Suicide in the Greek penal system and the problem of various limitations in relevant studies

Suicides in prison are not merely self-destructive acts or a "cry for help." They reflect the inherent need for freedom and the repercussions of imprisonment. SPACE statistics on suicides in prison reveal a rate above 10 per 10,000 in 10 European countries, 4 of which have a rate above 20. Greek data do not appear in all SPACE statistics. This fact has stimulated the present paper. Unpublished data obtained from the Greek Ministry of Justice reveal that Greece belongs to the group of countries with a rate below 10 in 1995 (the year of SPACE statistics). However, the suicide rates fluctuated widely in Greece from a low rate of 3.2 per 10,000 prisoners (convicted, on remand, or hospitalized) in 1982 to the incredibly high rate of nearly 40 in the year 1979 (11 suicides, 10 of which occurred in prison hospitals). A review of the literature indicates that various limitations mentioned in relevant studies lie in the unreliability of data (doubts about the validity of official statistics, missing data in archives, missing files on the victims, suicide in juvenile institutions not always recorded separately, etc.). The research emphasizes the importance of improving suicide statistics (recording, clearing up the incidents of deaths that are recorded without specification of cause, etc.) in order to plan and enforce suicide prevention and intervention strategies that seem to "work" in a particular milieu and are not debatable (e.g., the use of "suicide proof" cells).     

Suicide in Japan: present condition and prevention measures

This article introduces the reader to present conditions and suicide prevention measures in Japan. The suicide rate has increased gradually since the early 1990s, reaching a postwar peak in 1998. The number of suicides has remained at about 30,000 every year since 1998. Middle-aged (55-59 years) and elderly men have especially high suicide rates. In 2002, The Council of Learned People on Measures Against Suicides (organized by the Japanese Ministry of Health, Labor, and Welfare) released its report on national suicide prevention strategies. Although national suicide prevention strategies have just begun to be established, some prefectures or regions have undertaken unique suicide prevention measures.     

Motor vehicle exhaust gas suicide in Victoria, Australia 1998-2002

Motor vehicle exhaust gas suicide (MVEGS) is the second most frequent method of suicide in Victoria, Australia. It is a highly lethal method of suicide with 1.5 deaths for every hospital admission. Australian regulations require all vehicles manufactured since 1998 to have a maximum carbon monoxide exhaust emission level of 2.1 g/km, reduced from the previous level of 9.6 g/km. Information surrounding all Victorian MVEGS between 1998-2002 was analyzed to determine whether suicides occurred in vehicles with the lower emission levels. Between 1998-2002, 607 suicides by this means were recorded while just 393 hospital admissions were recorded for the same period. Mean carboxyhaemoglobin levels were significantly lower in fatalities using vehicles manufactured from 1998, however suicide still occurred in these vehicles (n = 25). The extent to which the new regulations contributed to the relatively low rate of suicide in vehicles less than 5 years old compared to their frequency in the fleet remains unknown. Based on international experience and the age of the Victorian vehicle fleet, it may take well over a decade until substantial decreases in MVEGS are observed in the absence of active preventive measures.     

Suicide in Bahrain in the last decade

A combination of social, legal, and religious factors make reporting of suicide difficult in Bahrain, an Islamic country. Limited available data indicates a very low incidence rate of 3 per 100,000. The objective of the present study was to describe the pattern of suicide in Bahrain during a 10-year period. The registered suicide cases (N = 304) at the Ministry of Interior for the 10-year period from 1995 to 2004 were reviewed and analyzed. The mean suicide rate was 0.6 per 100,000 for the Bahraini nationals and 12.6 per 100,000 for the non-Bahrainis with and 17.7 per 100,000 for the Indian migrants. Men were six times more likely than women to commit suicide. The majority of the subjects were under 35 years of age with financial domestic problems being the most common reason reported in the record and hanging the mostly commonly used mode of suicide (92.8%). The suicide rate for the Bahraini population remains low compared to other countries. The higher rate of suicide among Indians merits further investigation. Moreover, more research is needed on the epidemiology of suicide risk factors in ethnic groups for further prevention and intervention.     

