressors in their lives. While Zeno succumbs to a relatively minor accident and takes his life, Job withstands cataclysmic losses, survives, and ultimately is restored. While Zeno's search for meaning ends in his suicide, Job's sense of purpose enables him to survive and ultimately thrive. The essential difference is that while Zeno greatly catastrophizes a relatively minor stressor in a desperate search for meaning, Job lives a life of purpose which gives his life intrinsic meaning. This distinction may be most relevant in today's chaotic world, with so many young people striving to "find themselves" in often the most destructive ways. While Job is resilient, Zeno is not. Job's biblical faith provides the grounding for his self-knowledge. Zeno the Stoic does not seem to have this foundational self-knowledge and is searching for signs that he is not adrift in an indifferent world. For some people, at least, biblical religion seems to provide a healthy foundational view which gives life essential purpose. [ABSTRACT FROM AUTHOR]

We modified an accident analysis model for the study of acute suicidal episodes (ASEs). Our aim was to use this model (SCREAM, Suicidal Cognitions' Reliability and Error Analysis Method) as a lens to understand the worst-ever ASEs of nine patients who took part in repeated in-depth interviews. Guided by the theory of SCREAM including four predetermined categories, nine themes were identified. ASEs were triggered by interactions with the interpersonal and physical environment and spiraled into a state of lost control. Timing and the availability of promoters and barriers in the environment were salient features. Findings may aid person-centered safety planning. [ABSTRACT FROM AUTHOR]

Two years ago, in the early stages of the COVID-19 pandemic, there were widespread and grim predictions of an ensuing suicide epidemic. Not only has this not happened but also by the end of 2021 in the majority of countries and regions with available data, the suicide rates had, if anything, declined. We discuss four reasons why the predictions of suicide models were exaggerated: (1) government intervention reduced the economic and mental costs of lockdowns, (2) the pandemic itself and lockdowns had less of an effect on mental health than assumed, (3) the evidence for a link between economic downturns, distress and suicide is weaker and less consistent than the models assumed and (4) predicting suicide is generally hard. Predictive models have an important place, but their strong modelling assumptions need to acknowledge the inherent high degree of uncertainty which has been further augmented by behavioural responses of pandemic management. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the relationship between identity crisis and suicide resilience and quality of life in adolescents with burns in Iranian society. Design: A cross‐sectional study. Methods: Four hundred thirty adolescents with burn in three hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. Results: Findings showed a strong and inverse correlation between identity crisis with suicide resilience (r = −.92, p <.001) and quality of life (r = −.87, p <.001). Variables of suicide resilience, being a child of a divorced family, cause of burns, extent of burn, financial situation, gender and age can predict 68.74% of the variance in identity crisis in these patients. Patient or Public Contribution: Adolescents with burns suffer from an identity crisis, and although they report high resilience to suicide, they have a mediocre quality of life. Therefore, it is suggested that basic planning and extensive support be taken to improve physical and mental health, promote the quality of life and consequently reduce the identity crisis in these adolescents. [ABSTRACT FROM AUTHOR]

Suicide deaths have a profound impact on whānau and community and are a tragic loss. However, from a statistical point of view, suicide is a relatively rare event. Predicting rare events is difficult, and the implications for suicide prevention were highlighted in an important editorial in this journal more than a decade ago, yet little seems to have changed. Risk assessment that focuses on accurate prediction of suicide in real-world contexts is given a great deal of attention in mental health services, despite the fact that current scientific knowledge and best practice guidelines in this area highlight that it is unlikely to be a good basis on which to provide access to treatment. It is our view that we have a good enough understanding of the common conditions people who struggle with suicidal distress experience and energy is better directed at acting to reduce exposure to these conditions and providing treatment for those who seek it. Blueprints for successful suicide prevention exist. If we lessen the focus on prediction, we will have greater resources to focus on treatment and prevention. [ABSTRACT FROM AUTHOR]

To explore how social media users react to suicide, we collected and analyzed 3,482 public comments on Bangladeshi suicide news emphasizing the user's gender, victim's gender, victim's profession, and suicide risk factor. The quantitative content analysis found that users react to suicide in nine different ways: angry, sadness, surprise, irony, ridicule, judgmental, justification, speculation, and miscellaneous. Of them, angry (20.3%) is the dominant reaction. In many cases, users mock the suicide victims (12.7%), showing less empathy. We found strong positive correlations between users' reactions and victims' profession (φ = 0.493; p <.05) and users' reactions and suicide risk factors (φ = 0.233; p <.05). [ABSTRACT FROM AUTHOR]

