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The article discusses the controversy surrounding the TV series "13 Reasons Why" and its potential impact on adolescent suicide rates. The series, which portrays the suicide of a teenage girl and the factors that led to it, received criticism from suicide prevention organizations for its potential to trigger contagion effects. Several studies have reported detrimental effects of the series on suicide rates, suicide attempts, self-harm presentations, and suicidal ideation among young people. The article responds to a critique of these studies, arguing that the critique did not provide valid evidence to cast doubt on the previous findings. The authors emphasize the need for entertainment media to follow best practices in suicide portrayals and raise awareness about their role in suicide prevention. [Extracted from the article]

Introduction: Media guidelines for the responsible reporting of suicide are a recognized universal suicide prevention intervention. While implemented in numerous countries, including Australia, little is known about whether they are cost‐effective. We aimed to determine the cost‐effectiveness of Mindframe, the national initiative implementing media guidelines in Australia. Method: We conducted a modelled economic evaluation (5‐year time‐horizon) incorporating two types of economic analysis: (i) return‐on‐investment (ROI) comparing estimated cost savings from the intervention to the total intervention cost, and (ii) cost‐effectiveness analysis comparing the net intervention costs to health outcomes: suicide deaths prevented and quality‐adjusted life‐years (QALYs). We also included uncertainty analyses to propagate parameter uncertainty and sensitivity analyses to test the robustness of the model outputs to changes in input parameters and assumptions. Results: The estimated ROI ratio for the main analysis was 94:1 (95% uncertainty interval [UI]: 37 to 170). The intervention was associated with cost savings of A$596M (95% UI: A$228M to A$1,081M), 139 (95% UI: 55 to 252) suicides prevented and 107 (95% UI: 42 to 192) QALYs gained. The intervention was dominant, or cost‐saving, compared with no intervention with results being robust to sensitivity analysis but varying based on the conservativeness of the parameters entered. Conclusion: Mindframe was found to be cost‐saving, and therefore, worthy of investment and inclusion as part of national suicide prevention strategies. [ABSTRACT FROM AUTHOR]

Objective: In the United States, there was an increase in calls to helplines following media reporting of Robin Williams' suicide. We aimed to determine whether this was the case in Australia. Method: The helpline services Lifeline and Beyond Blue provided us with weekly data on calls received for 2013–2015. We conducted interrupted time series regression analyses to determine whether there was an increase in the average weekly number of calls received by each helpline in two periods after the story about Williams' suicide broke (1 week and 4 weeks). Results: We found strong evidence of an increase in calls to Lifeline (incidence rate ratio [IRR] =1.13; 95% confidence interval [CI] =1.02–1.25; p = 0.016) and Beyond Blue (IRR = 1.32; 95% CI = 1.09–1.59; p = 0.004) in the week after Williams' suicide was first reported. We found no evidence of higher than normal call volumes for Lifeline (IRR = 1.04; 95% CI = 0.99–1.10; p = 0.104) or Beyond Blue (IRR = 1.10; 95% CI = 1.00–1.22; p = 0.058) over the four weeks following Williams' death, however, suggesting that calls leveled out over this period. Conclusion: Suicide prevention experts and media professionals must work together to minimize the negative impacts of reports on suicide and maximize their positive ones. In cases where the story is likely to receive extensive international coverage, it may be important for local media to encourage help‐seeking. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of the "Pause. Call. Be Heard" campaign on help-seeking and suicidal behaviors within rail environment in Victoria, Australia.Methods: An anonymous online survey was conducted to measure noticeability of and engagement with the campaign and help-seeking intentions and behaviors among rail commuters at 10 rail stations. We generated descriptive statistics to report these data and used logistic regression models to examine the association between campaign-related factors and help-seeking. Changes in Lifeline crisis calls and rail suicide behaviors from precampaign to campaign periods were examined using proportion tests.Results: About 25% of rail commuters noticed the campaign and rated the materials as "moderately noticeable." Over half of these individuals correctly identified the campaign intentions and 75% engaged with the materials. Approximately 80% indicated that the materials increased their help-seeking intentions and about half indicated that they had engaged with help-seeking and/or self-caring behaviors. Engaging with the campaign was positively associated with help-seeking. A significant increase in crisis calls but not in suicide-related calls, and a nonsignificant decrease in rail suicidal behaviors were found during the campaign period.Conclusions: Continued implementation of the campaign is warranted as it showed some desirable effects on help-seeking among rail commuters. [ABSTRACT FROM AUTHOR]

Objective: We aimed to identify Australian adults' current level of confidence and intentions to help a person close to them in distress or at risk of suicide to inform the content and targeting of suicide prevention messages aimed at family and friends of those at risk.Methods: We conducted a nationally representative computer-assisted telephone survey of confidence and intentions to help someone in distress or at risk of suicide (n = 3,002). We used logistic regression to determine whether sociodemographic and exposure variables predicted confidence and intentions to help.Results: Confidence to help was high. About half of the respondents had intentions inconsistent with best practice. Listening and talking, and encouraging the person to seek professional help were the most common types of intended helping actions. Intentions to ask suicide risk assessment questions were least common. Men were more likely than women to have intentions to carry out nonrecommended actions, and less likely to have intentions to carry out recommended actions.Conclusions: Suicide prevention messaging aimed at family and friends could encourage them to ask direct questions about suicide risk and could include messages about "what not to do." Suicide prevention messages aimed specifically at men are indicated. [ABSTRACT FROM AUTHOR]

