Crisis-The Journal of Crisis Intervention and Suicide Prevention最新文献

Background: The interpersonal theory of suicide (ITS) may explain the link between alcohol use severity and suicidal ideation (SI) through interpersonal stressors at elevated alcohol use levels. Aims: This study aimed to clarify the indirect effects of perceived burdensomeness (PB) and thwarted belongingness (TB) in this relationship. Method: Cross-sectional data on SI, ITS, and alcohol use severity variables were collected via an online sample (N = 299) screened for lifetime suicidal thoughts or behaviors, nonsuicidal self-injury, and alcohol use. Associations were tested using linear regression with parallel mediators. Results: Alcohol use severity was indirectly linked to SI through the unique indirect effect of PB, and the total indirect effect of both TB and PB. Limitations: Limitations include the cross-sectional design and use of an online sample, which limit causal inferences and generalizability to other high-risk populations. Conclusion: PB and the additive indirect effect of TB and PB may explain the positive relation between alcohol use and SI; implications are discussed.

Background: Suicide is a leading cause of death among individuals with a schizophrenia spectrum disorder (SSD). Individuals who identify with a sexual and/or gender minority (SGM) identity are also at increased risk for suicidal thinking and behavior. Aims: To explore the association between SGM status and suicidality among university students with an SSD. Method: We used the 2019-2020 Healthy Minds survey data to explore the relationship between SGM status and past-year suicidal ideation, plan, and attempt among individuals with SSDs using bivariate and multivariable analyses. Results: Of 134 students with SSDs, 47.5% endorsed a sexual minority identity and 18.7% endorsed a gender minority identity. Gender minority individuals had 3.98 the odds of suicidal ideation compared to cisgender individuals (95% CI 1.16-13.60, p = .0277). There was no association between sexual minority identity and suicidal ideation. Limitations: This work was limited to a cross-sectional assessment using self-report survey data from a predominantly non-Latino White college student cohort, resulting in a small sample size and limited generalizability. Conclusion: The intersectionality of having a gender minority identity and an SSD may confer a heightened risk of suicidal ideation among young adults. University campuses and first-episode psychosis programs should consider targeted suicide prevention efforts in this population.

Background: Identifying gaps in skill levels and increasing access to training focused on patient-centered skill delivery among integrated primary care providers (i.e., primary care providers, such as physicians and embedded behavioral health providers in primary care, such as psychologists) are needed to improve suicide prevention care. Aims: This pilot study examined an adapted suicide prevention measurement tool's acceptability and feasibility among established (nontrainee) integrated primary care providers and examined preliminary validity of total scores with patient experience. Methods: Thirty-three providers completed a virtual simulation, which was rated using the suicide prevention measurement tool. Twenty-four primary care patients also listened to four pre-recorded simulations with previously agreed upon scores using the measurement tool to preliminarily examine construct validity with the patient's experience. Descriptive statistics for primary study variables (e.g., acceptability) were calculated. Results: Findings suggest that this suicide prevention tool is feasible and acceptable among established integrated primary care providers. There was also preliminary support for its validity. Limitations: The sample is small. Conclusion: Utilizing an evidence-based suicide prevention measurement tool, with good feasibility and acceptability, may be an important next step to address the gaps in suicide training to achieve high-quality suicide prevention care.

Objectives: Media plays a crucial role in shaping perceptions of suicide; however, little is known about the extent to which Saudi newspapers adhere to the World Health Organization (WHO) guidelines for responsible suicide reporting. This study aims to assess the adherence of Saudi newspapers to WHO recommendations and identify harmful and helpful reporting practices. Methods: A content analysis was conducted on 471 suicide-related news articles from five major Saudi newspapers (2010-2024). Each report was evaluated for harmful elements, such as graphic details of methods used, and helpful elements, such as mental health information or hotline details. Results: The findings showed significant variability in adherence to WHO guidelines. Harmful practices included mentioning the method of suicide in 85.4% of reports, describing the method in 21.4%, and specifying the location in 81.3%. The age of those who died by suicide was disclosed in 63.5% of cases, and nationality in 70.1%. In contrast, helpful reporting practices were rare, with only 3.2% of reports mentioning warning signs and 0.8% including expert opinions. Limitations: The study only analyzed online newspaper content and did not assess audience impact. Conclusion: These findings highlight the urgent need to promote and implement media coverage guidelines, whether locally developed or based on existing WHO recommendations, in Saudi Arabia. However, this study is limited to online newspaper content and does not assess audience impact.