This study unpacks the dimensions of suicide stigma through an analysis of the stories told by college students in China. The phronetic iterative approach was used to analyze the interview data of 30 college students. Findings showed that college students use the strategy of othering in creating a distinction between us and them. Those who attempt or die by suicide are labeled as irresponsible, fragile, impulsive, and attention-seeking. Suicides of ingroup members are usually described as controllable, while the suicides of outgroup members are often deemed uncontrollable. Finally, suicides lead to a status loss for individuals and their social groups. [ABSTRACT FROM AUTHOR]

Background: Suicide is a public health issue, and there are differences between men and women in terms of suicide ideation, behavior, and completion. Obstetrician/gynecologists (OB/GYNs) are uniquely positioned to assess women's suicide risk. Materials and Methods: A 53-question survey was distributed to the Pregnancy-Related Care Research Network, assessing practice, attitudes, and knowledge regarding suicide risk assessment and management, and personal experience with suicide. Wilcoxon signed-rank tests with paired samples were used to compare the frequency of screening and interventions for different groups of women, and practices of those with and without suicide experience. Significance was set at p < 0.05. Results: Response rate was 31.9%. Respondents were largely White females. OB/GYNs reported more frequently screening for suicide ideation/intent/behavior among pregnant and postpartum patients than nonpregnant/nonpostpartum patients of childbearing age. The most common assessment tool was the Edinburgh Postnatal Depression Scale; half ask about past suicide ideation/behavior or current thoughts/plans. The most common intervention for at-risk patients was a mental health referral; all interventions were reported more frequently for pregnant patients. Common barriers to screening were inadequate mental health services, time constraints, and inadequate training. Most agreed suicide screening is within their purview, and were knowledgeable about the topic, although gaps were identified. Few reported adequate training in suicide risk assessment, and believed continuing education would be beneficial. A majority endorsed experience with suicide and some practice differences emerged. Conclusions: OB/GYNs view suicide risk assessment in their scope. Some knowledge gaps were identified, and respondents believe additional training would be beneficial. [ABSTRACT FROM AUTHOR]

The TAPS Suicide Postvention ModelTM is a three-phase approach to suicide grief that offers a framework for survivors and providers in the aftermath of a suicide. This framework proposes guidance on how to build a foundation for an adaptive grief journey and creates a research-informed, proactive, intentional pathway to posttraumatic growth. The Model follows the Tragedy Assistance Program for Survivors' peer-based model of care and has supported more than 16,000 military suicide loss survivors over the past decade. The Model is applicable to anyone grieving a suicide loss or coping with any associated trauma. [ABSTRACT FROM AUTHOR]

The current study examined hypotheses related to the development of suicidal ideation as directed by the interpersonal theory within a sample of acutely suicidal psychiatric inpatients. Consistent with ideation-to-action models, we distinguished suicidal desire from resolved plans and preparations. Although thwarted belongingness and perceived burdensomeness were correlated with suicidal desire, only perceived burdensomeness was associated with suicidal desire controlling for depression and thwarted belongingness. Depression alone was related to plans and preparations. Findings are interpreted as challenging the mechanisms hypothesis of the interpersonal theory and suggest that alternative conceptualizations of the development of suicidal desire may be warranted. [ABSTRACT FROM AUTHOR]

Objectives: The article aims to explore the studies performed on suicide because of coronavirus disease 19 through a bibliometric analysis. A quantitative analysis of the topic furnishes data on the publication pattern, influential research journals, highly cited articles, productive countries and organizations, the authorship pattern, and the collaborative pattern between authors. Methods: Data regarding the type of documents, most cited articles, influential research journals, contributions per country, and so on were extracted for the study from the Scopus database. Data analysis and visualization were performed through R-Studio and the VOSviewer application. Results: A bibliometric analysis encompassing scientific contributions based on suicide or suicide-related ideation because of the coronavirus pandemic showed a total of 494 documents published in 230 journals/books. The articles published by proficient authors in reputed journals highlighted the key areas of research in the field. USA dominated the list of scientific production of countries contributing to 340 documents. Conclusion: The results provided by this analysis could act as a steppingstone for experts to design a roadmap for mental health research during the pandemic. Studies can be designed to gather information on mental health conditions across specific age groups. Research collaborations that facilitate the publication of pooled protocols and data are encouraged. [ABSTRACT FROM AUTHOR]

