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Objective: The revised Willingness to Intervene against Suicide questionnaire and the Expanded Revised Facts on Suicide Quiz were employed to examine the relationship between college students' knowledge about suicide and intention to intervene. Participants: College students (n = 515) participated, a majority being women and Caucasian. Methods: Participants completed an online survey. Data were analyzed in SPSS. Results: College students have poor knowledge of suicide facts; however, this low level of accurate knowledge was not associated with intention to intervene with a suicidal person. Attitudes, subjective norms, perceived behavioral control, sex, and no previous suicide attempt were all significant predictors of intention to intervene. Conclusions: These results challenge the notion that one must be well-informed in order to intend to take action.

Although exposure to the suicide death of a military colleague has been shown quantitatively to increase suicide risk factors among veterans, there are very few studies where veterans have been asked about this experience. This article presents a qualitative analysis of 38 interviews with U.S. veterans with exposure to the suicide death of a military colleague in past war operations. Participants described the impact of exposure in relation to the military context and official response to the death, which had long-term ramifications. Our findings suggest suicide prevention and postvention responses for veterans should be informed by the lived experience of veterans, including those for whom this experience occurred significantly in the past, as the impacts of different military policies and practices in response to suicide deaths over time are relevant to the impact of exposure to death of a military colleague in the short and long term. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the reliability and validity of the Willingness to Intervene against Suicide Enhanced (WISE) questionnaire. The WISE is a revised version of the Willingness to Intervene against Suicide (WIS) questionnaire, which was based on the theory of planned behavior, and it has consistently predicted the intention to intervene with a suicidal individual. Evaluation of the WIS showed that it was internally consistent with adequate goodness-of-fit indices for three of the four scales. The subjective norms scale did not meet the goodness-of-fit indices standard cutoff criteria. Due to this, the WIS questionnaire has been revised into the WISE. However, the dimensionality of these factors needed to be tested. College students (n = 824) completed an online survey to test the WISE. The data were analyzed using confirmatory factor analysis, reliability analysis, and multiple regression. The WISE was internally consistent, and the scales met acceptable criteria for goodness-of-fit indices. The WISE explained a range of variance in participants' intention to intervene from 12 to 40%. [ABSTRACT FROM AUTHOR]

This cross-sectional study examines data from the 2003-2020 National Violent Death Reporting System to identify distinct suicide profiles among US suicide decedents and determine associations to signs of suicidal intent and risks. Key Points: Question: Are there distinct suicide profiles linked to varying signs of suicidal intent and risks? Findings: This cross-sectional study including 306 800 US suicide decedents from 2003-2020 identified 5 suicide profiles or classes: comorbid mental health and substance use disorders; mental disorders alone; crisis, alcohol-related, and intimate partner problems; physical health problems; and polysubstance use. Class 4 (physical health problems) was the largest, exhibiting minimal explicit suicidal intent, rarely detected psychiatric diagnoses, and minimal psychotropic medication use. Meaning: Suicide prevention strategies may be more effective when tailored to different suicide profiles because integrated care enhances the detection and treatment of comorbid mental health conditions, substance and alcohol use disorders, and physical health problems. Importance: Suicide rates in the US increased by 35.6% from 2001 to 2021. Given that most individuals die on their first attempt, earlier detection and intervention are crucial. Understanding modifiable risk factors is key to effective prevention strategies. Objective: To identify distinct suicide profiles or classes, associated signs of suicidal intent, and patterns of modifiable risks for targeted prevention efforts. Design, Setting, and Participants: This cross-sectional study used data from the 2003-2020 National Violent Death Reporting System Restricted Access Database for 306 800 suicide decedents. Statistical analysis was performed from July 2022 to June 2023. Exposures: Suicide decedent profiles were determined using latent class analyses of available data on suicide circumstances, toxicology, and methods. Main Outcomes and Measures: Disclosure of recent intent, suicide note presence, and known psychotropic usage. Results: Among 306 800 suicide decedents (mean [SD] age, 46.3 [18.4] years; 239 627 males [78.1%] and 67 108 females [21.9%]), 5 profiles or classes were identified. The largest class, class 4 (97 175 [31.7%]), predominantly faced physical health challenges, followed by polysubstance problems in class 5 (58 803 [19.2%]), and crisis, alcohol-related, and intimate partner problems in class 3 (55 367 [18.0%]), mental health problems (class 2, 53 928 [17.6%]), and comorbid mental health and substance use disorders (class 1, 41 527 [13.5%]). Class 4 had the lowest rates of disclosing suicidal intent (13 952 [14.4%]) and leaving a suicide note (24 351 [25.1%]). Adjusting for covariates, compared with class 1, class 4 had the highest odds of not disclosing suicide intent (odds ratio [OR], 2.58; 95% CI, 2.51-2.66) and not leaving a suicide note (OR, 1.45; 95% CI, 1.41-1.49). Class 4 also had the lowest rates of all known psychiatric illnesses and psychotropic medications among all suicide profiles. Class 4 had more older adults (23 794 were aged 55-70 years [24.5%]; 20 100 aged ≥71 years [20.7%]), veterans (22 220 [22.9%]), widows (8633 [8.9%]), individuals with less than high school education (15 690 [16.1%]), and rural residents (23 966 [24.7%]). Conclusions and Relevance: This study identified 5 distinct suicide profiles, highlighting a need for tailored prevention strategies. Improving the detection and treatment of coexisting mental health conditions, substance and alcohol use disorders, and physical illnesses is paramount. The implementation of means restriction strategies plays a vital role in reducing suicide risks across most of the profiles, reinforcing the need for a multifaceted approach to suicide prevention. [ABSTRACT FROM AUTHOR]

