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Suicide is a global health concern whose rates are soaring in many low-and-middle-income countries. Public awareness campaigns have been implemented in Brazil; however, their impact is uncertain. This was an ecological study using population data from DATA-SUS, a Brazilian official notification system, selecting only deaths that were voluntarily self-inflicted (CID-10 × 60-X84). We analyzed all available data from 2000 to 2019 to assess trends before and after the national Yellow September (YS) campaign started in 2015. Differences in trends were assessed by Joinpoint Analysis (JA) and Regression Discontinuity Analysis (RDD), unadjusted and adjusted for economic factors. Overall, there was a progressive increase in the rate of relative (per 100,000 inhabitants) number of suicides over time between 2000 and 2019 (57 % increase). The JA detected a change in the slope of the curve representing an acceleration in suicides starting in the year 2015. Adjusted RDD revealed the year that Yellow September started significantly change the slope of the association between time and rates of suicide (p interaction < 0.01), and marginal analysis detected the coefficient increased from 0.07 (95%CI 0.04–0.10) to 0.27 (95%CI -0.07-0.60) suicides/year per 100,000 inhabitants. The ecological nature of the manuscript compromises causational implications. We found an increase in suicidal trends in Brazil, against the global trend that coincides with the beginning of a large national awareness campaign. Although we cannot attribute causality, our results reinforce the need of further studies to better understand the role of awareness campaigns in suicide reduction interventions, including potential unintended effects. • Despite the implementation of the Yellow September campaign, the study reveals a worrying nationwide increase in suicide rates in Brazil. • After the implementation of Yellow September Campaign, suicides tended to cluster more closely to months following September. • The study recommends a multifaceted approach integrating awareness campaigns with concrete healthcare modifications, emphasizing the need for campaigns to focus on positive coping strategies and destigmatization. [ABSTRACT FROM AUTHOR]

Suicidal ideation (SI) and suicide attempts (SA) are risk factors for suicide which peak during adolescence; however, evidence focused on differences in SI and SA risk among racial/ethnic minority youth is limited despite increasing suicide rates among several racial/ethnic minority groups. We analyzed a representative sample of adolescents aged 12–17 with prior depressive symptoms (n = 32,617) from the cross-sectional National Surveys on Drug Use and Health (2008–2019). Survey-weighted adjusted logistic regressions estimated the association of race/ethnicity with self-reported lifetime SI and SA, controlling for sociodemographics, lifetime substance use, lifetime major depressive episode, and self-rated health. Compared to white adolescents, Black and Hispanic adolescents had a 2.5 % (p = 0.04) and 4.2 % (p < 0.001) lower likelihood of reporting SI. However, among participants reporting SI, Black and Hispanic adolescents had a 3.2 % (p = 0.03) and 3.1 % (p = 0.03) higher likelihood of reporting SA than white adolescents. Multiracial adolescents were 5.9 % (p = 0.03) more likely to report SA than white adolescents. Although racial/ethnic minority groups are less likely to self-report mental health symptoms, we could only assess SI/SA among adolescents self-reporting prior depressive symptoms, and we could only assess SA among adolescents self-reporting SI due to survey methods. Variation in the racial/ethnic distribution of suicidality supports theories conceptualizing separate pathways for SI and SA. This underscores the need for greater attention to racial/ethnic differences in suicide-related research, surveillance, and prevention efforts, including ensuring that mental health risk assessments directly evaluate SA in addition to SI in order to better identify high-risk racial/ethnic minority youth. • Risk factors differ for adolescent suicidal ideation (SI) and suicide attempts (SA). • Black and Hispanic adolescents are less likely to report SI than white adolescents. • Black and Hispanic adolescents are more likely to report SA than white adolescents. • Multiracial adolescents are more likely to report SA than white adolescents. [ABSTRACT FROM AUTHOR]

Background: Suicidal behavior is a public health problem whose incidence has increased recently. The Suicide Risk Attention Program (ARSUIC) is developed for the detection and prevention of suicidal behavior. The data obtained allow us to study suicidal behavior. The aim of this study is to analyze predictive variables of clinical outcomes. Method: A quantitative and associate design with a retrospective viewpoint was carried out. Data from 459 adults, children, and adolescents referred to the ARSUIC program from 2018 to 2022 were collected. The analysis was conducted using SPSS and R. Results: The number of appointments, social support, and attempted suicide explain the abandonment of the program; the number of appointments, psychiatric history, and suicide attempts the permanence in the program; and finally, clinical discharge was explained by the number of appointments, a psychiatric personal history, social support, and past psychological violence. Conclusions: This is the first study analyzing predictive variables of outcomes in the ARSUIC program. Increasing our knowledge about this is necessary to improve clinical interventions and reduce dropouts. [ABSTRACT FROM AUTHOR]

Background: Some physiotherapists find assessing and managing clients experiencing psychological distress challenging and are uncertain regarding the boundaries of the profession's scope. Objective: To map the approaches recommended for physiotherapists in scholarly literature, with respect to the assessment and management of clients experiencing psychological distress. Methods: A systematic mapping review was conducted. CINAHL, APA PsycINFO, Embase, and Medline ALL databases were systematically searched for secondary and tertiary literature relevant to the research objective. Recommended approaches were extracted from each article and analyzed descriptively and thematically. Results: 3884 records were identified with 40 articles meeting the inclusion/exclusion criteria. Most recommendations related to identifying, assessing, and managing pain-related distress, with depression screening and referral also receiving some attention. Three approaches to detecting and assessing psychological distress were identified: 1) brief depression screen; 2) integrated suicide/nonsuicidal self-harm and depression screen; and 3) multidimensional screen and health-related distress assessment. Regarding the management of psychological distress the main approaches identified were: 1) education and reassurance; 2) cognitive-behavioral approaches; 3) mindfulness; and 4) case management. Conclusion: While assessment and management of health-related distress by physiotherapists is commonly recommended, further guidance is needed to differentiate various forms of distress. [ABSTRACT FROM AUTHOR]

Objectives: Youth suicide is an urgent public health problem. Gatekeeper training aims to prevent suicide by training people to identify warning signs and make referrals to appropriate services. Many states in the United States have enacted gatekeeper training laws (GTLs) to train school staff in suicide prevention. The objectives of this study were to describe the development of a dataset on GTLs and use the dataset to summarize trends in uptake of GTLs from 2002 through 2022 as well as differences in characteristics (eg, frequency and duration of training) of GTLs. Methods: We used publicly available legal databases from all 50 states and the District of Columbia to conduct a policy surveillance assessment of GTLs. We cross-checked data with the American Foundation for Suicide Prevention's 2022 Suicide Prevention in Schools (K-12) issue brief and used Westlaw Edge to conduct a sensitivity analysis. We included the following data in the full dataset: type of laws (encouraged, mandatory, or conditional mandatory), date passed, effective date, frequency of training, and length of training. Results: In 2022, 49 states and the District of Columbia had GTLs, 31 of which were mandatory laws. In 2002, only 6 states had such laws, and none were mandatory. Conclusion: The growing proliferation of laws on suicide prevention training for school staff warrants evaluation of the laws' effectiveness. Our policy surveillance data may be used to better understand the role of these laws in a school-based approach to youth suicide prevention. [ABSTRACT FROM AUTHOR]