Suicide, as the third leading cause of death among individuals aged 15 to 24 years, is substantially more frequent in non-metropolitan/rural counties, where college/university students may be at particular risk; however, little is known about risk and protective factors and prevention strategies specific to this population. The current integrated review was completed to explore such factors and evidence-based interventions. A systematic literature search was performed, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and using computerized databases, for studies published from 2008 to 2021; nine met inclusion criteria. Data were classified into subgroups, which included risk and protective factors for suicidality, stressors and risk factors for psychological distress, and barriers to psychological help-seeking. Key findings included depression as a risk factor, religiosity as a protective factor, decreased social support as a stressor, and various barriers to help-seeking. No evidence-based interventions for this population have been identified in the literature. Research is needed to explore evidence-based interventions for rural college/university students. [Journal of Psychosocial Nursing and Mental Health Services, 60(9), 15–23.] [ABSTRACT FROM AUTHOR]

This autoethnography explores the experience of societal meanings of suicide from the perspective of people bereaved by suicide. The research focuses on three autoethnographic stories of everyday experiences in which personal meaning making and societal meanings of suicide intersect in contemporary Australian settings. Personal perspectives are positioned alongside broader discussions of suicide taboo to consider the implications for agency and meaning making. Key differences between conventional notions of stigma and structural stigma, and ways in which suicide taboo influences meaning making for people bereaved by suicide are explored. The paper proposes a recasting of action previously framed as internalised stigma as proactive self-preservation by people bereaved by suicide. It concludes by arguing that building capacity to see the societal taboos of suicide creates opportunities for strengthening agency in personal narratives of bereavement by suicide. [ABSTRACT FROM AUTHOR]

Despite Hong Kong's ranking as having one of the lowest homicide rates worldwide, it has one of the highest female homicide rates globally. This research catered to the need for a systematic empirical analysis of the femicide phenomenon in Hong Kong by examining census data of femicide cases that occurred in Hong Kong in 5 years: from January 2015 to December 2019. Thirty-eight cases were examined and coded, covering 17 variables relating to victims, perpetrators, and modus operandi. Despite the small number of cases, this article highlights femicide's sociocultural diversity by discussing its unique patterns in Hong Kong, with a high share of femicide-suicide cases and overrepresentation of foreigners and women older than 60. The article concludes with recommended policy strategy reformulations needed to better combat femicide in Hong Kong. [ABSTRACT FROM AUTHOR]

It is well established that there is a fundamental need to develop a robust therapeutic alliance to achieve positive outcomes in psychotherapy. However, little is known as to how this applies to psychotherapies which reduce suicidal experiences. The current narrative review summarizes the literature which investigates the relationship between the therapeutic alliance in psychotherapy and a range of suicidal experiences prior to, during and following psychotherapy. Systematic searches of MEDLINE, PsycINFO, Web of Science, EMBASE and British Nursing Index were conducted. The search returned 6472 studies, of which 19 studies were eligible for the present review. Findings failed to demonstrate a clear link between suicidal experiences prior to or during psychotherapy and the subsequent development and maintenance of the therapeutic alliance during psychotherapy. However, a robust therapeutic alliance reported early on in psychotherapy was related to a subsequent reduction in suicidal ideation and attempts. Study heterogeneity, varied sample sizes and inconsistent reporting may limit the generalizability of review findings. Several recommendations are made for future psychotherapy research studies. Training and supervision of therapists should not only highlight the importance of developing and maintaining the therapeutic alliance in psychotherapy when working with people with suicidal experiences but also attune to client perceptions of relationships and concerns about discussing suicidal experiences during therapy. [ABSTRACT FROM AUTHOR]

Survival after attempted hanging is a rare event. Many patients who suffer from hypoxic brain damage following hanging die immediately. The study was conducted in the Department of Forensic Medicine, Government Medical College, Thiruvananthapuram during the period January 2013 to June 2014. 50 cases were included in the study. Among the 50 cases, 25 cases were the hanging cases that survived for varying periods before death and 25 cases were from the non-survived victims of hanging. Macroscopic and microscopic changes in the brain, were compared to find out the changes resulting from hypoxic insult. The cases were studied in detail and are described below. [ABSTRACT FROM AUTHOR]