Background: Inert gases are an emerging means of suicide in Toronto, Canada. Trends in suicide by these methods change over time, yet long-term patterns remain uncharacterized in cities like Toronto. Aims: To update trends in suicide using inhalational gas and explore the profiles of individuals using different methods in Toronto. Methods: Suicide deaths were identified from coroner's records and classified by suicide methods. Time trends were explored, and bivariate analyses were performed to characterize differences in profiles between groups. Results: There were 229 suicide deaths by inert gas between 1998 and 2020. For 2016-2020, suicide by nitrogen increased by 100%, whereas there was a decrease in suicide by helium (-38%) and charcoal burning (-57%) compared to 2011-2015. Males comprised a higher proportion of inhalational gas deaths compared to other methods. Individuals who died by compressed gas and charcoal burning were more likely to have left suicide notes compared to people who died by other methods. Limitations: The number of suicide deaths by gas inhalation may be underestimated due to potential misclassification. Conclusions: Suicide prevention strategies including restricting access to suicidal means, providing helpline information on the products, and responsible media reporting should each be advocated for.

Background: Suicide is one of the leading causes of death in the United States, and safety planning is a best practice to reduce the risk of suicide. It is currently unknown if electronic safety planning with a phone app results in effective safety planning compared to paper versions. Aims: To evaluate electronic safety planning vs. a paper safety plan in the ED setting. Methods: A pilot randomized controlled trial was conducted in which 30 participants were randomized 1:1 into traditional paper safety planning versus safety planning on a phone app (My3). Outcomes of interest included safety plan completeness, safety plan quality, and return ED visits within 3 months. Findings/Results: Despite taking less time to complete, paper safety planning was more complete than electronic safety planning. There were no significant differences in quality or return ED visits within 3 months. Limitations: This study was limited to a small sample size by our local IRB. Conclusions: Given that plan completeness has previously shown mixed associations with clinical outcomes, further research is needed to refine and evaluate electronic formats.

Background: Rising suicide rates and their impact on families underscore the need for reliable tools to assess grief's social dimensions. Aims: This study validated the Spanish version of the Social Meaning in Life Events Scale (SMILES) for Spanish-speaking adults bereaved by suicide. Method: Three hundred seven suicide-bereaved adults completed the Spanish SMILES. Confirmatory factor analysis confirmed its two-factor structure -Social Validation and Social Invalidation - while construct validity analysis explored its relationship with depressive symptoms, social support, posttraumatic growth, and meaning in life. Results: The two-factor structure was supported, with strong internal consistency and construct validity. Social Invalidation correlated with higher depressive symptoms and lower social support, growth, and meaning, whereas Social Validation was linked to positive outcomes. Limitations: Self-reported data and a cross-sectional design limit generalizability and causal interpretations. Conclusion: The Spanish SMILES is a valid tool for assessing bereavement's social dynamics, highlighting the need to foster validation and reduce invalidation to support suicide loss survivors.

Background: Over three-quarters of suicides occur in low- and middle-income countries (LMICs) and a better understanding of this behavior within these settings is crucial. Aim: To investigate stakeholders' knowledge, attitudes, and experiences of self-harm and suicide in LMICs. Method: A systematic search was conducted using British Nursing Index, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, MEDLINE, PsycINFO, and Social Sciences electronic databases from inception to March 2022, combined with hand-searching reference lists. The search was updated using the PubMed Similar Articles function in February 2024. Analysis followed a modified narrative synthesis approach. Results: One hundred and fifty-four articles met the inclusion criteria, of which 60 included relevant quantitative data. Attitudes toward suicide were often contradictory although, overall, were negative and suicide literacy was poor. Healthcare staff reported lacking training in this area. Willingness to seek help was linked to suicide literacy and attitudes toward suicide. Limitations: Heterogeneity of included studies. Conclusion: Tackling stigma and improving awareness of suicide and self-harm in LMICs are needed to facilitate suicide prevention. Training should include people with lived experience of suicide and self-harm. The complex and contradictory influences of age, gender, religious, and cultural beliefs and lived experience must be considered.