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

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: The impact of earthquakes on mental health is profound. Aim: This study examines the short-term impact of the Noto Peninsula earthquake (magnitude 7.6) in Japan in January 2024 on the number of suicides and investigates the existence of the pulling together effect or honeymoon phase in suicide trends. Method: Suicide data from disaster-affected areas in Ishikawa Prefecture from January 2017 to June 2024 were analyzed using Poisson regression and prophet models. Results: Both models identified fewer suicides than predicted for 3 consecutive months (March-May 2024). This trend was observed even when the affected areas were subdivided into multiple regions. Limitations: Economic factors and data on suicide attempts or mental disorders were not included in the analysis. Conclusion: This study provides evidence supporting the pulling together effect or honeymoon phase, suggesting that increased community support following a disaster temporarily reduces suicide risk.

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.

Background: The issue of where suicides take place has rarely been studied. Aims: To examine the distribution of suicide locations and which factors may influence this choice. Method: Data were obtained from the Tyrol Suicide Register. In total, 3,257 suicides were included. Suicide sites were categorized according to proximity to community of residence (COR), actual place of suicide, and potential visibility. Results: About three quarters of suicides occurred in the COR and nearly half in the person's own apartment/house or adjoining places. In the case of 1/3 of suicides, it was considered possible that the suicide could have been observed. Higher age was associated with suicide in the COR. There were associations of the actual place of suicide with gender, age, living situation, period, season, and daytime. Similar associations were found for potential visibility. There was a temporal trend from tracks/bodies of water/public spaces at the beginning of the study to own apartment/house and toward less possibility of suicides to be observed in the last decade. Limitations: Lacking data due to post hoc data processing. Conclusion: Locations chosen for suicide vary significantly in a number of variables. In a considerable number of cases, suicides may have been observed what offers perspectives for suicide prevention.

Background: The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based approach to reducing suicidal ideation. To date, there is limited evidence of the feasibility of implementing CAMS within the United Kingdom's National Health Service (NHS). Aims: The paper aims to describe the implementation of CAMS in an NHS adult mental health service and to report data on engagement and change in self-rated suicidal ideation. Method: Data on engagement, suicidal ideation, and care pathways were gathered for 88 people who started CAMS. Results: 75% of participants completed CAMS. Attendance rates were good. Self-rated suicidal ideation decreased significantly, with 68% of completers reporting a decrease. Participants with Emotionally Unstable Personality Disorder (EUPD) showed higher initial ratings of suicidal ideation but similar improvements. Just over half the participants were referred for psychological therapy after CAMS. Limitations: As an uncontrolled case series, the study could not conclude that changes in suicidal ideation were due to CAMS. It was not possible to report on changes in suicidal behavior. Key demographic data were missing. Conclusion: Implementation of CAMS in an NHS setting appears feasible and merits further study.

Background: Veterans die by suicide at higher rates than their civilian counterparts. Given this, it is likely veterans also experience high rates of suicide exposure. Aims: The purpose of this study was to explore suicide exposure in veterans and its impact on mental health. Method: Survey data were collected from 3,188 veterans. Data were collected online using a multipronged sampling strategy. Suicide exposure, PTSD, depression, and suicide risk were measured in the survey. Odds ratios were produced through a series of bivariate logistic regressions. Results: Just under 60% (59.2%) of veterans reported experiencing exposure to suicide, with the majority of participants indicating multiple exposures. Veterans exposed to suicide were twice as likely to meet criteria for PTSD, depression, and suicide risk. Limitations: The use of convenience samples and the geographically distinct sampling area may limit the generalizability of the findings. The fact that the survey used self-reported measures, the inability to infer causality, and the severity of exposure were also limitations. Conclusions: Findings demonstrate veterans may be exposed to suicide at high rates and that exposure may create increased risk for negative mental health outcomes. Results have implications for risk assessment, intervention after suicide exposure as well as suicide prevention efforts.