Suicide prevention efforts have focused primarily on screening, education, and brief interventions rather than on treatment of underlying vulnerabilities. The Psychiatry High Risk Program (PHRP) is a specialized outpatient program for suicidal youths and young adults that facilitates transitions in care and provides comprehensive treatment aimed at healing and recovery. The authors evaluated the program's impact on inpatient utilization and suicide risk for patients (N=32) who were referred to the PHRP after psychiatric hospitalization for suicidality. Results indicate that program participants had large reductions in depression and suicidal ideation over 180 days postdischarge; they also had significantly fewer rehospitalizations than did a matched historical cohort, with an average savings of >6 hospital days per patient. These preliminary results suggest that a recovery-based suicide prevention program can be feasible and sustainable and may be cost-effective in a value-based system of care. [ABSTRACT FROM AUTHOR]

The interpersonal theory of suicide posits people are more likely to consider suicide when they perceive themselves as alone and as a burden. However, there is limited research on whether these self-perceptions reflect caregiver experiences. As part of a larger study of collaborative safety planning, 43 Veteran/caregiver dyads (N = 86 individuals) completed measures of belongingness and burdensomeness, caregiver burden, family problem solving, and suicide-related coping. We conducted dyad-level actor interdependence models allowing two types of social coping (i.e., general problem solving and suicide-specific coping) to predict Veteran's self-views and caregiver interpersonal perceptions. Results suggested that Veteran social coping predicted lower Veteran thwarted belonginess and burdensomeness and caregiver involvement in problem solving was similarly associated with their own lower caregiver emotional burden. But examination of cross- partner effects demonstrated that greater Veteran coping was associated with greater time burden for caregivers. Findings suggest that social coping is associated with positive perceptions at the individual level (i.e., Veterans and caregivers to themselves) but does not indicate positive effects at the partner level. Clinicians working with Veterans may wish to involve supports in care to encourage effective collaboration that meets both caregiver/recipient needs. [ABSTRACT FROM AUTHOR]

This study explored reasons for living among those with lived experience of suicide entering the suicide prevention workforce. The study recruited 110 participants from two Roses in the Ocean training programs (79% female, mean age 46.5). Responses to open-ended survey questions about reasons for living were analyzed using qualitative content analysis method. Connection to others and service were the most commonly stated reasons for living. Other categories included orientation toward future, life, self, pleasure, and spiritual reasons and values. These findings can be used in further research and design of support programs for peer specialists. [ABSTRACT FROM AUTHOR]

Objectives: To investigate psychoactive medication use and risk of suicide in long-term care facility (LTCF) residents aged 75 and above. A second aim was to investigate the role of psychiatric and medical conditions in the occurrence of suicide in LTCF residents.Methods: A Swedish national register-based cohort study of LTFC residents aged ≥75 years between 1 January 2008 and 31 December 2015, and followed until 31 December 2016 (N = 288,305). Fine and Gray regression models were used to analyse associations with suicide.Results: The study identified 110 suicides (15.8 per 100,000 person-years). Half of these occurred during the first year of residence. Overall, 54% of those who died by suicide were on hypnotics and 45% were on antidepressants. Adjusted sub-hazard ratio (aSHR) for suicide was decreased in those who were on antidepressants (aSHR 0.64, 95% confidence interval 0.42-0.97), even after the exclusion of residents who had healthcare contacts for dementia or were on anti-dementia drugs. The aSHR for suicide was more than two-fold higher in those who were on hypnotics (2.20, 1.46-3.31). Suicide risk was particularly elevated in those with an episode of self-harm prior to LTCF admittance (15.78, 10.01-24.87). Specialized care for depression was associated with increased risk, while medical morbidity was not.Conclusions: A lower risk of suicide in LTCF residents was found in users of antidepressants, while elevated risk was observed in those on hypnotics. Our findings suggest that more can be done to prevent suicide in this setting. [ABSTRACT FROM AUTHOR]

