The prevention of suicide in India and the developing world: the need for population-based strategies

Very high rates of suicide have been reported from India and the developing world. However, much of the debate on suicide prevention focuses on individuals, methods, site-specific solutions, or particular suicide prevention strategies. This article argues for population based approaches that focus on improving the general health of populations (e.g., macroeconomic policies that aim for social justice, schemes to meet basic human needs, organizing local support groups within vulnerable sections of society, developing and implementing an essential pesticide list, addressing gender issues, and increasing public awareness through the mass media) rather than medical, psychiatric, and other strategies that target individuals (e.g., treatment of mental illness, counseling, etc.) in order to reduce high suicide rates in India and developing countries. Individual approaches will help people in distress and prevent individuals from committing suicide, but will not reduce population suicide rates.     

SOPRoxi: a research-intervention project for suicide survivors

In Italy, postvention models specifically designed for people surviving the suicide of a loved one are very scarce. The SOPRoxi project was developed to respond to this particular lack. By involving different professional and nonprofessional figures (GPs, mental health professionals, social workers, volunteers, etc), the SOPRoxi project aims to remove the stigma associated with this condition and to offer adequate, multifaceted help to survivors.     

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.     

Evidence-based prevention strategies of suicide behavior in the world: implications for Slovenia

In this review we consider how Slovenia could consider tackling its high rate of suicide (overall 29 per 100,000, 46 in males, 13 in females). First, we consider the evidence for risk factors that may contribute to Slovenia's high rate of suicide. Second, we describe the interventions to try to reduce the impact of these factors and the evidence for such interventions. We categorize interventions in terms of their operation at either the population level or that of high-risk groups. However, it should be borne in mind that settings often assumed to provide access to population groups, such as general practice and schools, do not reach some people who are likely to be at high risk; for example those who have dropped out of school or who have been excluded from a GP's list. We focus particularly on those for high-risk groups, as a number of East-European countries with high suicide rates such as Slovenia, Hungary, and the Baltic republics are currently considering a shift toward more community-based mental health services. The provision of community mental health services in Slovenia would provide an opportunity to study their impact on the suicide rate. However, we conclude that their development should be accompanied by other initiatives operating at population levels. This multilevel approach acknowledges the complexity of the etiology of suicide, the impossibility of reaching all those at risk through services and the lack of strong evidence for any one intervention.     

Struggling with the Challenges of Right-Wing Extremism and Terrorism within Democratic Boundaries: A Comparative Analysis

Since the 1990s, jihadist terrorists have leveraged the power of the Internet in more imaginative ways than state security services charged with countering them. Terrorist groups are now harnessing the unique characteristics of the new media environment that has taken shape in the past decade, while security services struggle to conceptualize this rapidly evolving virtual landscape. But new media offers unique opportunities to these services, particularly intelligence agencies, to confront the terrorist threat. Identifying and exploiting these opportunities, both strategic and tactical, will lend critical advantage to governments in their worldwide confrontation with global jihadists.     

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.     

Administrative ethics and organizational learning in Kuwait and the united states: an empirical approach

This article explores how a sample of public agencies in Kuwait respond to ethics failure. The learning response is examined in detail, in order to understand how these agencies attempt to inquire into the organizational causes of ethics failures and implement organizational changes in response to the inquiry. This study builds upon a previous methodology for measuring the strength of the organizational learning response. The data from Kuwait is compared to an earlier, similar study of organizational ethics learning conducted in the United States. The sampled agencies devote only moderate efforts to learning from ethics failure.     

Mayor vs. manager revisited: an archival approach to comparing efficiency

The efficiency of municipal government is defined as a function of two factors: financial indicators such as per capita spending and taxation, and quality of life. If the financial indicators differ between cities without a corresponding change in quality of life, then the city with the lower value can be said to be better managed. An analysis of data from the County and City Data Book and the Places Rated Almanac found that large cities managed by city managers are more efficient than those managed by mayors. There was no significant difference in efficiency between mayors and managers of small cities; theoretically, mayors of small cities are unable to tax, spend, and borrow in relative anonymity. A cluster analysis of 114 large U.S. cities suggested that they may be classified into one of four categories: (1) Drunken Sailors; (2) High rollers; (3) Prudent Big Boys; and (4) Solvent Citizens.     

The most common method of suicide in Tehran 2000-2004: implications for prevention

The likelihood of completing suicide depends to some extent on knowledge of effective means and also on the availability and/or acceptability of such methods. Since studying suicide methods may have an implication for prevention, the focus of this study was on the most favored method of suicide in Tehran, Iran. The study uses confirmed suicide data provided by the Beheshet Zahra Organization (BZO), which gathers all mortality data within Tehran and enters them into a computerized database, from which the relevant information for all the recorded suicide cases during the year 2000 to 2004 were obtained and analyzed. There were 703 cases of suicide (632 males and 71 females) in the BZO database, with a sex ratio of 8.9. The mean (standard deviation) of age at suicide for those who chose hanging and for those who have chosen other methods of suicide were 33.93 (14.2) and 34.60 (13.4) years, respectively. Hanging was the method favored by 572 (85.9%) of cases. Use of hanging was higher in females (61, 85.9%) than in males (511, 80.9%), and higher among the married (304, 53.6%) than among singles (268, 46.4%). The high proportion of persons using hanging as a method of suicide in Tehran may reflect the fact that this method is more acceptable and/or easily available and/or less likely to be misclassified as accidental or undetermined death. The prevention of such suicides is extremely difficult in the general population. Therefore, it is suggested that, to prevent suicide by hangings, the authorities should focus on the causal factors of suicide rather than on the acceptability and/or the availability of this method.     

Socioeconomic change and suicide: a time-series study from the Republic of Ireland

This ecological study examined the association between seven socioeconomic indicators (GDP, unemployment rate, female labor force participation rate, alcohol expenditure, marriage rate, percentage of births outside of marriage, and indictable crime rate) and total, male, and female rates of suicide and suicide plus undetermined death in Ireland during the period 1968-2000. Analysis of the data expressed as absolute values showed highly significant associations between the socioeconomic indicators and the total, male, and female suicide rates. However, these associations were explained by the strongly trended data. The trended nature of the data was removed by using year-to-year differences. Analysis of the first-differenced data showed that none of the socioeconomic indicators was associated with the total, male, or female suicide rates with the exception of indictable crime, which had a significant independent effect on the female suicide rate (coefficient = 2.0, p < .01) but not on suicide plus undetermined death. This study highlights the need to use econometric methods in time-trend analyses, the lack of age-sex specific exposure data in this area, and the challenge of understanding trends in suicide in their socioeconomic context.