Suicide prevention

SOURCE: Baril, A. (2020). « Queeriser le geste suicidaire : penser le suicide avec Nelly Arcan », dans I. Boisclair, P.-L. Landry et G.P. Girard (dirs.). QuébeQueer : Le queer dans les productions littéraires, artistiques et médiatiques québécoises, Montréal, Presses de l’Université de Montréal, p. 325-341.

Baril, Alexandre (2018). « Conférence d’honneur : “Vivre avec” la mort : développer une éthique de la reconnaissance et de la responsabilité envers les personnes suicidaires », The Poetics and Ethics of “Living With”: Indigenous, Canadian and Québécois Feminist Production Today/Les poétiques et éthiques du « vivre avec » : Productions féministes autochtones, canadiennes et québécoises de nos jours, Colloque organisé par le Canadian Literature Centre of the University of Alberta, Banff Centre, Banff, 13 octobre.

During the period February 2009-February 2012, the Office of Refugee Resettlement of the U.S. Department of Health and Human Services reported 16 suicides among the approximately 57,000 Bhutanese refugees who had resettled in the United States since 2008. In 2012, the office requested assistance from CDC and the Massachusetts Department of Public Health's Refugee Health Technical Assistance Center to identify risk factors that might be associated with suicidal ideation among Bhutanese refugees. In collaboration with the Massachusetts refugee health center, CDC conducted a survey of randomly selected Bhutanese refugees in four U.S. states with large populations of resettled refugees. The results indicated significant associations between ever having expressed suicidal ideation and current self-reported symptoms of mental health disorder (e.g., anxiety, depression, or posttraumatic stress disorder) and postmigration difficulties (e.g., family conflict or inability to find work). T...

The current study examined racial/ethnic differences in utilization of mental health services in a nationally representative sample of suicidal adults. Data were extracted from the National Survey on Drug Use and Health (NSDUH) from 2009 to 2016. Participants consisted of adults with severe suicidal ideation and/or behavior in the past 12 months (unweighted n=17,338). Multivariate logistic regression analyses were conducted to assess racial/ethnic differences in mental health treatment utilization after adjusting for health insurance status, family income, age, sex, and major depression. Analyses were conducted separately for suicidal ideators with no attempts (i. e., “pure” ideators; unweighted n=14,578) and for suicide attempters (unweighted n=2760) for psychiatric inpatient and outpatient care, respectively. Racial/ethnic disparities in mental health treatment utilization were less apparent for inpatient care and most evident for outpatient care. For inpatient care, no racial/ethnic differences were observed among suicidal ideators with no attempts. Among suicide attempters, only Hispanics were less likely than non-Hispanic whites to receive inpatient care. In contrast, for outpatient care, treatment use was lower for all racial ethnic minorities, except Native American and multiracial individuals, relative to non-Hispanic whites among suicidal ideators with no attempts. Outpatient service use was also lower for non-Hispanic blacks, Hispanics, and multiracial individuals relative to non-Hispanic whites among suicide attempters. This pattern of findings is consistent with the possibility that suicidal racial/ethnic minorities may delay use of mental health services until clinical severity becomes such that elevated clinical care (i.e., inpatient treatment) is required. Future research accounting for these disparities is warranted.

Iedere hulpverlener die werkt met jongeren kan geconfronteerd worden met een jongere die aan zelfmoord denkt, een zelfmoordmoordpoging ondernomen heeft of overlijdt door zelfdoding. Wat kan je als hulpverlener doen in deze situaties? Ben je verplicht om je beroepsgeheim te doorbreken? In dit artikel geven we tips voor het omgaan met suïcidale jongeren, staan we stil bij het spanningsveld tussen de hulpverleningsplicht en het beroepsgeheim en geven we enkele aanknopingspunten voor wanneer je geconfronteerd wordt met een cliënt die zelfmoord pleegt.

This paper presentation is formatted into the following sections: 1) A vignette on my own experiences coping with depression and suicide; 2) Statistics on depression and suicide as it relates to various populations music educators work with; 3) A vignette of a music educator helping a musician through depression and suicidal thoughts; 4) Risk factors and warning signs; 5) Suggestions for providing support; 6) A vignette from a music educator's perspective on a musician who committed suicide; 7) Closing thoughts. This paper presentation ends with an open discussion.