Suicide is a global public health concern. The Stigma of Suicide Scale–Short Form (SOSS-SF) is a brief measure on the stigma toward suicide. This study aimed to examine the psychometric properties of the SOSS-SF in a sample of 1,946 adolescents and early adults (M age = 23.3, 69% females) in Hong Kong. The participants completed the SOSS-SF, measures on suicidal ideation and perceived distress, and binary items on lifetime risk behaviors online. Exploratory structural equation modeling evaluated the factor structure and reliability of the SOSS-SF in split samples and its measurement invariance, convergent validity, and discriminant validity in the overall sample. Contrary to a poor fit for the three-factor structure in the original 16-item SOSS-SF, the four-factor model showed a good fit in the revised 12-item version in both subsamples. The four factors (Glorification, Isolation, Disgrace, and Selfishness) loaded significantly on three items each (λ =.52-.93) and had adequate reliability (ω =.78-.88). The SOSS-SF displayed scalar invariance across age group, gender, and suicidal ideation and significant associations with validating variables. These results demonstrate a valid and reliable four-factor structure for the SOSS-SF and support its use for assessment of multifaceted stigma toward suicide. [ABSTRACT FROM AUTHOR]

Aims: To describe the research protocol for an ecological momentary assessment (EMA) designed to examine patterns of suicidal ideation and relevant psychosocial stress indicators in adults at risk for suicide. Design: This observational and longitudinal study will collect data for 28 consecutive days. Methods: A total of 150 adults at risk for suicide will be recruited from a single suicide prevention centre and an outpatient clinic in Korea. Self-report questionnaires will be administrated during weeks 0, 1, 3 and 5. Participants will receive text messages three times a day for 4 weeks prompting them to access an online survey link for daily mood survey including depression, anxiety, stress and suicidal ideation. In addition, for the first 2 weeks, they will wear an actigraphy device designed to collect actigraphic data in terms of sleep patterns and physical activity. Data analyses such as descriptive statistics, independent t-tests, one-way ANOVA, chi-squared statistics and time-series and correlation analyses will be performed using IBM SPSS 26.0 and SAS version 9.3. The study received funding from National Research Foundation of Korea in February 2020. Institutional Review Board approval for our study was obtained in April 2021. Discussions: This study will yield fundamental information about daily patterns of suicide ideation and psychosocial stress indicators to develop preventive interventions for adults at risk for suicide. Impact: Our study will contribute to the development of EMAs and interventions for adults at risk for suicide aimed at providing timely and individualized mental health services in a community setting. Trial Registration: The trial is registered with the Clinical Research Information Service (CRIS). CRIS Registration Number: KCT0006165. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between contextual factors, represented by geographic and community health variables, and suicide among rural and urban Department of Veterans Affairs health care users (VA users). Methods: We performed a retrospective cohort study of 12,700,847 VA users between 2003 and 2017. We assigned contextual factors based on individuals' home address at the ZIP Code (area deprivation), county (sunlight exposure, altitude, and community health), and state level (firearm ownership), using publicly available data sources. We grouped contextual factors by quintiles or prespecified thresholds, depending on the nature of each variable. We obtained mortality data from the National Death Index. We measured the effect of living in a place with the highest versus lowest level of each contextual factor on odds of suicide using logistic regression, adjusting for individual compositional factors abstracted from VA electronic medical records data. We used random forest modeling to build prediction models for suicide based on contextual factors among rural and urban veterans. Findings: Almost all contextual factors we examined were significantly associated with suicide among rural and urban VA users, even after adjusting for individual compositional factors. However, no contextual variables were strong protective or risk factors (0.52.0), and prediction models leveraging these contextual factors had poor accuracy among both rural (0.51, 95% CI: 0.48‐0.54) and urban (0.53, 95% CI: 0.51‐0.55) VA users. Conclusions: A wide variety of contextual factors is significantly associated with suicide among rural and urban VA users. However, the factors we measured contributed very little to individual‐level suicide risk. [ABSTRACT FROM AUTHOR]

Approximately 5% of individuals with schizophrenia die from suicide. However, suicide in psychosis is still poorly characterized, partly due to a lack of adequate population-based clinical or genetic data on suicide death. The Utah Suicide Genetics Research Study (USGRS) provides a large population-based cohort of suicide deaths with medical record and genome-wide data (N = 4380). Examination of this cohort identified medical and genetic risks associated with type of suicide death and investigated the relative contributions of psychotic and affective symptoms to method of suicide. Key differences in method of suicide (common vs. atypical methods) were tested in relation to lifetime psychosis and genome-wide genetic risk for schizophrenia, major depressive disorder, and neuroticism. Consistent with previous studies, psychosis-spectrum disorders were observed to be common in suicide (15% of the cohort). Individuals with psychosis more frequently died from atypical methods, with rates of atypical suicide increasing across the schizophrenia spectrum. Genetic risk for schizophrenia was also associated with atypical suicide, regardless of clinical diagnosis, though this association weakened when filtering individuals with schizophrenia from the analysis. Follow-up examination indicated that high rates of atypical suicide observed in schizophrenia are not likely accounted for by restricted access to firearms. Overall, better accounting for the increased risk of atypical suicide methods in psychosis could lead to improved prevention strategies in a large portion of the suicide risk population. [ABSTRACT FROM AUTHOR]