Suicide in the Ukraine

The suicide rates of the 24 provinces (oblasts) of the Ukraine were found to be strongly associated with indices of social disintegration (such as divorce and illegitimacy rates), with the Western provinces incorporated in the USSR later than other Ukrainian territories having lower suicide rates and lower levels of social disintegration.     

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.     

Suicide and undetermined deaths among youths and young adults in Latin America: comparison with the 10 major developed countries--a source of hidden suicides?

In Latin American (LA) and the major developed countries' (MDC) suicide and undetermined deaths are analyzed as methods of suicide and the number of undetermined deaths are similar, possibly containing hidden suicides. The goal was to test the likelihood that LA cultural attitudes lead to higher undetermined rates and more hidden suicides. We used 3-year WHO average mortality data to compare LA and MDC mortality by age and gender, and chi2 tests to examine any differences. In 13 LA countries younger-aged (15-34) men and women's suicides were higher than all-age rates, and undetermined deaths exceeded the suicide rates. Nine LA countries had significantly more undetermined younger-aged male deaths than females. Sixteen of 18 LA countries had significantly higher undetermined death rates than the MDC. LA younger-aged malefs24 146s differential suicide: Undetermined rates indicated they may contain substantial numbers of hidden suicides. Inadvertently, cultural attitudes to suicide may hinder prevention.     

Suicide,gender, and age variations in India. Are women in indian society protected from suicide?

A new set of data concerning the pattern of suicide in India between 1991-1997 are presented. Suicide rates rose over this period despite a small decline in the Indian suicide rate in 1995 and 1996. It was found that between 1995 and 1997 there was a modest fall in the suicide rates among under 29-year-olds of both sexes, and an increase among those 30 years and older. The pattern of suicides in India is bimodal: the incidence of suicides is highest for those in the 30-44-year-old category of both sexes and tends to decline in higher age categories. Suicide rates were nearly equal for young women and men, a contrast with the pattern of suicide sex ratios in eight developed countries.     

Child and adolescent suicide deaths in New Mexico, 1990-1994

The suicide death rate in New Mexico is consistently higher than the national rate. Among adolescents, suicide is the third leading cause of death nationally, but in New Mexico it is the second leading cause of death. This study describes the pattern of adolescent suicide deaths in New Mexico. We conducted a retrospective review of all medical examiner autopsies for adolescent suicides (ages 20 years and younger) in New Mexico from 1990-1994. Records were reviewed for demographics and possible contributing factors such as depression, previous attempts, and alcohol and drug use. We identified 184 suicide deaths among children and adolescents ages 9-20 years for an overall rate of 12.9 per 100,000. Our rates for ages 5-9 years (0.2), 10-14 years (3.8), and 15-19 years (22.3) are over twice the U. S. rates. Suicide deaths resulted primarily from firearms (67%), hanging (16%), poisoning (6%), inhalation (4%), and other methods (7%). Method varied by ethnicity (p = .01) and gender (p = .03); males and non-Hispanic Whites were overrepresented among firearm deaths. Firearm ownership was known in 60 (48%) of the firearm deaths. Of these, 53% of the firearms belonged to a family member, 25% to the decedent, and 22% to a friend. Over one-third of decedents (41%) experienced mental disorders, primarily depressed mood and clinical depression. Previous suicide attempts were noted for 15% of the decedents. Some 50% of the decedents had alcohol or drugs present at the time of death; among American Indians/Alaska Natives, 74% had drugs or alcohol present (p = .003). Targeted interventions are needed to reduce adolescent suicide in New Mexico. We suggest raising awareness about acute and chronic contributing factors to suicide; training physicians to look for behavioral manifestations of depression; and involving physicians, teachers, and youth activity leaders in efforts to limit firearm accessibility, such as advising parents to remove firearms from their households.     

Ukraine between Russia and the European Union: Triangle Revisited

Ukraine has long been considered as a bone of contention between the EU and Russia which could eventually lead to a geographical split of the country. This interpretation, however, fails to explain the dynamic of the Ukrainian revolution and Russian–Ukrainian war. To address the deadlock in understanding the mixed dynamics of the situation in Ukraine, the article argues that the relations in the EU–Ukraine–Russia triangle are affected by the combination of choices that the Ukrainian political class, business elites and broader society make in four major dimensions: internal political practices; economic dimension; a dimension of international politics; and an ideological dimension.     