One transdiagnostic process that may be critical to depression and suicidal ideation is beliefs about the nature of one's own emotions, both concurrently and longitudinally. In a sample of community adults (n = 143), we assessed personal emotion beliefs about the degree to which one's own emotions are malleable, unique, and last a long time. There were significant associations between stronger views that one's own emotions were fixed, unique to you, and had a longer duration and higher clinical symptom severity, including higher levels of current suicidal ideation, and less adaptive emotion regulation. Mediation analyses using longitudinal data clarified that the differential engagement in emotion regulation, specifically rumination, represented the link tying specific personal emotion beliefs to clinical symptoms and that, in certain cases, the opposite pathway is also significant – differences in clinical symptoms mediated the relationship between specific personal emotion beliefs and emotion regulation (rumination) longitudinally. Additionally, personal emotion beliefs varied based on depression status, as determined using a semi-structured clinical interview. For example, individuals meeting current criteria for Major Depressive Disorder (MDD) held stronger views that their emotions were unique to them compared to individuals with remitted MDD or no history of MDD. The current study's findings highlight the important role of specific personal emotion beliefs in clinical symptoms concurrently and longitudinally and mechanisms in these relationships. These results could guide future research on interventions to promote more adaptive beliefs about emotion to improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Literature on temporal patterns of suicidality among youths during the COVID-19 pandemic is growing. The present work proposes a Bayesian approach to assess temporal patterns of suicide-related behaviours among inpatient adolescents during the COVID-19 pandemic. Data referred to the first hospital discharge record with ICD9-CM codes related to suicide-related behaviour and/or suicidal ideation among adolescents aged 13–19 between 1 January 2017 and 31 March 2021 were collected in the Piedmont region, Italy (n = 334; median age: 15 years, IQR: 14–16; 80% girls). A Poisson Bayesian regression model performed on pre-COVID-19 data (2017–2020), adjusted by seasonality and stratified by sex, was adopted to provide the probability that the predicted counts exceed the observed ones in each pandemic year quarter. A declining trend of suicidality was observed in April–June 2020 among both sex groups. Among females, an increasing pattern of suicidality was registered in early 2021 (January–March) compared to the pre-pandemic period. The present findings contributed to a growing literature on the COVID-19 pandemic's impact on adolescents' suicide-related behaviours from a gender perspective and encouraged wider adoption of Bayesian approaches as valuable tools to explore rare events and deeply enlighten open public health issues. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) continues to be an important problem in adolescents, and it was aimed to investigate the relationship between suicide probability, cyberbullying, impulsivity, and aggression with NSSI history in the adolescent clinical population on the basis of gender. 267 adolescents with a history of NSSI and 210 without were included. They filled the Inventory of Statements About Self-Injury (ISAS), Cyberbullying and Online Aggression Screening Scale (COASS), Buss-Perry Aggression Questionnaire (BPAQ), Suicide Probability Scale (SPS), Barratt Impulsiveness Scale-11-Short Form (BIS-11-SF). Four subscales and total scores of SPS, BPAQ, BIS-11-SF total scores were found to be significantly higher in males with a history of NSSI. BPAQ, BIS-11-SF motor, and attention impulsiveness, BIS-11-SF total scores, four subscales, and total scores of SPS were found to be significantly higher in females with a history of NSSI. Lower BIS-11-SF non-planning impulsivity, higher SPS/suicide ideation and hostility scores, and lower father's education level were found to be the best predictive factors for ISAS total scores in males. In females, experience cyberbullying, lower age, higher SPS/suicide ideation and total scores were the best predictors. Knowing the factors associated with NSSI and the differences between genders will be effective in both preventing NSSI and shaping treatment modalities. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine mortality for people living with dementia/mild cognitive impairment who self-harmed. Methods: We conducted a retrospective cohort study in New South Wales, Australia, using data ranging from 2001 to 2015. From people who accessed hospital services in the study period, we identified 154,811 people living with dementia/mild cognitive impairment, 28,972 who self-harmed and 1511 who had a record of both dementia/mild cognitive impairment and self-harm. We examined rates, causes and predictors of death for people with dementia/mild cognitive impairment and/or self-harm diagnoses using flexible parametric survival analyses. We explored rates of repeat self-harm in people living with dementia who self-harmed. Results: Circulatory disorders accounted for 32.0% of deaths in people with a living with dementia who self-harmed, followed by neoplasms (14.7%), and mental and behavioural disorders (9.6%). Death was more likely for someone who had self-harmed if they developed dementia/mild cognitive impairment. Predictors of death included male sex, greater physical comorbidity, a history of delirium, more previous emergency department presentations and fewer previous mental health ambulatory service days. Greater engagement with outpatient mental health services predicted a decreased likelihood of repeat self-harm. Discussion: We found that mortality increases when people who self-harm develop dementia. We argue post-diagnosis support offers a potential opportunity to reduce mortality rates in people with both dementia and self-harm diagnoses. [ABSTRACT FROM AUTHOR]

Taking as my cue the Introduction to the First Folio edition of his plays, I examine Shakespeare's particular interest in English law and juridical procedure. It is likely that his considerable, detailed knowledge of law derived at least in part from his association with the Middle Temple, whose members included neighbours and friends from Stratford-upon-Avon. I proceed to consider the profound influence of The Commentaries or Reports of Edmund Plowden (Plowden himself was a member of the Middle Temple) over the content of his plays, notably Plowden's report of Hales v Petit to Shakespeare's depiction of the death by suicide of Ophelia in Hamlet. I develop the thematic link with the Middle Temple by interrogating the thesis, proposed by various scholars, that an early version of Shakespeare's Troilus and Cressida was given a performance there during the revels of 1597–98. The theatrical transplantation of the city of Troy to London, described by writers and lawyers alike as Troynovant, the utopian city of commerce and the mythical birthplace of English law, leads me to analyze the predominant tropes of the marketplace which populate Troilus and Cressida. I conclude with the observation that in his epilogue to the play, Pandarus addresses in appropriately base terms the very people (lawyers) whose skills were supposed to redress the injustices engendered by commerce and the marketplace, but who failed to acknowledge the relevance of ethics and community to the attainment of societal cohesion. [ABSTRACT FROM AUTHOR]

Background: India currently accounts for a majority of global suicide deaths. Research in European ancestry has established that suicide mortality has a significant genetic component, and suggests that inflammation may play a crucial role in the pathophysiology of suicide. Inflammation is also highly relevant in regions of increased pollution exposure, such as the megacities of India. To address the existing gaps in genetic research on suicide and possible association with inflammatory biomarkers, we examined genetic polymorphism and clinical risk phenotypes in a population-based suicide-death cohort, India. Material and methods: Genotyping of IL-1β(rs16944) & (rs1143627), IL-4(rs2070874), IL-6(rs1800795) and IL-10(rs1800896) was done in 234 post-mortem suicide-death cases and 256 post-mortem controls (N = 490) using PCR RFLP method. Results: Our analyses identified three significant (p < 0.001) associations of cytokine variants with suicide death, including IL-1β(rs16944), OR = 0.627; IL-4(rs2070874), OR = 0.524; and IL-6(rs1800795), OR = 2.509. Cases were more likely female and were more likely to have a history of psychiatric illness, though rate of psychiatric illness was low in suicide cases(9%). Conclusion: Our genetic results are generally consistent with previous research on risk for depression and suicidal behaviour, and both genetic and phenotypic results provide new insights into risk factors that may contribute to suicide in India. [ABSTRACT FROM AUTHOR]

The authors present the case of a 58-year-old man found hanging from a radiator by his shoelaces. The time of death was approximately 6 h before the body was discovered. An autopsy was performed approximately 24 h after the body was found, which revealed hemorrhages in the thoracic aorta at the junctions of the posterior intercostal arteries. Before autopsy, a routine whole-body CT scan was performed. Histologic examination of the aorta and the posterior intercostal arteries revealed a fresh hemorrhage into the tunica adventitia of the aorta. To our knowledge, there is no case description of such findings in hanged persons in the literature. Conclusion: Hemorrhages into the tunica adventitia of the junction of the posterior costal arteries may occur in association with suicidal hanging. The significance of these hemorrhages as a sign of vitality may be debated. [ABSTRACT FROM AUTHOR]