To understand how suspected suicides are investigated in New Zealand we conducted a thematic analysis of in-depth interviews with coroners. Coroners identified the inquisitorial nature of the coronial system and coroners' wide powers of jurisdiction as key strengths of the system. Important influences in key areas of coronial decision making in cases of suspected suicides included; the need for more evidence – especially to determine intent, and family factors, including therapeutic jurisprudence. Coroners identified lack of follow up and monitoring of recommendations, poorly resourced coronial training and the personal impact of suicides as challenges of working in the coronial system. [ABSTRACT FROM AUTHOR]

There has been plenty of philosophical discussion about the morality and/or rationality of suicide and physician‐assisted suicide. There has also been plenty of discussion about non‐prosecution policies (such as the British DPP 2010 Guidance) as a legal response to cases of one friend assisting the suicide of another. There has been much less attention paid to the particular conversations that might follow the request for suicidal assistance, and to the particular kinds of moral complexity involved. I will consider a 'Subject', who wants to commit suicide, but lacks the means or the information to do so, and therefore asks his 'Friend' for assistance. (Importantly, the Friend is not a physician.) Without aiming for anything comprehensive or theoretical, I sketch three 'easier' cases and two 'harder' cases, in order to explore the sorts of things that might be said, and thought, by each party, based on the different sources of meaning and morality. [ABSTRACT FROM AUTHOR]

Suicide-related behavior (SRB) is a growing mental health concern on college campuses. We argue that causes of this rising trend go beyond student stress, to include outdated campus policies, overburdened counseling center staffing, and untapped targets for prevention efforts. We outline the social-ecological model applied to suicide and related public health problems. Such a viewpoint provides an example road map to redress suicide and related risk factors (e.g., violence, substance abuse) through multiple levels of prevention-focused programing. Using our SAMHSA-funded campus suicide prevention programmatic approach as a case illustration, we proffer lessons and guidelines for the implementation of a social-ecological suicide prevention program (SESPP). Emphasis is placed on review of evidence-informed prevention programs, utilization of interdisciplinary prevention teams, need for rigorous program evaluation, and consideration of the unique demography of each campus. [ABSTRACT FROM AUTHOR]

Despite a plethora of existing literature on the topic of suicide, very little attention has been given to research ethics in practice in research on suicide. When suicide research does pay attention to the ethical issues researchers are likely to face, the focus is on the roles institutional human ethics review committees fulfil to ensure ethical conduct in all stages of research. In response to this problem, this article focuses on the philosophical relationship between qualitative methodology and research ethics in the context of researching queer youth suicide. In so doing, I draw on my experiences of interviewing gender-and sexually diverse young people about their familiarity with suicide. These experiences are based on a qualitative pilot study I conducted on queer youth suicide, which used the unstructured interview technique to collect data. Drawing on the works of Emmanuel Levinas and Judith Butler, I examine what it means to face the alterity of the suicidal 'Other', and what this facing entails in terms of research ethics as relational. I argue that facing reveals not only myself as more vulnerable than I anticipated, but also the suicidal 'Other' as agentic instead of only vulnerable and at-risk of suicide. [ABSTRACT FROM AUTHOR]

Aim: To analyze how people cope with suicide loss and the implications for primary health care. Background: Previous studies have shown that primary health care will often be an initial source of support for those bereaved by suicide. Methods: We included adult persons who were ready to talk about a suicide completed by a person they knew well (family member or close friend). Participants were recruited via mixed media (television, radio, print, social media, etc.). Altogether, we conducted 37 individual interviews, which were recorded using a dictaphone and lasted from 46 to 158 min. The interviews were transcribed verbatim and analyzed using a content analysis method. The interviewees were mostly women (n = 27) and family members (n = 28) of a person who had died by suicide during the years 2012–2018. Findings: We identified two main themes in the data: supporters and barriers in support. Coping with suicide takes time, and support was mostly found among friends and family. Support from GPs was mentioned in the context of diagnosing medical problems and prescribing medicines. Respondents indicated that feeling ashamed and a lack of trust impeded their willingness to seek help from their GP. Unmet needs among the bereaved may increase their risk of diminished mental health outcomes. Thus, primary health care practitioners may have a substantial opportunity to support those who are bereaved by suicide. Conclusion: Primary care providers have an opportunity to provide bereavement support among their patients. Continuing medical education regarding the needs of the bereaved and a coordinated approach among primary care practitioners may be useful to proactively identifying and supporting those in need. [ABSTRACT FROM AUTHOR]