Previous research has documented many behavioral problems associated with being a female victim of sexual assault, but little attention has been devoted to whether this experience might be related to premature mortalities. We investigated this utilizing the National Longitudinal Study of Adolescent to Adult Health survey, collected from over 10,000 adolescent females in 1995, whose premature deaths (n = 65) were noted in 2007 in National Death Index records. Significant associations were found between females with a substance misuse history and their premature deaths, but not with being a sexual assault victim. The subset of respondents (n = 208) evincing both these characteristics showed significantly higher risks of dying prematurely, as did those females with early histories of drug misuse alone. Yet, adolescent females with histories of drug misuse who also attempted suicide (n = 214) did not show similar elevated risks of dying prematurely compared to others without these experiences. This exploratory evidence points to an affinity between both being a female sexual assault victim and having an early history of misusing drugs, putting such people at heightened risks for dying prematurely, suggesting the potential benefits of counseling and supportive services for those so affected. [ABSTRACT FROM AUTHOR]

Survivors' adaptation to a suicide loss is likely influenced by their attitudes toward suicide and their respective sociocultural contexts. Our study aimed to compare suicide attitudes and their association with depressive symptoms and sense of community safety in Japanese and American suicide loss survivors. A total of 193 Japanese survivors and 232 American survivors completed online surveys. The results show that Japanese survivors tended not to consider suicide as an illness or to recognize that others understood their experience but were more likely than American survivors to consider suicide as justifiable. Regression analyses indicated that taking suicide as a right was associated with depressive symptoms. Further, their sense of being understood by others was positively correlated with perceived community safety in both samples, but justifying suicide and considering it to be an illness was positively related to perceived community safety only among Japanese survivors. [ABSTRACT FROM AUTHOR]

This analysis of a convenience sample survey of 195 suicide bereaved adults focuses on predictors of three important highly interrelated experiences among the suicide bereaved: grief problems, depression and suicidal thinking. Although each of these three experiences can be explained by a unique set of predictors, they share many commonalities. Several predictors stood out especially in either aggravating or alleviating these experiences: personal (or post-traumatic) growth, perceived social support, feelings of blameworthiness, perceived suicide stigma, years since loss and a respondent's mental health difficulties experienced prior to their suicide loss. We also review the clinical implications of these results. [ABSTRACT FROM AUTHOR]

Myth-busting, in which a so-called myth is presented and dispelled by facts, is used in suicide prevention gatekeeper trainings such as QPR. Evidence from other areas of public health shows this technique leads to memory for myths and not facts. An internet survey was used to determine if the "myths" and "facts" presented in QPR are endorsed as such by the suicidology community and to determine if demographics influenced statement identification. Overall, statements did reflect the opinions of the suicidology community and any type of training increased correct identification. Future research should focus on whether myth-busting is an appropriate strategy for suicidology.

To update and expand Rubey and McIntosh's (1996) survivors of suicide support groups report, SPAN USA completed a survey of U.S. support group leaders (n = 100; 24% completion). There are now more survivor groups (from 280 to 417), and the majority of groups now have a survivor leader (78% vs. 25%). Groups continue to be small (88% less than 10 members per session) and meet on a monthly basis (55%). Sharing continues to be a universal experience in groups, which tend to be open-ended (85%). Current groups are newer, and more operate without a sponsor. Further research is needed to examine group member perspectives and effectiveness of groups.

Support groups for suicide survivors (those individuals bereaved following a suicide) are widely used, but little research evidence is available to determine their efficacy. This paper outlines the pressing public health need to conduct research and determine effective ways to identify and meet the needs of suicide survivors, particularly through survivor support groups. After describing the various approaches to survivor support groups, we explain the need for further research, despite the inherent challenges. Finally, we pose several questions for researchers to consider as they work with survivors to develop a research agenda that sheds more light on the experiences of survivors and the help provided by survivor support groups.

Archival data from suicide survivors presenting for treatment from 1999-2005 at the Baton Rouge Crisis Intervention Center (BRCIC) were used to examine differences in those who received an active model of postvention (APM; n = 150) compared to those who received a traditional passive postvention (PP, n = 206). APM presented sooner for treatment (48 days) than PP (97 days). APM survivors were more likely to have been the survivor of a violent suicide. APM were more likely than PP to attend survivor support group meetings and APM attended more groups. To better understand the efficacy of APM in helping survivors, a prospective evaluation is needed.