Ukraine twenty years after independence: Concept models of the society

This paper attempts to create an overview of the Ukraine twenty years after independence by presenting prevailing conceptual narrative models of Ukraine employed by Ukrainian and foreign experts. Based on the analysis of 58 interviews of Ukrainian political and intellectual elites and foreign experts, the study revealed several categories of conceptual narrative models employed by respondents: (1) a state without a national idea and a common identity; (2) a country in an unfinished transition and degradation; (3) a divided society; and (4) Ukraine as a colony or “wild capitalism”. The analysis of these categories helps to assess conflict potential in Ukraine and discuss some ideas for conflict prevention and resolution.     

Suicide on the Indian subcontinent

The Indian subcontinent comprises eight countries (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, and the Maldives) and a collective population of more than 1.3 billion people. 10% of the world's suicides (more than 100,000 people) take place in just three of these countries, viz. India, Sri Lanka, and Pakistan. There is very little information on suicides from the other four countries. Some differences from suicides in Western countries include the high use of organophosphate insecticides, larger numbers of married women, fewer elderly subjects, and interpersonal relationship problems and life events as important causative factors. There is need for more and better information regarding suicide in the countries of the Indian subcontinent. In particular, studies must address culture-specific risk factors associated with suicide in these countries. The prevention of this important public health problem in an area of the world with myriad socio-economic problems, meager resources, and stigmatization of mental illness poses a formidable challenge to mental health professionals, policy makers, and governments of these countries.     

Assessment of accuracy of suicide mortality surveillance data in South Africa: investigation in an urban setting

Although it is not a legal requirement in South Africa, medical practitioners determine the manner of injury death for a surveillance system that is currently the only source of epidemiological data on suicide. This study assessed the accuracy of suicide data as recorded in the system using the docket produced from standard medico-legal investigation procedures as the gold standard. It was conducted in one of three cities where the surveillance system had full coverage for the year 2000. In the medico-legal system, one-third of cases could not be tracked, had not been finalized, or had unclear outcomes. For the remaining cases, the sensitivity, specificity, and positive and negative predictive values were generally high, varying somewhat across sex and race groups. Poisoning, jumping, and railway suicides were more likely than other methods to be misclassified, and were more common among females and Whites. The study provides encouraging results regarding the use of medical practitioner expertise for the accurate determination of suicide deaths. However, suicides may still be underestimated in this process given the challenge of tracing disguised suicides and without the careful examination of potential misclassifications of true suicides as unintentional deaths.     

Seasonality in suicide: a study of farming suicides in England and Wales

Seasonality in suicide rates has long been reported. Spring peaks in suicide deaths have been positively correlated with the proportion of the workforce engaged in agriculture. Some studies have indicated that suicides using violent methods are more likely to show seasonality. Recent research has suggested that seasonal patterns have diminished. This study examined deaths in male farmers, an occupational group which might be expected to be more vulnerable to seasonal influences because of the nature of their work and the relatively high proportion of farmers using violent methods for suicide. Data on suicides between 1982 and 1999 by males in England and Wales aged 15 years and over were provided by the Office for National Statistics. Seasonal patterns of suicide in farmers and nonfarmers were examined by nonparametric tests and harmonic analysis. No significant seasonal variation was found for farmers. For nonfarmers, although a chi-square test showed significant variation in monthly distribution, this was not found when a harmonic analysis was applied. There was no significant difference in the variation of violent suicides throughout the year. This study reinforces recent findings that seasonal variation in suicide appears to be diminishing, even in an occupational group where this might be expected.     

Epidemiology of completed suicides in Singapore for 2001 and 2002

This study provides an analysis of 640 completed suicide cases in Singapore for the years 2001 and 2002, compared to previous years and in relation to demographic and socioeconomic factors, as well as to the characteristics of a subgroup of suicide victims with prior psychiatric illness. There was little change in the suicide pattern over the 2 years studied compared to previous years. The sex ratio was constant at 1.5. Population-adjusted ratios were 1 for Chinese, 0.5 for Malays, and >1 for both Indians and other ethnic groups. Falling from heights ranked first in terms of method adopted for both years. A disproportionately higher number of suicides were recorded for the 25-34 and the > or =75-year-old age groups. A total of 47 (17.2%) in 2001 and 74 (20.2%) in 2002 of the cases had a history of prior psychiatric illness, with psychotic disorders being the most common diagnostic category. There was also a statistically significant correlation between unemployment and incidence rates. Although the overall rate of elderly suicides had gone down since the 1990s, prevention strategy should focus on the elderly as this rate is still about 3-4 times the national average.     