Suicide is a public health crisis that has been increasing the past few years. Stigma associated with mental health and suicide can contribute to suicide attempts and completion. With suicide as the second leading cause of death among college-aged adults, colleges are continuing to find ways to combat stigma. As such, the authors employed a thematic analysis to examine the words and messages written during a university-based participatory community art project aimed at preventing suicide stigma. Results yielded six distinct themes including Positive Affirmations, Shame-Free Mental Health Awareness, Advice-Giving, Permission Granting, Togetherness, and Religious/Spiritual Support. Implications and recommendations for mental health practitioners and universities are provided. [ABSTRACT FROM AUTHOR]

Humans have been mystified by suicide perhaps from the earliest oral and written accounts of Homo sapiens. This article considers a variety of issues with reference to suicide in adolescents and young adults including its history, epidemiology, suicide risk factors, neurobiology, and management concepts. Suicide remains a major cause of death in adolescents and young adults but is a preventable condition in most cases if society provides principles of known prevention and mental health management. [ABSTRACT FROM AUTHOR]

Background: the pandemic caused by the new coronavirus emerged in China and brought a hard reality to the world population. The disease as well as its preventive measures, in addition to affecting people's physical health, is also affecting their mental health. The impact caused by the pandemic can lead people to put their lives at risk through suicidal acts. Objective: to investigate in the literature the reasons for suicides related to the pandemic caused by the new coronavirus. Methodology: it is an integrative review of articles published in 2020 through searches on Google Scholar and the National Library of Medicine - PubMed, based on the guiding question: what is the literature approach on the reasons for suicides related to the pandemic caused by the new coronavirus? Results: the new coronavirus (SARS-CoV-2) and the social isolation brought damage to the population's mental health. In the articles analyzed, it was observed that the reasons for the suicides associated with the pandemic are related to fear of the disease and of spreading it, economic recession and fear of losing the job, isolation, depression and obsession. Conclusions: it is necessary to pay attention to the reasons that lead individuals to put their lives at risk as a result of the pandemic and to create measures to protect the population's mental health. [ABSTRACT FROM AUTHOR]

The article appeals to nurse leaders, educators and nurses to make a difference for someone they work with who might be suffering from mental health issues or suicidal attempts. It raises concern over suicide risk and the impact of observed traumatic emotional reactions on nurses. It stresses the need for nurses to know the risk factors for suicide and signs of depression or self-harm and to be ready to intervene and urges for advocacy for suicide prevention.

Objective: This observational study examined the effects of electroconvulsive therapy (ECT) on suicide and all-cause mortality risk in older psychiatric patients.Methods: Participants were Medicare-insured psychiatric inpatients age 65 or older. Patients receiving ECT were exact-matched to control subjects (in a 1:3 ratio) on age, gender, principal hospital diagnosis, past-year psychiatric hospitalizations, past-year suicide attempts, and Elixhauser comorbidity index. Cox proportional hazard models were risk-adjusted for race, year of hospitalization, rural-urban continuum code, year of index hospitalization, median income of zip code, and all matched covariates to estimate hazard ratios with 95% confidence intervals.Results: A total of 10,460 patients in the ECT group and 31,160 in the control group were included in the analyses (total N=41,620; 65.4% female; mean age, 74.7 years [SD=7.09]). Compared with the control group, patients receiving ECT had lower all-cause mortality for up to 1 year following hospital discharge (adjusted hazard ratio=0.61, 95% CI=0.56, 0.66). For death by suicide, 1-year survival analysis showed no group difference. A significant association was observed with suicide in the first months following ECT, but this pattern waned over time (1 month: hazard ratio=0.44, 95% CI=0.21, 0.91; 2 months: hazard ratio=0.52, 95% CI=0.29, 0.92; 3 months: hazard ratio=0.56, 95% CI=0.37, 0.92; 6 months: 0.87, 95% CI=0.59, 1.28; 12 months: 0.92, 95% CI=0.68, 1.25).Conclusions: In this observational study, ECT was associated with lower 1-year all-cause mortality and with short-lived protective effects on suicide risk. These findings support greater consideration of ECT for inpatients with mood disorders at short-term risk of suicide. [ABSTRACT FROM AUTHOR]