This article uses data from a doctoral thesis concerning service users' views on what works for them in relation to their mental health wellness following a suicidal ideation/attempt in Aotearoa New Zealand. In particular, it focuses on the experiences of service users regarding mental health crisis team responses and what they wanted from their crisis teams specifically. Participants indicated that what they wanted was to feel heard, respected and not judged, consistent with the core conditions of therapeutic alliance within such professions as social work, counselling and psychology. Social work has a valuable role to play in emphasising and advocating for social, contextual and non-medical responses within crisis teams and service delivery. [ABSTRACT FROM AUTHOR]

Suicide is a complex, multifaceted crisis affecting children and adolescents, and has become a major public health concern. While there is a plethora of research on this topic among neurotypically developing youth, much less is known about the nature of suicidality in autistic individuals. Autistic youth show an increased vulnerability for suicidal tendencies that are poorly understood among school mental health (SMH) professionals, who report a range of competency and self‐efficacy to address suicidality in school settings (Debski et al., 2007; O'Neill et al., 2020). Co‐occurring mental health difficulties pose significant challenges in the early detection of suicide risk in autistic youth. Given that suicide is the leading cause of death among autistic individuals, the incidence of suicidality among autistic youth is of particular concern. This article provides a practice‐friendly review of the research outlining innate vulnerabilities that present risk factors for suicide among autistic youth, along with assessment considerations that help inform the management of suicide risk in autistic youth. We conclude with recommendations for integrating a multi‐tiered neurodiverse‐affirming approach with sensitivity for student intersecting identities and system‐level influences on student mental health that enables SMH professionals to create supportive school environments for autistic youth that prevent further harm. Practitioner Points: Autistic youth show higher rates of suicidality compared to rates seen in nonautistic youth.Common approaches to suicide screening and prevention in schools do not adequately address issues of mental health, self‐harm, and suicidal intent in autism.A neurodiverse‐informed approach can help school mental health professionals understand suicide risk presentation and enhance safe and affirming school environments. [ABSTRACT FROM AUTHOR]

Firearm suicides among adolescents have increased in the US and rates vary across racial and ethnic groups. In this study, we examined contextual information around adolescent firearm suicides and analyzed how incident characteristics vary across racial and ethnic groups. We analyzed firearm suicides among adolescents (ages 10–18 years) from 2004 to 2020 using data from the National Fatality Review-Case Reporting System (NFR-CRS). There were 4,153 firearm suicides during that period. Suicides often involved males, older adolescents (15–18 years), and handguns. Most firearms belonged to the primary caregiver and incidents frequently occurred at home. However, we found that characteristics varied substantially across racial and ethnic groups. Overall, we provide new information on firearm suicides among adolescents in the US using a larger dataset than previous studies and found significant differences in characteristics and demographics across racial and ethnic groups. This finding suggests the need for tailored prevention strategies. [ABSTRACT FROM AUTHOR]

The coronavirus infection 2019 (COVID-19) pandemic has affected on mental health and contributed to increased depression and anxiety. We assessed the impact of the COVID-19 pandemic on suicide-related the emergency department (ED) visits. We compared the characteristics of suicide-related patients who visited the ED between the "COVID-19 period" and the "pre-COVID-19 period". The mean age of patients was younger after COVID-19 pandemic. In comparison by age group, the proportion of patients during the COVID-19 period increased in their teens and 20s, and the rest of the age groups decreased. The proportion of patients who requested help was higher during the COVID-19. The authenticity of suicide attempts showed a higher proportion of patients during the pre-COVID-19. Therefore, during the pandemic, attention should be paid to worsening mental health problems, such as anxiety or depression, rather than the lethality of suicide attempts. [ABSTRACT FROM AUTHOR]

Thinking about our own death and its salience in relation to decision making has become a fruitful area of multidisciplinary research across the breadth of psychological science. By bringing together experts from philosophy, cognitive and affective neuroscience, clinical and computational psychiatry we have attempted to set out the current state of the art and point to areas of further enquiry. One stimulus for doing this is the need to engage with policy makers who are now having to consider guidelines on suicide and assisted suicide so that they may be aware of their own as well as the wider populations' cognitive processes when confronted with the ultimate truth of mortality. [ABSTRACT FROM AUTHOR]

Evidence suggests that child maltreatment is a risk factor for adolescent suicidal behavior. However, the differential influence of distinct forms of child maltreatment on adolescent suicide attempts is understudied and the factors that might exacerbate or ameliorate these associations warrant attention. We examined the associations between two distinct forms of child maltreatment (threat and deprivation) and suicide attempt history, and investigated whether executive function domains moderated these associations. Participants were 119 adolescents (M = 15.24, SD = 1.46, 72.3% female) recruited from an inpatient psychiatric hospital during hospitalization for suicidal thoughts and behaviors. Results indicated that the executive function domains of initiation, shifting, and planning/organization moderated the associations between threat and suicide attempt history. Associations between threat and suicide attempt history were significant only when initiation and shifting T-scores were lower (OR = 1.22, p =.03 and OR = 1.32, p =.01, respectively). The association between threat and suicide attempt history trended toward significance when planning/organization T-scores were lower (OR = 1.15, p =.10). None of the executive function domains moderated the link between deprivation and suicide attempt history. Findings highlight the need for research investigating whether initiation, shifting, and planning/organization might be amendable to intervention in the context of threat-related child maltreatment. [ABSTRACT FROM AUTHOR]

Background: Admission to the university changes life conditions and thereby increases mental pressure. If the students cannot bear the psychological pressure of being a student, that may lead to suicide among the vulnerable persons. Therefore, in this research, we would like to investigate the prevalence and associated factors of suicide-related behaviors in Iranian students. Methods: This online, cross-sectional survey was performed from March 18 to April 15, 2023, in Iran. The questionnaires were completed by 2181 students. In this study, Perceived Stress Scale (PSS-4), Meaning in Life Questionnaire (MLQ), Generalized Anxiety Disorder Scale (GAD-7), and Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Oslo Social Support Scale (OSSS-3) were used. Finally, we identified the factors associated with suicide-related behaviors using univariate and multiple regression. Results: The prevalence of suicidal behaviors in students was 57.95%. According to the results, male gender, marriage, having meaning in life, occasional smoking, sleeping after 1 a.m., and having social support were associated with a reduced risk of suicide. In addition, a history of sexual abuse, more anxiety, and higher perceived stress were associated with an increased risk of suicide. Conclusions: The prevalence of suicide-related behaviors in Iranian students was higher than expected. Urgent interventions should be considered to prevent students from committing suicide. Helping students find meaning in life, as well as eliminating the causes of students' anxiety and stress, may be effective in this respect. Additionally, teaching students how to control anxiety and stress may be helpful. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionThe purpose of this study was to assess the implementation of suicide-focused treatments delivered via a hybrid telemental health (TMH) and in-person format.This study was conducted at four university counseling centers (UCCs) across the United States. Treatment-seeking clients were recruited from their local UCCs and participated in adaptive treatment strategies (ATSs) involving Treatment as Usual (TAU), Collaborative Assessment and Management of Suicidality (CAMS), and Dialectical Behavior Therapy (DBT). Implementation outcomes, including appropriateness, acceptability, feasibility, fidelity, safety, and client satisfaction, were assessed. UCC clinicians participated in qualitative interviews focused on implementation of TMH for clients presenting with suicidal ideation (SI).Overall, treatments delivered via hybrid format were reported to be appropriate, acceptable, feasible, and satisfactory by clinicians and clients. Implementation of TMH was reported to be equivalent to in-person treatment across multiple measurement methods.Results from this study demonstrate that TMH is an implementable treatment modality for addressing suicidality, particularly for college students presenting to UCCs with SI. This study has implications for real-world clinical settings planning to offer hybrid treatment modalities to address SI.Trial registration: ClinicalTrials.gov identifier: NCT04728815. [ABSTRACT FROM AUTHOR]

