Potentially preventable suicide

Suicide Prevention in an International Context.

Suicide is a growing public health concern in Brazil, with significant increases in mortality rates over the last decade and disparities among vulnerable populations. This study aimed to systematically synthesize the recent literature reviews on suicidality and suicide prevention in Brazil, providing an overview of key findings, research gaps, and implications for future studies. This systematic review of reviews follows a pre-registered PROSPERO protocol (CRD42024561892). Searches across five databases (MEDLINE, Scopus, CINAHL, SciELO and LILACS) identified 10 eligible reviews, published between 2019 and 2024, including systematic, integrative, narrative reviews, and meta-analyses. The reviews examined populations such as Indigenous peoples, adolescents, university students, older adults, and healthcare professionals. Findings showed that the risk of suicidal behavior was associated with mental health conditions, social vulnerability, and limited access to mental health services. Particularly high suicide rates were observed among Indigenous populations and adolescents. Across reviews, a lack of interventional studies, limited geographical coverage, and the inadequate training of health professionals were recurrent themes. This review highlights the urgent need for culturally sensitive suicide prevention strategies, greater research investment in underserved populations, and improved healthcare training and coordination. These findings aim to support the development of more effective national suicide prevention policies.

BackgroundSuicide rates have increased substantially among Asian American, Native Hawaiian, and Pacific Islander Veterans. However, little is known about the context of suicide risk or how best to tailor care for this population, especially as it relates specifically to Asian American Veterans, for whom extant research has been limited. We explored Asian American Veterans’ lived experiences with suicidal thoughts and behaviors, their perspectives regarding suicide risk and prevention, and the broader context in which these occurred.MethodsQualitative interviews were conducted in 2022–2023 with 20 Asian American Veterans with histories of suicidal ideation and/or suicide attempt(s). Interviews explored participants’ identities and values (i.e., for context), as well as their beliefs, experiences and perspectives regarding suicide prevention (e.g., how suicide is discussed among Asian American Veterans, factors that might cause Asian American Veterans to experience suicidal ideation, and how suicide prevention initiatives can be tailored to address the needs of Asian American Veterans). Interview transcripts were analyzed through inductive thematic content analysis.ResultsWe identified four themes relevant to Asian American Veterans’ experiences with suicidal thoughts and behaviors, perspectives on suicide risk and prevention, and the context in which these occurred. First, participants spoke to the “model minority” stereotype and pressure to convey self-discipline and perfectionism and to acculturate to American or Western values, which were also shaped by their own or familial immigration experiences. Second, participants reflected upon their minoritized status within the U.S. military, which often mirrored the sense of “otherness” experienced outside of their military service. While participants described positive overall experiences in the military, they also described experiencing racism during their military service. Third, mental health stigma was salient, shaped by cultural beliefs and perceived as consistent with military culture, deterring disclosure and help-seeking and posing an obstacle for suicide prevention. Lastly, destigmatizing mental healthcare and increasing the visibility of Asian American Veterans seeking mental health services were considered paramount to suicide prevention.ConclusionConsiderations for preventing suicide among Asian American Veterans include addressing the sociocultural factors that shape mental health, suicide risk, and healthcare use. In particular, findings suggest the importance of addressing stereotypes about Asian Americans (e.g., model minority myth), preventing behaviors that contribute to a sense of “otherness,” and increasing the visibility of Asian American Veterans in outreach and messaging to promote help-seeking.

Suicide research and prevention are complex. Many practical, methodological and ethical challenges must be overcome to implement effective suicide prevention interventions. Implementation science can offer insights into what works, why and in what context. Yet, there are limited real-world examples of the application of implementation science in suicide prevention. This study aimed to identify approaches to employ principles of implementation science to tackle important challenges in suicide prevention. A questionnaire about promoting implementation science for suicide prevention was developed through thematic analysis of stakeholder narratives. Statements were categorised into six domains: research priorities, practical considerations, approach to intervention design and delivery, lived experience engagement, dissemination and the way forward. The questionnaire (n=52 statements-round 1; n=44 statements-round 2; n=9 statements-round 3) was administered electronically to a panel (n=62-round 1, n=48-round 2; n=45-round 3) of international experts (suicide researchers, leaders, project team members, lived experience advocates). Statements were rated on a Likert scale based on an understanding of importance and priority of each item. Statements endorsed by at least 85% of the panel would be included in the final guidelines. Eighty-two of the 90 statements were endorsed. Recommendations included broadening research inquiries to understand overall programme impact; accounting for resources in the translation of evidence into practice; embedding implementation science in intervention delivery and design; meaningfully engaging lived experience; considering channels for dissemination of implementation-related findings and focusing on next steps needed to routinely harness the strengths of implementation science in suicide prevention research, practice and training. An interdisciplinary panel of suicide prevention experts reached a consensus on optimal strategies for using implementation science to enhance the effectiveness of policies and programmes aimed at reducing suicide.