Background The Union Territory of Puducherry has a high rate of suicide in India. This study aims to find the prevalence of suicidal ideation, plan and suicide attempts and the risk factors of suicidal behaviours. Methods This community-based cross-sectional study was conducted among adults aged 18 years and above in rural and urban areas of Puducherry, India. Columbia Suicide Severity Rating Scale questionnaire was used. Prevalence ratio was estimated to assess the factors associated. Results The 12-month and lifetime prevalence of suicidal ideation was reported to be 12.5% (95% CI: 10.4–15.0%) and 20% (95% CI: 17.4–22.9%), respectively. About 0.7% (95% CI: 0.3–1.5%) and 2.1% (95% CI: 1.2–3.3%) of the participants had suicide plan in past 12 months and ever in their lifetime, respectively. Around 1% (95% CI: 0.5–2.0%) and 5.7% (95% CI: 4.3–7.6%) of the participants had attempted suicide in past 12 months and ever in their lifetime, respectively. Family issues, physical abuse, unemployment and place of residence were significantly associated with suicidal ideation in multivariable analysis. Conclusion Prevalence of suicidal ideation and suicide attempt were very high in the study area. Unemployment, physical abuse and family issues were significantly associated with suicidal behaviour. [ABSTRACT FROM AUTHOR]

Despite the alarming suicide rate among South Korean emerging adults, relatively little is known about their unfettered perspectives on death and suicide. Therefore, an innovative data collection technique was developed to apprehend the meanings that emerging adults attribute to death and suicide in their explorations of the phenomena through a selection of short stories. A convenience sample (N = 114) responded to a survey in which participants transferred their feelings toward death and suicide to characters or events in the short stories. A qualitative content analysis revealed relatively permissive perspectives toward death and suicide. Negative perspectives on death are associated with societal victimization and positive perspectives with naturalistic fatalism. Positive perspectives on suicide are overwhelmingly rooted in existential, individual choices while negative perspectives focus on societal pressures. These perspectives contribute to illuminating tensions between traditionalist collectivism and contemporary individualism in Korean society that could inform suicide prevention initiatives for emerging adults. [ABSTRACT FROM AUTHOR]

Children often have difficulty talking openly about a parent's suicide. Bibliotherapy can help, but no bibliotherapy studies address parental suicide. We gave a focus group (5 paraprofessionals) 15 children's books addressing grief, parental suicide, and emotional expression, asking them which books were most helpful. They emphasized individualizing treatment to fit the child, recommending the books that honestly portrayed suicide, showed a way forward, provided hope, and assured children that they are not alone. The most highly recommend books were Bart Speaks Out: Breaking the Silence on Suicide and After a Suicide Death: A Workbook for Grieving Kids. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a common psychiatric disorder characterized by constant sadness and a lack of interest in work and social interactions. Maintaining the transcriptome levels via the controlled regulation of mRNA processing and transport is essential to alleviating MDD. Various molecular phenotypes such as aberrant RNA splicing and stability are identified as critical determinants of MDD. Aim: This study aims to compare the mRNA expression profiles between major depressive disorder non-suicide (MDD), major depressive disorder suicide (MDD-S), and control groups using RNA-Seq. Materials and Methods: A transcriptomics and sequencing analysis of gene expression profiling was conducted in 9 patients with MDD, 10 patients with MDD-S, and 10 control patients. Results: A comparison of the sample groups revealed that the PRKACB gene was upregulated in patients with MDD. At the same time, GRM3, DLGAP1, and GRIA2 were downregulated in these patients—these genes are majorly involved in the glutamatergic pathway. Five genes (GRIA1, CAMK2D, PPP3CA, MAPK10, and PPP2R2A) of the dopaminergic pathway were downregulated in patients with the MDD-S condition when compared with the MDD and control groups. Cholinergic synapses were altered in patients with MDD when compared to the control group due to the presence of dysregulated genes (KCNQ5, PLCB4, ADCY9, CAMK2D, PIK3CA, and GNG2). Conclusion: The results provide a new understanding of the etiology of depression in humans and identify probable depression-associated biomarkers. [ABSTRACT FROM AUTHOR]