Background and aims Design Setting Participants Measurements Findings Conclusion Opioid dependence is associated with an increased risk of suicide. Drug‐related mortality among people with opioid dependence in Scotland has more than tripled since 2010; less is known about changes in suicide risk. We aimed to determine if opioid agonist therapy (OAT) in Scotland is protective against suicide and to measure trends in suicide rates in those with opioid dependence over time.Retrospective cohort study.Scotland, UK.46 453 individuals in Scotland who received at least one prescription for OAT between 2011 and 2020 with over 304 000 person‐years (pys) of follow‐up.We calculated standardised mortality ratios (SMR) using the age‐ and sex‐specific suicide rates in Scotland for years 2011–2020. We fitted multivariable competing‐risk regression models to estimate suicide rates by OAT exposure and to estimate trends over time, adjusting for potential confounders.There were 575 deaths classed as suicide among the cohort and the overall suicide rate was 1.89 (95% confidence interval [CI] = 1.74–2.05) per 1000 pys. Age and sex SMR for suicide was 7.05 times (95% CI = 6.50–7.65) higher than in the general population. After adjustment, OAT was shown to be highly protective against suicide, with rates more than three times greater (adjusted hazard ratio: 3.07; 95% CI = 2.60–3.62) off OAT compared with on OAT. Suicide rates decreased over time, falling from 2.57 (95% CI = 2.19–3.02) per 1000 pys in 2011–12 to 1.48 (95% CI = 1.21–1.82) in 2019–20.People with opioid dependence in Scotland appear to have a greater risk of suicide than the general population. Treatment is protective, with rates of suicide lower among those on opioid agonist therapy. Suicide rates have decreased over time, during a period in which drug‐related death rates in Scotland have risen to globally high levels. [ABSTRACT FROM AUTHOR]

Very high rates of suicide and self‐harm in prisons worldwide emphasise the need for evidence‐based approaches to prevention. Real world evaluations of organisational changes and service developments within prisons could yield important insights, but there are challenges to achieving this, as we found from an evaluation in a single UK institution. [ABSTRACT FROM AUTHOR]

This article reports on a two-year study of a community-based suicide postvention support service in the UK. Attention centres on the implementation of four integrated elements within the service model: multi-agency working with real-time suicide surveillance, persistent pro-active contact; volunteer-led support; continuous open-ended support. Our approach involved analysing utilisation data and qualitative techniques, including in-depth interviews with a diverse group of stakeholders. The study is the first of its kind to provide an in-depth examination of an innovative approach focusing on the integrated model and its constituent components. Our findings offer evidence-based examples of collaborative service efforts in implementing real-time interventions, with agencies working together to provide timely, co-ordinated, proactive responses and support with the potential to alleviate suffering and prevent loss of life. The value of volunteer-led support and open-ended access and associated challenges are emphasised. Findings hold promise for international impact with policy implications for services worldwide. [ABSTRACT FROM AUTHOR]

Background: Suicide is a global public health problem. In childhood, the risk factors are less clear, highlighting family and individual factors. This study aims to investigate the prevalence and sociodemographic, social, family, and individual factors associated with suicide ideation and attempts in pre-adolescents in a Brazilian city. Methods: The sample comes from a cohort of 500 schoolchildren of a city in Rio de Janeiro/Brazil. The data are analyzed cross-sectionally. The research incorporated data from the years 2005, 2006, and 2008 to evaluate suicide ideation and attempts in childhood, as reported by parents/caregivers, teachers and children. A hierarchical logistic model evaluated the association between the explanatory variables related to sociodemographic, social, family, and individual factors and the outcome. Results: 22.2% of the children (95% CI 18.0%-27.0%) had suicide ideation/attempts, reported either by their mothers, teachers, or the child at some point in a cohort. The following variables were associated with suicidal ideation/attempts in the final adjusted model: regular or poor quality of relationship with friends (OR = 1.84; 95% CI 1.31–2.58), having a family member incarcerated (OR = 1.44; 95% CI 1.07–1.92) and having worse performance in portuguese or mathematics than other students (OR = 2.05; 95% CI 1.29–3.26). Conclusion: Suicidal behavior in childhood is severe and affects everyone around the case, demanding to promote friendships, helping with school activities, and providing greater support and attention to children at risk. Bad relationships with friends and incarcerated family members are particularly key risk factors for suicide ideation and attempts. It is essential to improve prevention policies and to disseminate protective behaviors. There is a critical need to augment community mental health resources, mainly in less developed countries and regions that lack these services. [ABSTRACT FROM AUTHOR]

Background: Suicide is a global, preventable public health issue, with nearly more than 700,000 people dying by suicide annually. The majority of suicides occur in developing countries, including Nepal. This study is aimed at examining the trends and patterns of suicide in Nepal over the past 5 years in the federal context. Methods: Using the Nepal Police suicide database, we analyzed data from 2019 to 2023 based on age, gender, methods of suicide, and provincial distribution. Trends in suicide rates over the past 5 years were examined, with graphs and tables created to represent the observed trends and patterns visually. Excel was used to support the data analysis. Results: Overall, the suicide rate was found to be higher among males (59.1%). However, the suicide rate varied by gender and age group, with females having a higher suicide rate below 18 years of age, while males had a higher suicide rate above 18 years of age. Hanging has consistently been the preferred method of suicide over the past 5 years. The national suicide rate showed an increasing trend. Similarly, an increasing trend in suicide was observed in all seven provinces of Nepal, with Koshi, Madhesh, and Gandaki provinces showing significant growth over the past 5 years. Conclusion: The increasing trend in suicide rates at both the national and provincial levels highlight the necessity to prioritize this issue and it is imperative for all levels of government to formulate targeted policies, programs, and strategies to prevent suicide. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Suicidal ideation has high rates among individuals at Clinical High Risk for Psychosis (CHR‐P). CHR‐P mental states are currently defined as attenuated psychotic symptoms, brief intermittent psychotic symptoms, or genetic risk and functioning deterioration syndrome. However, the relationship between psychotic experiences and suicidality in CHR‐P subjects is still not fully understood. Research emphasizes the need to address suicidality in CHR‐P individuals due to its incidence and severe socio‐economic impact. This study aimed to assess the baseline prevalence and 2‐year incidence rates of suicidal thinking and behaviors in an Italian CHR‐P sample, investigate the stability of suicidal ideation over 2 years, and examine its associations with treatment outcomes, sociodemographic characteristics, and clinical factors.CHR‐P participants were treated in an “Early Intervention in Psychosis” program and completed the PANSS and the GAF scale at baseline and every 12 months.180 CHR‐P individuals were enrolled (92 with suicidal ideation [SI+]). SI+ subjects had a higher baseline prevalence of past suicide attempts. Over 2 years, a decrease in suicidal ideation severity was observed in the total group. Longitudinal improvement in disorganized symptoms was a key predictor of the decrease in suicidal ideation. Participants with a history of suicide attempts were more likely to attempt again.Addressing disorganization is crucial for suicide prevention in the CHR‐P population. Continuous risk monitoring and preventive actions are needed for those with past suicide attempts. [ABSTRACT FROM AUTHOR]