Objective: Pesticide ingestion is among the most commonly utilized means of suicide worldwide. Restricting access to pesticides at a local level is one strategy to address this major public health problem, but little is known about its effectiveness. We therefore conducted a systematic literature review to identify effective community-based suicide prevention approaches that involve restricting access to pesticides.Method: We searched Embase, Scopus, PsycINFO, Cochrane Library, CINAHL, and PubMed for well-designed studies that reported on suicide-related outcomes (i.e., attempted or completed suicide).Results: We identified only five studies that met our eligibility criteria (two randomized controlled trials, two studies with quasi-experimental designs, and one study with a before-and-after design). These studies tested different interventions: the introduction of nonpesticide agricultural management, providing central storage facilities for pesticides, distributing locked storage containers to households, and local insecticide bans. The only sufficiently powered study produced no evidence of the effectiveness of providing household storage containers. Three interventions showed some promise in reducing pesticide suicides or attempts, with certain caveats.Conclusions: Our review identified three community interventions that show some promise for reducing pesticide suicides by restricting access to means, which will require replication in large, well-designed trials before they can be recommended. [ABSTRACT FROM AUTHOR]

We sought to compare clusters of suicidal events between two different time periods and examine the extent to which earlier clusters predict later clusters. We included data on suicides and suicide attempts from New South Wales between July 2001 and June 2012 and Western Australia between January 2000 and December 2011. Suicide attempts included admissions to hospital for deliberate self-harm and suicides were deaths due to deliberate self-harm. We combined data on suicides and suicide attempts and grouped them into two equal time periods. We detected clusters in each period using Poisson discrete scan statistics adjusted for socio-economic status. We estimated the predictive values of earlier clusters on later clusters. The results showed that clusters from earlier time period had a moderate power (36%) in predicting later clusters. During the later time period, some additional cluster areas (14%) were found and some earlier cluster areas subsided (64%). Historical clusters predict 36% of the subsequent clusters, which is probably not sufficient for targeting interventions. Our study highlights the need for other strategies to detect emerging clusters, for example, up-to-date data. [ABSTRACT FROM AUTHOR]

Assessment of a patient after hospital-treated self-harm or psychiatric hospitalization often includes a risk assessment, resulting in a classification of high risk versus low risk for a future episode of self-harm. Through systematic review and a series of meta-analyses looking at unassisted clinician risk classification (eight studies; N = 22,499), we found pooled estimates for sensitivity 0.31 (95% CI: 0.18-0.50), specificity 0.85 (0.75-0.92), positive predictive value 0.22 (0.21-0.23), and negative predictive value 0.89 (0.86-0.92). Clinician classification was too inaccurate to be clinically useful. After-care should therefore be allocated on the basis of a needs rather than risk assessment. [ABSTRACT FROM AUTHOR]

Failure to provide follow-up care after a suicide attempt is associated with increased risk of reattempt. This online survey examined the experiences of patients of the Australian health system after a suicide attempt. Just over half of the participants had a psychiatric assessment within 1 week of their attempt. Fewer than half believed they had been offered enough help. Low service satisfaction was associated with lower help-seeking intentions. Support for individuals who have made a suicide attempt needs to be enhanced, and an integrated approach to care is required, including improved referral pathways and staff attitudinal change. [ABSTRACT FROM AUTHOR]

The Gap Park Self-Harm Minimisation Masterplan project is a collaborative attempt to address jumping suicides at Sydney’s Gap Park through means restriction, encouraging help-seeking, and increasing the likelihood of third-party intervention. We used various data sources to describe the Masterplan project’s processes, impacts, and outcomes. There have been reductions in reported jumps and confirmed suicides, although the trends are not statistically significant. There has been a significant increase in police call-outs to intervene with suicidal people who have not yet reached the cliff’s edge. The collaborative nature of the Masterplan project and its multifaceted approach appear to be reaping benefits. [ABSTRACT FROM AUTHOR]

There are worldwide concerns that pro-suicide web sites may trigger suicidal behaviors among vulnerable individuals. In 2006, Australia became the first country to criminalize such sites, sparking heated debate. Concerns were expressed that the law casts the criminal net too widely; inappropriately interferes with the autonomy of those who wish to die; and has jurisdictional limitations, with off-shore web sites remaining largely immune. Conversely, proponents point out that the law may limit access to domestic pro-suicide web sites, raise awareness of Internet-related suicide, mobilize community efforts to combat it, and serve as a powerful expression of societal norms about the promotion of suicidal behavior. [ABSTRACT FROM AUTHOR]

There is a paucity of studies examining which suicides are considered newsworthy. By combining data on media reports of individuals' suicides with routinely collected suicide data, it was found that 1% of Australian suicides were reported over a 1-year period. There was evidence of over-reporting of suicides by older people and females, and those involving dramatic methods. Reported suicides fell into three groups: suicides reported in a broader context; suicides by celebrities; and suicides involving unusual circumstances/methods. The data suggest a need for media professionals and suicide experts to work together to balance newsworthiness against the risk of copycat behavior. [ABSTRACT FROM AUTHOR]