Nearly a million people take their own lives every year, more than those murdered or killed in war. Suicide is a problem that affects people of all ages and economic levels, and is recognised by the WHO as a significant public health problem. A large significant proportion of suicides are among young women. This document emerging out of the experience

Social media data is increasingly used to gain insights into trends in mental health, but prior studies aimed at confirming a link between online expression of suicidal ideation on social media and actual suicide deaths have been inconclusive. Using comprehensive six-year data sets of Twitter posts and suicide deaths in Japan, we examine the diurnal relationship between the proportional incidence of a suicide-related keyword, “kietai” (“I want to disappear”), and suicide deaths with an OLS regression model. We also use co-occurrence analysis to reveal changes in the linguistic context of the suicide-related keyword at different hours of the day. We find a clear diurnal pattern in the use of this suicide-related keyword, peaking between 1am and 5am. This diurnal trend is positively correlated with suicide deaths among younger cohorts (ages 15 to 44), but the correlation is negative among older adults (45 and over). The correlation among young adults strengthens when a delay between tweet incidence and suicide deaths is included. Compared to daytime tweets, nighttime tweets exhibited a stronger relationship between words related to self-disgust and words directly indicating suicidal intent. This study confirms the hypothesised link between online suicidal ideation and suicide death. Despite frequent flippant use of the keyword, the consistent correlation and the diurnal changes in the context of the keyword's usage demonstrate the value of social media data to the study of mental health trends in groups at risk of suicide.

Abstract
In 2010, a coroner’s inquest was held into the 2007 suicide of Ms Charmaine Dragun, an Australian television news anchorwoman. The main findings were that if Ms Dragun had been diagnosed with bipolar II disorder and prescribed a mood stabilizer, her suicide could have been prevented; that the “cross-tapering” treatment by her psychiatrist, and the clinical management by her healthcare professionals were inadequate; and that the incorporation of meditation and mindfulness in therapy was inappropriate. In this article, I examine the coroner’s findings and recommendations alongside the evidence tendered at the inquest. I also discuss a) whether bipolar II disorder is under or overdiagnosed; b) the responses to the coroner’s findings on bipolar II disorder; c) the impact of the coroner’s findings and recommendations on healthcare professionals and the public; d) my personal reflections and e) my recommendations for making suicide prevention programs more effective: increased open-minded and respectful collaboration among professionals, the importance of educating legal professionals about the reality of clinical practice, and promoting recognized suicide prophylactic measures. For healthcare professionals worldwide, especially clinicians, this “Australian Story” provides important insights and lessons.
Keywords: Coroner’s inquest; suicide & suicide prevention; bipolar disorder; diagnoses; clinical management, mindfulness. 


One of the reviewers of the article, an American psychologist and an experienced clinician from John Hopkins University School of Medicine wrote the following review:

Khong focuses her story on the verdict of the coroner whose primary conclusion is that, if a bipolar 2 diagnosis had been given and medication (presumably the so-called "mood stabilizers") prescribed, this tragedy could have been averted.

This is pure nonsense. By drawing from the reports of several clinicians who evaluated Charmaine Dragun, Khong shows us that the majority of clinical opinion was against the bipolar diagnosis. There is no evidence to support the idea that her depressive illness had a hypomanic or manic component, or that her "mood swings" were anything other than what would be expected from someone who had the character pathology—paralyzing anxiety, obsessiveness, compulsion, perfectionism, low self-esteem, excessive worry, etc.—that characterized so much of her clinical picture. We even get a glimpse of her rather harsh early upbringing, and the domineering influence of her mother and grandmother, which very likely was the foundation of the character pathology she displays as an adult, which ultimately led to her undoing.