Background and Aims Design Setting Participants Measurements Findings Conclusions With an epidemic of drug overdoses, contemporary research is needed to examine drug overdose deaths among homeless populations. This study measured rates, types and correlates of drug overdose deaths occurring over a 5‐year study period among veterans experiencing homelessness (VEH) and non‐homeless veterans (NHV) in the US Department of Veterans Affairs (VA) healthcare system.Retrospective cohort study.USA.A total of 6 128 921 veterans. We followed 399 125 VEH and 5 729 796 NHV between 2017 and 2021 using linked administrative VA and National Death Index data.Multivariable Cox regression models were constructed to estimate hazard ratios (HRs) for homelessness as a predictor of time‐to‐occurrence of overdose deaths with 95% confidence interval (CIs), sequentially controlling for demographic, medical, substance use and mental health characteristics.Among overdose deaths, 8653 [93.7%, 95% confidence interval (CI) = 93.2–94.2%] were unintentional and 5378 (57.8%, 95% CI = 56.8–58.8%) involved opioids. The overdose‐specific mortality rate (per 100 000 person‐years) was 227.3 among VEH and 23.2 among NHV (HR = 9.76, 95% CI = 9.36, 10.16), with rates 7–14 times higher among VEH than NHV, depending on the drug involved. In fully adjusted models, homelessness was associated with greater risk of drug overdose death (HR = 3.33, 95% CI = 3.18, 3.49), with the greatest risk involving psychostimulants (HR = 4.19), followed by antiepileptic/sedative/hypnotic drugs (HR = 3.69), synthetic opioids (HR = 3.50) and natural and semi‐synthetic opioids (HR = 2.79).US veterans experiencing homelessness appear to have three times the risk for drug overdose deaths than non‐homeless veterans. There may be specific risks associated with psychostimulant, antiepileptic, sedative and hypnotic drugs in this population that deserve greater attention. [ABSTRACT FROM AUTHOR]

Background: Given that the majority of suicide decedents visit primary care in the year preceding death, primary care has been identified as a key setting in which to engage patients at risk for suicide in mental health services. The objective of this research was to identify barriers and facilitators to engagement in mental health services among primary care patients at risk for suicide to inform the development of strategies to increase engagement. Methods: Seventy-four semi-structured qualitative interviews were conducted with primary care patients (n = 20), primary care (n = 18) and behavioral health (n = 12) clinicians, mental health intake coordinators (n = 4), and health system and clinic leaders (n = 20). Patients who had been referred for mental health services from primary care and reported an elevated score (≥ 1) on item 9 on the Patient Health Questionnaire at the time of referral were eligible to participate. Eligible clinicians and leaders were employed in a primary care or behavioral health setting in a single large health system with an integrated mental health program. Interviews typically lasted 30–60 min, were completed over video conference or phone, and were coded by members of the research team using a rapid qualitative analysis procedure. Results: Participants were primarily female (64.9%), white (70.3%) and non-Hispanic/Latine (91.9%). The most identified barriers to mental health care engagement were waitlists, capacity limits, insurance, patient characteristics, communication, collaboration, and/or difficulties surrounding travel. The most commonly cited facilitators of engagement included telehealth, integrated care models, reminders, case management support, psychoeducation, motivational enhancement, and scheduling flexibility. Concrete suggestions for improving engagement in mental health services included increasing communication between providers, streamlining referral and intake processes, providing reminders and follow ups, and advocacy for increased reimbursement for suicide risk assessment. Conclusions: Results underscore the myriad barriers patients at risk for suicide encounter when attempting to engage in mental health care in a primary care setting. Facilitators of engagement and suggestions for improving connections to care were also identified, which can inform the design of implementation strategies to improve engagement in mental health services among primary care patients at risk for suicide. Trial registration: ClinicalTrials.gov Identifier: NCT05021224 (Registered August 19, 2021). [ABSTRACT FROM AUTHOR]

Background: Suicide and its associated risk factors are of public health importance across the globe. The affected persons are mostly the youth. Empirical research in this crucial area of public health is generally lacking, especially among undergraduate university students in Ghana. This study sought to determine the prevalence of suicide ideation, and its associated risk factors that statistically predict suicide ideation among undergraduate students. Methods: A descriptive cross-sectional quantitative survey was conducted. A structured online questionnaire was used to elicit information on the prevalence of suicide ideation and its correlates. A systematic sampling technique was used to sample 400 respondents. Of this number, 53.25% were male and 46.75% were female. Data were analyzed using SPSS v26. Results were presented in charts, tables, and cross-tabulations. A regression analysis was also done to model suicide ideation with socio-demographic variables. Results: The prevalence of suicide ideation among participants was 24.5%. Significant risk factors for suicide ideation found in the study were academic stress and victimization. Suicide ideation was predicted with statistical significance by the presence of victimization (OR = 3), and academic stress (OR = 2). Conclusion: The prevalence of suicide ideation among participants is real and will need combined efforts of university management and, the counseling unit to put in place interventions that will help avert suicide ideation and its dreaded squeal of completed suicide. [ABSTRACT FROM AUTHOR]

The relationship between suicidality and resilience is underexplored among the general population. This study aimed to explore the relationship between lifetime, one-year, and one-month prevalence of suicidality (ideation, plan, attempt) and resilience in the general population. Data on suicidality, resilience, prevalence of major mental disorders, and other key psychological factors were collected from the National Mental Health Survey of Korea 2021. Interviewees comprised 5511 South Koreans aged 18–79 years. The contribution of resilience to suicidality was evaluated using Rao–Scot logistic regression, adjusting for possible confounders such as mental disorder prevalence and demographic and psychological characteristics. Significantly lower resilience levels were noted among participants who reported lifetime, one-year, and one-month suicidal ideation, plan, or attempts. High resilience levels predicted no suicidal ideation, plans, and attempts in the lifetime, and no suicidal ideation and plans in the one-year and one-month time frames. First, this study's cross-sectional design has limitations for ascertaining a causal relationship between resilience and suicidality. Second, because the number of participants who had attempted suicide in the past year and reported suicidal thoughts/attempts in the past month was small, there were limitations in the analysis of suicidality in these time frames. Third, it was difficult to rule out the mediating effects of personality and temperament on the relationship between resilience and suicidality. High resilience levels predicted lower lifetime and current suicidal ideation and suicidal planning in the general population. This study shows that psychological resilience is an important factor in evaluating an individual's current suicidality. • This study examines the relationship between suicidality and resilience in Korea. • Interviewees comprised 5511 adults aged 18–79 years. • Lower resilience was noted among participants who reported suicidal ideation. • Resilience is an important factor in evaluating an individual's suicidality. [ABSTRACT FROM AUTHOR]