This paper addresses national responses to suicide prevention in the African region. Eighteen countries responded, of which none had a national suicide prevention strategy in place and only three countries, namely Algeria, Congo, and Madagascar, were in the process of developing any kind of strategy, at the time of this survey. Official national statistics on suicide were available in four of the 18 AFRO countries, with two countries publishing figures on suicide attempts nationally. Training programs on suicide assessment and interventions for general practitioners or mental health professionals were very limited, available in just four countries. One country had a national center specifically dedicated to suicide research or prevention and four countries have at least one NGO dedicated to suicide prevention. Postvention bereavement support for families affected by suicide was available in three AFRO countries. In more than half of the countries, suicide is not an option to certify cause of death. Statistics on suicide and suicide prevention are poorly monitored in all the 18 AFRO countries. The present state of suicide prevention in the region will require cross-country efforts that will generate a critical mass to move suicide advocacy in establishing national prevention strategies in the region.

Deaths by overdose and suicide have been steadily rising, yet efforts to jointly address them have been limited despite shared risk and protective factors. The purpose of this study was to explore ways of jointly addressing these two significant public health issues at the community level. To accomplish this goal, we distributed an electronic survey via email to all 58 Local Mental Hygiene Directors (LMHDs) and 184 substance use and 57 suicide prevention coalition leads in New York State in March 2019 to better understand attitudes, perceptions, and practice of community-based overdose and suicide prevention. A total of 140 unique individuals completed the survey for a 47% usable response rate. Participants overwhelmingly reported that suicide and overdose are preventable and that individuals with risky substance use would benefit most from suicide prevention services compared to other populations. In addition, substance use prevention coalition leads reported less awareness of key suicide prevention programs than suicide prevention coalition leads and LMHDs; LMHDs were generally most familiar with suicide prevention programs. Finally, substance use and suicide prevention coalition leads were interested in collaborating to raise awareness, provide training, and implement community-based activities. These findings demonstrate a consensus among county leadership and substance use and suicide prevention coalition leads that suicide and overdose are prevalent in their communities and that increased collaboration to address these two public health issues is warranted. Results suggest a need for education, training, and technical assistance to support collaboration.

Suicide is a public health crisis in the United States and is frequently encountered by licensed nursing staff working in psychiatric settings. The aim of the current study was to identify evidence-based best practices for universal suicide screening and suicide prevention that can be used in psychiatric settings. A systematic literature search was conducted to determine evidence-based best practices in suicide prevention. PubMed, DynaMed, and CINAHL databases were searched using the following key words: suicide prevention, interventions, and suicide screening in adults. Results were limited to publications focusing on suicide prevention for adults. The search yielded >6,000 articles, which was then narrowed to only those that were peer reviewed. Narrowing the search yielded 234 articles and eight were included in this review. Only articles <10 years old and published in English were included. Individuals at risk of suicide need to receive evidence-based care effective in preventing suicide. [Journal of Psychosocial Nursing and Mental Health Services, 60(4), 21-27.].

Trans people are at significantly elevated risk of suicide death, suicide attempts, and suicidal ideation than their cisgender peers. Suicide prevention efforts are needed that address the most important issues to the trans community. In this qualitative study conducted in the United States in 2021, we aimed to broadly explore trans community member perspectives on suicidality and suicide prevention needs. We conducted four virtual focus groups-including one exclusively for trans people of color. We also solicited additional online responses to the same focus group questions. A total of 56 trans individuals with a history of suicidality participated. We utilized reflexive thematic analysis to develop themes to inform suicide prevention efforts for the trans community. The themes were multicontextual, representing needs across healthcare, legal and political arenas, workplaces, community groups, and interpersonal relationships. The central organizing theme identified as crucial for suicide prevention was 'Having (Real) Rights and Respect.' Supporting themes were 'Being in Control of Our Own Bodies,' 'Being Safe as Ourselves,' and 'Feeling Support and Acceptance,' which also included a subtheme of 'Embracing Diversity within the Trans Community.' We provide suggestions and directions for suicide prevention, which build on these themes.