Back to the coroner's report. Another absurd suggestion: that a precipitant of [Dragun’s] suicide was "serotonin syndrome," an excess of serotonin rarely seen in patients taking SSRIs (selective serotonin reuptake inhibitors), that was caused by the cross tapering of Efexor and the initiation of Lexapro, both serotonin-altering drugs. No evidence is offered for this idea. The somatic symptoms of the serotonin syndrome include autonomic instability (decided changes in BP, heart rate and body temperature), of which there is no mention. It is as if someone just pulled this nonsense out of a hat! Serotonin syndrome, which can be a life-threatening medical condition, is very rare. I evaluated over 3,000 psychiatric patients, many of whom were on SSRIs and not a small number of whom had taken a deliberate excess of one or more of these drugs, in the ER during a 10-year period and saw no definitive case of this malady.... The primary diagnosis is unipolar major depression, severe.

In our second article, Vassiliki Karkou and Judy Glasman provide an illuminating overview of current debates about the place of the arts within education. They explore the emotional and social role of the arts in school, illustrating their discussion with insights gained from the Labyrinth Project, an arts-based prevention programme developed in schools in Hertfordshire and North London.

Child and youth care (CYC) professionals often provide care to children, youth and families in conjunction with professionals from other disciplines. How CYC professionals engage other service providers in the provision of care for suicidal adolescents requires examination. The purpose of the overall study was to understand and explain the process of CYC professionals' mental health literacy practices with suicidal adolescents. Findings presented here provide insight into the process of CYC professionals' practice with other service providers in the context of their encounters with suicidal adolescents. Using a constructivist grounded theory method, data were collected and analysed from interviews with CYC professionals, supervisors within youth-serving community agencies, educators within Schools of Child and Youth Care, and extant texts of relevance to suicide, such as organisational policies, assessment tools, and suicide education curricula. One practice identified during analysis, flooding the zone, is the focus of the present paper. Flooding refers to the process of contacting and informing a myriad of professionals or services of the adolescent's suicidality, and was comprised of making decisions as to whom to contact, informing the adolescent, and negotiating with services. Professionals' perceptions of their role and the availability and accessibility of mental health services influenced the practice of flooding. Based on analysis of the data, flooding the zone has the potential to disrupt CYC professionals' relational proximity to the adolescent and may reinforce a devalued role for CYC professionals in suicide intervention within the larger mental health system of care.

Suicide is a major public health problem that affects people of all ages, including children. A child's decision to commit suicide is influenced by many social and psychological factors, as well as mental illness and addiction. Aim of this paper is to discuss the large scale of suicidal behaviors among children and adolescents, to select the most common causes and methods of suicide and to present a practical approach to the problem. For this purpose comprehensive review of the literature has been conducted. The most common suicide methods among children and adolescents are: hanging, jumping from a height and poisoning. According to the existing studies, quick reaction in the event of a suicide attempt is essential. The key to life-saving moment is a proper guidance of the child in the emergency department. Children after suicide attempts require long-term care, in which many people are involved like doctors, nurses and parents.

Suicide rates in Sri Lanka have steadily risen from the 1970’s to peak in 1995 thereafter showing a gradual decrease. We investigated whether pesticide control regulations had an impact on suicide rates. A graphical approach and regression analysis was used to identify time trends in suicide from 1980-2016 and determine the impact pesticide control regulations had on suicide rates while considering other economic variables. A gradual decrease was seen in suicide rates from 1996 to 2016. Mean numbers of suicides have decreased steadily between the time-intervals significant bans on pesticides were imposed. The regression model showed that with the enactment of each regulation, suicide rates were likely to reduce by 9 times when considered with population and economic changes. Restrictions on the use of harmful pesticides in Sri Lanka where pesticide poisoning is a common method of committing suicide has been useful in curtailing suicide rates.

Involving patients and families in mental healthcare is becoming more commonplace, but little is known about how they are involved in the aftermath of serious adverse events related to quality of care (sentinel events, including suicides). This study explores the role patients and families have in formal processes after sentinel events in Dutch mental healthcare. We analyzed the existing policies of 15 healthcare organizations and spoke with 35 stakeholders including patients, families, their counselors, the national regulator, and professionals. Respondents argue that involving patients and families is valuable to help deal with the event emotionally, provide additional information, and prevent escalation. Results indicate that involving patients and families is only described in sentinel event policies to a limited extent. In practice, involvement consists mostly of providing aftercare and sharing information about the event by providers. Complexities such as privacy concerns and ...