The current study uses a nationally representative longitudinal dataset of sexual minority adults in the US to investigate the pathways from adverse childhood experiences (ACEs) to adulthood suicidal thoughts and behaviors. ACEs were measured at year one, potential mediators at year two, and suicidal thoughts and behaviors (suicidal ideation, intent, plan, and attempt) at year three. We conducted an exploratory mediation analysis to identify potential mediating factors linking ACEs to suicidal thoughts and behaviors. Ten candidate mediators were examined: social well-being, felt stigma, experiences of everyday discrimination, social support, psychological distress, alcohol and drug use, importance of sexual identity, community connection, and internalized homophobia. Participants were 1518 adults who identified as lesbian or gay (n = 833; 55 %), bisexual (n = 493; 33 %), or with other sexual minority identities (n = 181; 12 %) and were on average 36.48 years (SD = 14.7) of age. Psychological distress served as a common mediator between ACEs and suicidal ideation, intent, plan, and attempt. Additionally, experiences of everyday discrimination emerged as a specific mediator leading to suicidal intent, whereas social support uniquely mediated the relation between ACEs and suicide plan. Potential recall bias due to retrospective reporting of ACEs may be a limitation. Future studies should broaden the measurement scope of ACEs and implement intersectional methods. The current findings underscore the urgent need for targeted interventions that address the specific mental health needs of sexual minority individuals, particularly focusing on mitigating psychological distress, combating systemic discrimination, and enhancing social support. • Psychological distress is a universal mediator linking adverse childhood experiences to suicidal thoughts and behaviors. • Everyday discrimination and social support are specific mediators for suicidal intent and plan, respectively. • Pathways related to suicide attempts are less stable compared to other forms of suicidal thoughts and behaviors. [ABSTRACT FROM AUTHOR]

Suicide ranks as a leading cause of premature death among adolescents globally. Understanding the trends and key determinants of suicidal behavior in youth are critical for implementing educational policies and supporting preventive strategies in schools. This retrospective study examined all hospitalizations due to suicidal behavior in children and adolescents aged 11 to 18 years in Spain, using data from the Spanish National Registry of Hospital Discharges spanning 2000 to 2021. Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9 %) cases involving mental disorders. There were 2855 admissions with suicidal behavior, constituting 2.4 % of the hospitalizations among youth with mental disorders. Girls represented 73.4 % of all hospitalizations, with a median age of 16 years. Admissions for suicidal behavior saw a four-fold increase during the last decade (p < 0.001). The in-hospital mortality rate for adolescents with suicidal behavior doubled that of those hospitalized for other mental disorders. During the first year of the COVID-19 pandemic, admissions of adolescents with suicidal behavior decreased, only to surge by 2.5-fold during 2021. Hospital admissions for suicidal behavior among adolescents have risen in Spain over the last two decades. Girls represented 73.4 % of these admissions, yet in-hospital mortality was more frequent in boys. • A total of 2855 hospitalizations in adolescents with suicidal behavior were recorded in Spain from 2000 to 2021. • They represented 2.4 % of admissions due to mental disorders in youth. • Girls represented 73.4 % of hospitalizations with suicidal behavior, with a median age of 16 years. • In-hospital mortality was more frequent in boys than girls. • Admissions for suicidal behavior in youth saw a 4-fold increase during the last decade [ABSTRACT FROM AUTHOR]

The current study aimed to assess whether online suicide risk assessment affects state mood and is the first to examine if suicide‐related self‐stigma or coping related to suicidal ideation are predictors of mood change. The Australian participants (N = 661, Mage = 34.9, SD = 12.3, 57.1% female), recruited through a crowd‐sourcing platform, completed a visual analogue mood measure before and after the Suicidal Ideation Attributes Scale (SIDAS), an assessment tool. Followed by a modified version of the Internalised Stigma Scale, the Brief COPE and DASS‐21. State mood did not change from pre‐ to post‐suicide risk assessment in the overall sample, t(662) = −.16, p = .868, d = −.01. Contrary to hypotheses, neither self‐stigma nor coping were related to mood change following exposure to the SIDAS. The multiple regression model was not significant, F(9,643) = 1.16, p = .31., nor was any single predictor including gender, current Suicide risk β = −.04, t = −.80 or psychological distress β = −.09, t = −1.76, p = .08. These findings suggest that online exposure to a suicide risk tool is unlikely to be iatrogenic in relation to state mood, even in the context of elevated self‐stigma, suicidal ideation and psychological distress. [ABSTRACT FROM AUTHOR]

Background: The suicide risk in patients with atrial fibrillation receiving novel oral anticoagulants or warfarin has not been evaluated in real-world practice. Moreover, reducing vitamin K levels may increase the suicide risk, underscoring the importance of selecting appropriate oral anticoagulants to prevent unintended outcomes. Therefore, we aimed to evaluate the association between different types of oral anticoagulants and the risk of attempted and completed suicide among patients with atrial fibrillation. Methods: This nationwide study retrieved data from Taiwan's National Health Insurance Research Database from 2012 to 2020. This study included patients with atrial fibrillation aged 20 years and older who newly received oral anticoagulant treatment, and who had no contraindications for NOACs and no history of suicide-related events. The main outcomes were suicide-related outcomes, including attempted suicide and completed suicide. This study employed the target trial emulation framework to improve the causal inference for the observed association. Results: A total of 103,768 (71.74%) patients taking NOACs and 40,877 (28.26%) patients taking warfarin were included in this study. Compared to those receiving warfarin, patients receiving NOACs were associated with a lower risk of suicide-related outcomes (HR, 0.82; 95% CIs, 0.69–0.96). Conclusions: The findings of this cohort study suggested that patients receiving NOACs were associated with a lower risk of suicidal attempts but similar risk of complete suicide, compared to those receiving warfarin. Considering the risk of suicide, NOACs could be the preferred anticoagulants for patients with atrial fibrillation. [ABSTRACT FROM AUTHOR]

AbstractThe present review explored the prevalence and factors of mental health conditions among lesbian, bisexual, and other sexual minority women (LBSW) in Southeast Asia. It found that the rates of significant depression and depressive symptoms range from 10% to 93.2%, with a median of 27.7%. This wide range can be due to a study conducted during the COVID-19 pandemic, which found elevated depression, stress, and anxiety rates. Studies also highlight high levels of sadness, hopelessness, sleep and eating problems, fatigue, and suicidal thoughts among LBSW. Suicide rates indicate that LBSW have higher odds of suicidal ideations and attempts than their heterosexual peers in the region. Additionally, bisexual and polysexual women report higher rates of depressive symptoms and suicidal behaviors than lesbian women, necessitating tailored mental health interventions. Substance use among LBSW is also notable, including smoking and heavy drinking, though some rates are below the global average. Factors influencing mental health include openness about sexuality, coping styles, and discrimination. Discrimination is linked to various mental health issues, supporting the minority stress model’s applicability in the region. Aging-related factors also affect mental health among LBSW, with older age being possibly protective against depression. Overall, this review highlights the urgent need for more inclusive mental health research and interventions in the region. Recommendations include training healthcare providers, developing tailored mental health programs, adopting suicide prevention initiatives, enacting anti-discrimination laws, and addressing substance use. Future research should focus on underrepresented regions and older LBSW. [ABSTRACT FROM AUTHOR]

\nKEY POINTSMale suicide is a significant public health concern, with devastating impacts on communities. Of the 3,144 deaths by suicide in Australia in 2021, three-quarters were males – a trend that has occurred for many years and across many countries. The pathway to suicide is highly individual and complex – influenced by social, systemic, and individual factors. This commentary explores the complex interplay of factors that contribute to the higher suicide rates among males, as well as the challenges in addressing this issue within the context of gender norms, mental health, social support, and life stressors. Collaboration with individuals with lived and living experience is crucial in developing gender-responsive services and systemic approaches that support males’ diverse and complex needs. Insights for responding to male suicide risk in clinical practice are provided. Psychologists can play a pivotal role in prevention efforts by: providing tailored support; delivering gender-sensitive programs; conducting research; and advocating for policy changes.What is already known about this topic:(1)  The suicide rate is higher among males in Australia and many other countries.(2)  Correlates of male suicide include mental health, substance use, relationship issues, social isolation, and alcohol use.What this topic adds:(1)  Suicide among men is influenced by a complex interplay between social, systemic and individual factors.(2)  Gender sensitive clinical and community approaches are needed that build collaborative relationships with males and people with lived experience, attend to the unique context of males’ lives, develop protective factors, and advocate for systemic change.(3)  Psychologists can play a critical role in prevention efforts by responding at both individual and community levels. [ABSTRACT FROM AUTHOR]

