The content of suicide notes from attempters and completers

A study of the content of suicide notes from attempted suicides and completed suicides was conducted using the Linguistic Inquiry and Word Count (LIWC) text analysis program. Notes from completed suicides had fewer metaphysical references, more future tense verbs, more social references (to others) and more positive emotions than did the notes from attempted suicides. The implications of these results were discussed.     

Methodological issues in community surveys of suicide ideators and attempters

There have been quite a number of community studies in recent years, with surveys being conducted among the general population, in schools, and among the elderly. While all of these studies have greatly contributed to our understanding of suicidal behavior, because of different approaches toward methodology and definitions, they also have some limitations. These limitations spring mainly from the fact that definitions of suicidal ideation and behavior vary widely across studies, which makes comparisons between studies unreliable. The different utilization of methodology is another problem that can impact the comparability of the community studies.     

Deliberate self-harm patients who discharge themselves from the general hospital without adequate psychosocial assessment

Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.     

Years of life lost from suicide in China, 1990-2000

Suicide is an important public health problem in China: It is the fifth leading cause of death in China, and suicide in China accounts for over 30% of the world's overall suicide deaths. The substantial burden due to suicide has not been well recognized. This study aims to provide an estimate of the socioeconomic burden of the suicide problem in China in terms of years of life lost (YLL) and to discuss its implications. Suicide rates and the related YLL by age, gender, and region (urban/rural) from 1990 to 2000 were estimated using the most recent data from the Ministry of Health of China. The suicide rate in rural China was three times higher than that in urban areas. Suicide completers in rural areas shared 90% of total YLL. Rural women aged 25-39 years contributed the largest share of YLL. Our results show that some population subgroups contributed a disproportionate share to the disease burden of suicide. National strategies for suicide prevention should include targeted programs in catering the need of these specified subgroups in China.     

High rates of suicide and attempted suicide using pesticides in Nickerie, Suriname, South America

Suicide and attempted suicide are identified as a serious mental health problem in Suriname, especially in the district of Nickerie. An epidemiological study in the Nickerie catchment area revealed high rates of suicide (48 per 100,000) and attempted suicide (207 per 100,000) on average in the years 2000-2004. Particularly remarkable is the high number of attempted suicides among males (49%), and the use of pesticides in both fatal (55%) and nonfatal suicidal behavior (44%). Probably this high incidence of suicidal behavior reflects the very poor economic situation of the district, poverty of most of the population, high levels of alcohol misuse, domestic violence, the rigidity of Hindustani culture regarding family traditions, the accessibility of pesticides, and the lack of future perspectives. Health care alone will not be sufficient to tackle this problem. One of the most urgent measures to prevent suicides is to stow away pesticides in locked cabinets with the key held by the proprietor.     

Psychological and psychosocial interventions after attempted suicide: an overview of treatment studies

A literature search was conducted to collect randomized controlled studies evaluating the outcome of psychological and psychosocial interventions after attempted suicide and deliberate self-harm. Twenty-five studies meeting the inclusion criteria were identified. The studies are grouped according to the psychological approach chosen for the intervention. They are discussed with regard to both the various therapeutic strategies and models used, and the repetition of self-harming behavior as the main outcome.     

Preventing suicide in prisons, part II. International comparisons of suicide prevention services in correctional facilities

The International Association for Suicide Prevention created a Task Force on Suicide in Prisons to better disseminate the information in this domain. One of its objectives was to summarize suicide-prevention activities in the prison systems. This study of the Task Force uncovered many differences between countries, although mental health professionals remain central in all suicide prevention activities. Inmate peer-support and correctional officers also play critical roles in suicide prevention but there is great variation in the involvement of outside community workers. These differences could be explained by the availability of resources, by the structure of the correctional and community services, but mainly by the different paradigms about suicide prevention. While there is a common and traditional paradigm that suicide prevention services are mainly offered to individuals by mental health services, correctional systems differ in the way they include (or not) other partners of suicide prevention: correctional officers, other employees, peer inmates, chaplains/priests, and community workers. Circumstances, history, and national cultures may explain such diversity but they might also depend on the basic way we think about suicide prevention at both individual and environmental levels.