In this pilot study we report on proximate outcomes of a 1-hour community gatekeeper training in-service for 76 nonclinical employees in a university hospital workplace setting. Pre-post analyses resulted in positive changes in participants' knowledge about suicide and attitudes (self-efficacy) about intervening with suicidal individuals. A subset of participants engaged in role play practice of gatekeeper skills following training and rated the experience positively. Fifty-five observations were rated using an observational measure developed for this study and approximately half of these demonstrated satisfactory skills post training. Participants in this workplace gatekeeper training reported sharing new knowledge and skills with family, friends, and coworkers.

Objective: Although the death of a parent is one of the most significant stressors a child can experience, the psychiatric sequelae of parental death are not fully understood. Method: A total of 360 parent-bereaved children (ages 6-17) and their surviving parents were directly interviewed four times during the first 2 years following the death (at 2, 6, 13, and 25 months). Data collection occurred from 1989 to 1996. Psychiatric symptomatology was compared among the bereaved children, 110 depressed children, and 128 community control children and their informant parents. Additional analyses examined simple bereavement without other stressors versus complex bereavement with other stressors and anticipated versus unanticipated death. Results: Bereavement following parental death is associated with increased psychiatric problems in the first 2 years after death. Bereaved children are, however, less impaired than children diagnosed with clinical depression. Higher family socioeconomic status and lower surviving parents' level of depressive symptoms are associated with better outcomes. Complex bereavement was associated with a worse course, but anticipation of the death was not. Conclusions: Childhood bereavement from parental death is a significant stressor. Children who experience depression in combination with parental depression or in the context of other family stressors are at the most risk of depression and overall psychopathology. (Contains 2 tables and 2 figures.)

The persistent stigmatization of suicide calls for a careful examination of the thought processes involved in perceptions of suicide. Hence, the present study is the first to apply terror management theory (TMT) and use experimental methods to examine whether reminders of death lead to increased stigma towards suicide and whether self-esteem moderates these stigmatized reactions. Consistent with the predicted effect of the death anxiety and self-esteem hypothesis, findings revealed that, for respondents with low self-esteem, thinking about their own death led to more stigma, less willingness to intervene, and allocated less money to a suicide prevention organization as compared to those who did not think about death. Findings from this study could have important implications for how we understand the psychological underpinnings of stigma and the role of death anxiety in hostile attitudes and decreased altruism – especially for mental health professionals working with individuals affected by suicide. [ABSTRACT FROM AUTHOR]

Objective: The revised Willingness to Intervene against Suicide questionnaire and the Expanded Revised Facts on Suicide Quiz were employed to examine the relationship between college students' knowledge about suicide and intention to intervene. Participants: College students (n = 515) participated, a majority being women and Caucasian. Methods: Participants completed an online survey. Data were analyzed in SPSS. Results: College students have poor knowledge of suicide facts; however, this low level of accurate knowledge was not associated with intention to intervene with a suicidal person. Attitudes, subjective norms, perceived behavioral control, sex, and no previous suicide attempt were all significant predictors of intention to intervene. Conclusions: These results challenge the notion that one must be well-informed in order to intend to take action. [ABSTRACT FROM AUTHOR]

Purpose: Those factors identified to increase the risk of suicide in rural dwellers were exacerbated by the SARS‐CoV‐2 pandemic, specifically economic factors, substance use, access to health care, and access to lethal weapons. Because the effects of SARS‐CoV‐2 on suicide ideation and attempts in rural populations have not been fully characterized in published literature, this study compares: (1) the rates of suicide ideation and attempts between the 6 months affected by SARS‐CoV‐2 to same months of the preceding year (3/18/2020‐9/18/20; 3/18/2019‐9/18/19), (2) demographics (ie, age, sex, residence, race, and ethnicity), and (3) the locations in which the encounters were billed (inpatient, outpatient, and emergency department). Methods: Deidentified claims data associated with patient encounters billed for Suicide Ideation and Suicide Attempt were grouped based on time period and analyzed using descriptive statistics, incidence rate ratio (IRR), 2‐sample t‐test, chi‐square test of association, or Fisher's exact test. Findings: Suicidal ideation encounters increased in the 6 months post‐SARS‐CoV‐2 when compared to the 6 months of the prior year (IRR = 1.19; P <.001). Males (IRR = 1.27, P <.001), those residing rural areas (IRR = 1.22, P =.01), and Black, non‐Hispanic (IRR = 1.24, P =.024) were found to have increased rates of suicide ideation post‐SARS‐Cov‐2. In adults, White, non‐Hispanics (IRR = 1.16; P <.001) had increased rates of post‐SARS‐CoV‐2. In the pediatric subset, those who were aged 14‐17 (IRR = 1.50; P <.001), resided in rural areas (IRR = 1.61, P =.009), and idenitifed as Hispanic (IRR = 1.89; P =.037) or Black, non‐Hispanic (IRR = 1.61, P =.009) had increased rates post‐SARS‐CoV‐2. Conclusions: Our study identified rural dwellers to be at increased risk for suicide ideation. [ABSTRACT FROM AUTHOR]