ABSTRACT Mental health issues such as anxiety and depression are on the rise in communities. Ignoring severe mental health issues can lead to suicide, which is a global public health issue. The use of advanced tools and methods to prevent suicide can help save human lives. Visual tools and virtual technologies have multiple applications in the medical and educational fields. The aim of this study was to investigate the effect of using virtual reality (VR) technology on suicidal thoughts. A quasi‐experimental study was conducted, in which 189 individuals who had a history of suicide were tested. These individuals were divided into three groups: one control group and two intervention groups that received traditional and VR‐based training for 90 days. The Beck Scale for Suicide Ideation was used. The posttest results after the training period showed that conducting the training course had a statistically significant effect on individuals' suicidal behaviour and those who participated in the VR‐based training course had better improvements in suicidal thoughts. Therefore, the use of 3D simulation and visualisation tools can have a significant impact on individuals' thoughts and perceptions. The results of this study have practical implications for hospital managers and counsellors in healthcare centres to use VR technology in counselling and training courses to improve the behaviour of individuals with a history of suicide. [ABSTRACT FROM AUTHOR]

ObjectivesDesignResultsConclusionPrior research shows that perceived racism was associated with higher risks of suicidal ideation among US Asians. Nevertheless, the relationship between internalized racism and the suicidal risks of US Asians has not been adequately researched. In addition, as an important social institution, religion has been left out of the studies of racism and suicide for US Asians. This study is aimed at filling in these gaps and contributing to a better understanding of internalized racism, religion, and the mental health of US Asians.This study surveyed 970 Asian or Asian American adults living in the United States. Survey participants were recruited using Qualtrics online panel samples between April and June 2024. Quotas were set for key demographic variables, such as sex and ethnicity, following the national census.The main results suggest that even after controlling important mental health measures such as anxiety and loneliness, higher internalized racism was still tied to higher risks of suicidal ideation. The effect of internalized racism was not only robust but also stronger than other mental health measures as well as perceived external racism. Finally, the deleterious internalized racism effect on suicidal ideation was stronger among US Asians, who attend religious services more often.Internalized racism exerts a fairly strong and robust effect on suicidal ideation among US Asians. This deleterious effect is also interactive with the religious characteristics of US Asians. Healthcare providers, community workers, and religious leaders may want to take internalized racism into consideration in their future service to the US Asian community. [ABSTRACT FROM AUTHOR]

Background: Among medical residents, suicide is the second most prevalent cause of mortality. In Iran, the suicide of medical residents has become one of the most important challenges. This study aimed to investigate the mediating role of psychological distress in the relationship between perfectionism and suicidal ideation among medical residents in Iran. Methods: This research was a descriptive-correlational study based on structural equation modeling. The statistical population of the present research included all the residents in Shahid Beheshti University of Medical Sciences (SBMU) in 2023, of whom 277 people were selected as a sample using the available sampling method. The Beck Scale for Suicidal Ideation (BSSI-1997), the Tehran Multidimensional Perfectionism Scale (TMPS-2007) and the Depression, Anxiety and Stress Scale (DASS-21-1995) were used to collect the data. Data was analyzed using structural equation modeling with SPSS and Amos software version 22. Results: Out of 277 participants, 30% (N = 83) were male and 70% (N = 194) were female. The findings showed that the research model had goodness of fit. There was a significant relationship between perfectionism and psychological distress (β = 0.76, P < 0/001) and between psychological distress and suicidal thoughts (β = 0.66, P < 0/001). However, there was no direct relationship between perfectionism and suicidal ideation (P > 0.01), but perfectionism played a role in residents' suicidal ideation through psychological distress (β = 0.50, P < 0/001). In other words, perfectionism led to suicidal ideation by increasing the psychological distress of the residents. In addition, perfectionism and psychological distress were able to explain 42% of the variances of suicidal ideation (R2 = 0/42). Conclusion: The results highlighted the crucial role of psychological distress in suicidal ideation of medical residents. Accordingly, substantial support from health-sector managers and policymakers is essential to meet the requirements of medical residents. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Method Result Conclusion Student suicide is one significant public health concern across the world, including India. In recent years, the surge in suicide cases has further worried mental health professionals and policymakers. The current study analysed the reported student suicide cases published in four leading Indian newspapers.Based on the analysis of newspaper reports published between 2019 and 2023, the study detected a total of 491 suicidal deaths of students.The result revealed that academic reasons (academic dissatisfaction, academic stress and academic failure), institutional reasons (bullying, caste discrimination, ragging, harassment and toxic institutional culture), mental health issues (depression, psychological stress and anxiety), financial crisis and online gaming are the most commonly reported reasons behind student suicides. The majority of suicide victims were within the age range of 16–21 years. The highest number of suicide cases are reported from Kota, a city often referred to as the coaching capital of India.The study highlights considering changes in the academic curriculum to make academic programs less stressful for students. More importantly, policies should ensure that the academic campuses are free from harassment, bullying or similar aggressive experiences. Furthermore, emphasising students' mental health should be the education system's biggest priority. [ABSTRACT FROM AUTHOR]

AbstractSemi-structured interviews were performed with 12 psychiatrists regarding their perceptions of the Swedish Vision Zero for Suicide. Focusing on the topic of rational suicide, we re-analyzed these interviews using descriptive content analysis. The informants generally acknowledged the existence of rational suicide and its occurrence also among severely ill psychiatric patients, but expressed varying perceptions of the relevance of the concept in clinical practice. The difficulty of identifying rational suicide was considered to be a major problem. Another experience was a potential conflict between promoting a patient’s rationality and preventing suicide. While the normative aspects of rational suicide have been addressed in the literature, our results highlight a need for further attention to the epistemological and practical aspects of rational suicide. [ABSTRACT FROM AUTHOR]

Background: Rising digitalization and individualism in the workplace after the COVID-19 pandemic have increased loneliness and related problems in the working-age population. The potential effects of various forms of loneliness on suicidal ideation may differ depending on employment status. Method: This is a cross-sectional study based on a national survey of mental health in the general Korean population. We classified occupations as "employed," "self-employed," or "unemployed." Loneliness was assessed using the UCLA Loneliness Scale, which measures both qualitative and quantitative aspects of loneliness. Suicidal ideation was evaluated using the Patient Health Questionnaire-9. Results: A total of 1770 participants aged 30–65 years (mean age: 47.7 years) were included. The mean loneliness score was 43.9 (SD = 10.4), and 28% of the participants experienced a high level of loneliness. The prevalence ratio for suicidal ideation in the group with high levels of loneliness was 3.06 (95% CI 2.57, 3.63) compared to the group with low levels of loneliness. In our subgroup analysis, we consistently observed an association between loneliness and suicidal ideation across the employed group; however, the employed was more related with qualitative loneliness, the self-employed and the unemployed were more related with quantitative loneliness. Conclusions: Loneliness was associated with suicidal ideation. According to employment status, the associations were consistent, but there were interactions between type of loneliness and employment status. These findings suggest that interventions to reduce loneliness and prevent suicidal ideation should be tailored to specific employment groups, focusing on qualitative aspects for employed individuals and quantitative aspects for self-employed and unemployed individuals. [ABSTRACT FROM AUTHOR]