Newspaper reporting of suicide cases in Hong Kong

This study addresses the concerns over newspapers' reporting of suicide cases in Hong Kong, SAR (Special Administrative Region), using the WHO guidelines on the reporting of suicide news as a reference for comparison. We compared the official suicide information extracted from the Coroner's Court for the year 2000 with newspaper reports on suicides taken from five major Chinese local newspapers, which accounted for about 80% of the total circulation in Hong Kong. The type of newspaper reporting on suicides was also examined. Newspapers tended to report on those suicide victims who suffered relationship problems, whereas those who had family problems were significantly underreported. Among the suicides reported in the newspapers, 6.2% were found on the front page and the majority of the reports were presented pictorially. The reporting of suicides was selective and the coverage was incomplete, with student suicides reported excessively. The method of reporting for Hong Kong newspapers was not in line with the recommendations of the WHO or international best practices on presenting suicide news. For this reason we recommend a partnership approach with active participation from the media on suicide prevention so that communication professionals can proactively participate in suicide prevention work more effectively.     

Suicide after deployment in UN peacekeeping missions--a Danish pilot study

This pilot study looks at the frequency of suicide among Danish soldiers who took part in the UN mandated forces (UNMF) during the 1990's. In a contingent of nearly 4000 Danish UN soldiers four suicides were documented, two of whom committed suicide less than one month before deployment and two who committed suicide within a year after discharge from mission. Contributing factors, prevention strategies, and implications for future research are discussed.     

Can a theory of suicide predict all "suicides" in the elderly?

Older adults consistently have the highest rates of suicide in most societies. Despite the paucity of studies until recently, research has shown that suicides in later life are best understood as a multidimensional event. An especially neglected area of research is the psychological/psychiatric study of personality factors in the event. This paper outlines one comprehensive model of suicide and then raises the question: Is such a psychiatric/psychological theory applicable to all suicides in the elderly? To address the question, I discuss the case of Sigmund Freud; raise the topic of suicide and/or dignified death in the terminally ill; and examine suicide notes of the both terminally ill and nonterminally ill elderly. I conclude that, indeed, greater study and theory building are needed into the "suicides" of the elderly, including those who are terminally ill.     

Social and economic burden of suicides in Hong Kong SAR: a year of life lost perspective

The paper proposes to use the years-of-life-lost method (YLL) in assessing the social and economic burden of suicides in Hong Kong SAR. The YLL from suicide by age group in 1981-2002 is calculated based on the standard set by World Health Organization (WHO). It shows that the middle age group (25-39) contributed most to the burden of disease in Hong Kong. The proportion of older adults' suicides is about 25% of the total number of suicides but its disease burden is less than 6% in terms of the YLL. Though the group aged 25-39 contributed disproportionately to the total YLL from suicide, the prevention effort for this particular group has been very much neglected and needs to be strengthened. It illustrates that use of YLL could provide a new viewpoint for setting up public health policies.     

‘Social Distancing’ and Hierarchies of Belonging: The Case of Displaced Population from Donbas and Crimea

Abstract

Following the 2013–2014 protests against then Ukrainian president Viktor Yanukovych, Russia’s annexation of Crimea and the armed conflict in Donbas, one of the major challenges for Ukrainian society has been the displacement of over two million of its inhabitants. In 2015, at the peak of the displacement, Ukraine found itself among the five countries in the world, after Yemen, Syria, Iraq and Nigeria, with the highest number of internally displaced persons (IDPs) associated with conflict and violence, and it continues to rank highest in Europe. Very little research has been done to provide a detailed analysis of how internally displaced persons living in Ukraine and outside the country claim and negotiate their belonging in the aftermath of the Revolution of Dignity and the ensuing war. Feeling of belonging is constructed through a relational process of self- and external categorisation and depends on acknowledgement by other members of the chosen group, therefore this essay also examines the strength and regional specificity of the social distancing towards different groups of Ukrainian IDPs.