Prévention des conduites suicidaires de l’enfant de moins de 13 ans : une revue de la littérature

ABSTRACTPurpose: In response to the rising suicide trend in Hong Kong, the Centre for Suicide Research and Prevention (“CSRP”) was established in 2002, with the aim to capitalize on the collective impact of research-support practices to prevent suicides.Method: The CSRP has since become an international knowledge hub that applies a public health approach and innovative strategies to address suicide-related problems at multiple levels.Results: The CSRP actively engages in research, teaching, and knowledge exchange with community stakeholders. These effort are associated with Hong Kong’s more than 30% reduction in suicide rates between 2003 and 2016.Discussion: The rationale for and examples of the CSRP’s practices in face of the suicide prevention challenges lay ahead were also discussed.Conclusion: The outcomes of these practices, which hold great potential for suicide prevention worldwide, have contributed to important academic debates in the field of suicidology.

Artificial intelligence-based suicide prevention and prediction: A systematic review (2019–2023)

Research on risk factor for suicidal behaviors has been broadly conducted to enhance knowledge of suicide prevention. However, there are still challenges for risk factor research. Four major research gaps have been identified: (1) uncertain effectiveness of the population approach versus the high-risk approach for suicide prevention; (2) lack of a valid and convenient Chinese-version screening tool for the severity of suicidal ideation among adolescents; (3) demand for testing the prospective associations of risk factors with suicidal ideation using a longitudinal designed population-based sample; and (4) necessity of pathway analysis to explore and confirm how risk factors interact with each other and lead to suicidality. This thesis aims to address these gaps through a combination of five studies.&#13;\nStudy 1 introduces an illness and death model to suicide prevention research. Elasticity and sensitivity analyses were performed. The findings revealed that the control of suicide incidence among the healthy population is the most effective prevention strategy whereas treatment of mental illness appears to be the least effective approach to suicide prevention. &#13;\nStudy 2 validates the psychometric properties of the Chinese versions of Reynolds’s Suicidal Ideation Questionnaire (SIQ) and Suicidal Ideation Questionnaire Junior (SIQ-JR, a short version of the SIQ) in a sample of Hong Kong adolescents. A short, four-item version of the SIQ-JR has been suggested as an alternative to the SIQ and the SIQ-JR. &#13;\nStudy 3 identifies the history of psychiatric treatment, depression, anxiety, hopelessness, unstable marital status, poor economic circumstance, and a recent death of a first-degree relative as significant risk factors for the incidence of suicidal ideation. The associations of change in risk factors with the development of suicidal ideation have been tested. There are gender and age differences in the patterns of such associations. &#13;\nStudy 4 focuses on psychological factors associated with the first-ever incidence of suicidal ideation. Psychological factors have been detected generally to differ in their associations with the incidence and persistence of suicidality. The idea that depression partially mediates the effect of average life distress on the persistence of suicidal ideation has clinical value.&#13;\nStudy 5 introduces and tests a stressor and illness model as a theoretical framework reference for future risk factor research. Risk factors are classified into stressor, illness, and pattern factors. Both the simple and complex models are tested. Evidence supported the proposed mediating role of mental disorders between negative life events and severity of suicidal ideation. A gender-specific pattern of associations between stressors, illness, and severity of suicidal ideation has also been detected. &#13;\nThis thesis has made substantial theoretical, psychometric, and empirical contributions to the existing knowledge of suicide research.

Suicide research and prevention during and after the COVID-19 pandemic.

Putting it on a map: Geographic visualization to inform suicide prevention in Asian, Native Hawaiian and Pacific Islander Veterans.

Suicide is complex and multifactorial, with social, cultural, and economic components, exacerbated by inequalities, social injustice, marginalization important contexts, along with the immediate presenting crisis. Social workers are uniquely equipped for suicide crisis support, employed across clinical and non-clinical settings. However, how social workers access pre- service suicide education and training at the university qualifying level is poorly understood. Despite taking on roles in which they will be required to respond to suicidal people immediately upon graduation. All Australian qualifying social work programs are required to adhere to the Australian Social Work Education and Accreditation Standards (ASWEAS). These standards identify that mental health content is to be embedded in Australian university curriculum. However, there are no clear directions regarding inclusion of suicide prevention in social work curriculum. An analysis of suicide-related education within 33 Australian universities with accredited social work qualifying degrees revealed that 1484 subjects are offered across all pre-service qualifying awards, only one currently offers standalone suicide focused subject. The focus on standalone suicide prevention reflects that suicide is not always connected to a mental ill-health presentation. Seeking to explore if targeted training to Social Work students on suicide intervention, postvention, and prevention occurs including recommendations for curriculum development.