Background: Given the limited research focusing on psychotherapeutic interventions for suicide attempters, it is noteworthy that the Attempted Suicide Short Intervention Program (ASSIP) has demonstrated promising results in previous studies. In this investigation, we aim to evaluate the effectiveness of ASSIP across diverse healthcare settings, outlining the study design and planned evaluation. Methods: Using a Randomized Controlled Trial (RCT) design with four assessment points (baseline, 3, 12- and 24-month follow-up), we aim to assess the effect of the 3-session psychotherapeutic intervention and hereafter brief contact via structured letters during 2 years in a clinical sample of recent suicide attempters (suicide attempts within three months before inclusion). Participants are randomly assigned to one of two groups; treatment as usual plus ASSIP or the control condition, treatment as usual. Assessments include measures of suicidal intent, coping, symptoms of depression, quality of life, self-stigma, and sick leave. The primary outcome is suicide attempt(s) within 3, 12, and 24 months and the secondary outcome is suicidal ideation within the same time frames after study inclusion. Discussion: Findings from this study will provide novel insights regarding the effects of ASSIP on not only subsequent suicidal behavior but also other outcomes including self-stigma, quality of life, social network, sick leave, and symptoms of depression. Trial registration: The trial was registered at ClinicalTrial.gov NCT04746261 on 2020-10-15. [ABSTRACT FROM AUTHOR]

Among the groupings of Social Work Grand Challenges is Individual and Family Well-Being. One threat to individual and family well-being is suicide. Between 2011 and 2022 over half a million Americans committed suicide. Suicide has profound effects on family members. Recent research has found violent political rhetoric (VPR) as an aspect of the social environment is associated with violence, including mass shootings and police shootings of civilians, both threats to individual and family well-being. No studies have investigated the possible relationship between VPR and suicide rates. This study, a secondary analysis of publicly available data, addresses this absence. The dependent variable was suicide rates in the U.S. Census regions. Independent variables included census region populations, VPR, gun ownership, and temperature. Panel analysis methods with Driscoll-Kraay robust standard errors were used. Statistically significant relationships between suicide rates and VPR, changes in gun ownership, and temperature were found, with between-region differences. Violent political rhetoric appears to be associated with increasing suicide rates, and these relationships may differ between regions. Implications of these findings for future research and for social work efforts to combat the effects of VPR and potentially reduce suicide rates, especially for populations targeted by VPR, are considered. [ABSTRACT FROM AUTHOR]

The Campaign Against Living Miserably (CALM) aims at advocating against suicide and changing the way mental health is addressed in everyday conversation. Social learning theory (SLT) explains how people imitate others’ behaviors—for example, through a process called learning by imitation. Observation and imitation are vital aspects of how people develop behaviors and habits. One of these behaviors is highly negative and controversial: suicide and the unhealthy mental health relationships that come with it. People can emulate the death of another by copying their behavior, sometimes without even entirely meaning to do so. This paper applies the tenets of SLT—i.e. attention, retention, reproduction, and motivation—to aspects of CALM and to the negative impacts of phenomena such as social media influencers (SMIs) and celebrity suicides. What makes this approach interesting is that the CALM campaign can benefit from the use of one of the longest-established theories in the fields of psychology and communication. More precisely, regarding mental health and the media, most studies have focused on how social media is causing depression or anxiety. This is why this manuscript adds fresh insights by using key SLT precepts to raise awareness as to how these suicidal thoughts and symptoms form. [ABSTRACT FROM AUTHOR]

Impulsivity, aggression, and suicide are the major clinical symptoms of borderline personality disorder (BPD). Although previous studies indicated poor sleep quality and its relationship with clinical symptoms in patients with BPD, chronotype, an important sleep parameter, was not investigated in these patients. This study aimed to analyze chronotype and its relationship with clinical symptoms in patients with BPD. Participants in this study consisted of 68 BPD patients and 65 healthy controls. Subjective sleep characteristics, impulsivity, aggression, suicide probability, and chronotype were assessed using the Pittsburgh Sleep Quality Index (PSQI), Barratt Impulsivity Scale, Buss-Perry Aggression Scale (BPAQ), Suicide Probability Scale, and Morningness – Eveningness Questionnaire, respectively. PSQI total and subscale scores subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime drowsiness were significantly higher in the BPD group (p < 0.001). There was a positive correlation between the PSQI total score and the BPAQ total score (r = 0.268, p = 0.027). The rate of evening type was significantly higher in the control group (p = 0.004). Suicide attempts and the subscale of suicide probability hopelessness, suicidal ideation, and negative self-evaluation scores were significantly higher in evening type BPD patients. (p = 0.017, p = 0.009, p = 0.001, p = 0.047). Sleep quality is associated with aggression, and the eveningness chronotype is associated with suicide. It may be useful to focus on sleep problems in treating BPD patients. [ABSTRACT FROM AUTHOR]

Mortality due to suicide is amongst the largest public health concerns across the world today in Bharat (India). There have been concerns that the COVID-19 pandemic has contributed to worsening mental health outcomes across the world, including in Bharat. Furthermore, long COVID has been proposed to be a major consequence of COVID-19, which can also worsen mental health outcomes. Therefore, our objective in this study was to analyse trends in suicide mortality across Bharat and to compare these trends to changes prior to the COVID-19 pandemic; in addition, we aimed to analyse if long COVID had any role in these changes. It was found that, at a national level, the average annual increase in the suicide rate between 2019 and 2022 was 0.7 per 100,000 people (a 6.41% increase). There was also an average annual rise in suicide rates across 27 states/union territories (out of the 33 that were analysed). States/UTs with the highest annual increases since the start of the COVID-19, despite a decrease from 2018 to 2019, were Tamil Nadu (increased by 2.7; a 15.17% increase) and Telangana (increased by 1.9; a 9.22% increase). Multi-linear regression showed that the annual suicide rate changes were not associated with COVID-19 deaths per 10,000 people (standardized beta coefficient = 0.077; p = 0.605) but were associated with COVID-19 cases per 100 people (standardized beta coefficient = 0.578; p < 0.001). It has been shown that suicide mortality has worsened, and long COVID may have a potential role in this in Bharat. [ABSTRACT FROM AUTHOR]

Introduction: Although major depression is the disorder most frequently associated with suicidal behavior, it is unclear that major depressive disorder patients may develop suicidal ideation. Basic affective system theory may provide a novel and beneficial viewpoint in this field. The goal of this study was to investigate the basic affective system in relation to suicidal ideation in individuals with depression. Method: The study population comprised 160 participants who had been formally diagnosed with major depressive disorder. Participants were divided into two groups according to whether they had suicide ideation (depression with suicide [DS]) (N = 93) or not (depression with no suicidal ideation [DNS]) (N = 67). The Beck Depression Inventory (BDI), the Suicide Probability Scale (SPS), the Beck Hopelessness Scale (BHS), and the Affective Neuroscience Personality Scale (ANPS) were applied. Statistical Product and Service Solutions (SPSS) 24 and the SPSS macroprocess, which were specifically developed for assessing complex models including serial mediators, were used to analyze the data. Results: The mean age of all participants was 31.1 ± 11 years, and most of them were female (65%). The DS group had a higher family history of psychiatric medication use and suicidal attempts. In addition, BDI, BHS, and SPS total scores were higher, as well as ANGER subscale scores were higher in the DS group. In mediation analysis, the ANGER subscale significantly predicted the presence of suicide ideation. We observed a direct effect of the ANGER subscale score on suicide ideation as well as an indirect effect of the ANGER subscale score on suicidal ideation via depression severity. Conclusion: Higher scores on ANGER are associated with suicidal ideation. Neurobiological correlates, including the ANGER system, may be promising in understanding suicidal behaviors. [ABSTRACT FROM AUTHOR]