This paper was presented at The 14th International Conference on the Social Context of Death, Dying and Disposal (at University of Bath, 7th September 2019). Original title was “Sources of Influence on the Taboo of Death and a Good Death: The Relationship between Social Construction and Education among Japanese People.”

In the Internet we can find many informations how commit a suicide, we can read about form of suicide. There are more and more cases of Internet suicides, comitted online, live. According to a report prepared by The British Medical Journal in 2008: the Internet more encouraged to suicide than discourage. In this article I analyze the problem from the media education perspective. How can be the Internet a "culture of life"? How can we make an effective suicidological prevention?

Involving patients and families in mental healthcare is becoming more commonplace, but little is known about how they are involved in the aftermath of serious adverse events related to quality of care (sentinel events, including suicides). This study explores the role patients and families have in formal processes after sentinel events in Dutch mental healthcare. We analyzed the existing policies of 15 healthcare organizations and spoke with 35 stakeholders including patients, families, their counselors, the national regulator, and professionals. Respondents argue that involving patients and families is valuable to help deal with the event emotionally, provide additional information, and prevent escalation. Results indicate that involving patients and families is only described in sentinel event policies to a limited extent. In practice, involvement consists mostly of providing aftercare and sharing information about the event by providers. Complexities such as privacy concerns and ...

Suicide is a growing social problem worldwide. Gender has been considered one of the risk factors for suicide, however, it has also been one of the misunderstood categories by some researchers. Gender is not a risk factor in itself. Political, economic, and cultural processes assign, distribute, and value social opportunities, roles, and expectations according to sexual differences, and it shape the ways of thinking and feeling ourselves. These ways of thinking and feeling can explain suicide at the individual level. In this sense, this article focus on the processes through which the current COVID-19 pandemic may be affecting our construction of gender, and as a result, our mental health. As a result, some directions are pointed out to understanding suicide and its relationship with human being as a historical totality.

Purpose: No prior study has been published on suicide-related behaviors among gay, bisexual, transgender and queer (GBTQ) men in Singapore, where sexual relations between men are criminalized. This study explores the association and mediational pathways between experienced homophobia and suicidal ideation or suicide attempts among young GBTQ men in Singapore.

Methods: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study, Singapore's first prospective cohort study among young GBTQ men. The sample comprised 570 young GBTQ men aged 18 to 25 years old who were HIV-negative or unsure of their HIV status. Statistical analyses were conducted through descriptive statistics, multivariable Poisson regression, and structural equation modelling techniques.

Results: Of 570 participants, 58.9% (n=308) reported ever contemplating suicide, while 14.2% (n=76) had ever attempted suicide. Controlling for key demographic variables, multivariable logistic regression revealed that experienced homophobia and depression severity were positively associated with a history of suicidal ideation, while depression severity and outness were positively associated with a history of suicide attempts. Mediation analyses revealed that depression severity and self-esteem partially accounted for the relationship between experienced homophobia and suicidal ideation, whereas depression severity and outness partially accounted for the relationship with suicide attempts.

Conclusions: The prevalence of suicidal ideation and past suicide attempts was found to be high in a sample of young GBTQ men in Singapore. Interventions to address experienced homophobia and discrimination among young GBTQ men are needed urgently in Singapore.

This study explored the relationship between sexual attraction status (same-sex, both-sex, and opposite-sex) and suicidal behavior in a diverse sample of adolescents (N = 1,533 youth). Adolescents with attractions to both sexes reported greater suicide proneness, recent and lifetime suicidal ideation, and past suicide attempts than those with exclusively opposite-sex attractions; individuals reporting same-sex attractions generally demonstrated moderate elevations on these variables. As hypothesized, both hopelessness and depression mediated the relationship between sexual attraction status and suicide proneness. Social support moderated the mediating effect of depression but not hopelessness in the sexual attraction status–suicide proneness link. Targeting the distress that can be associated with experiencing same-sex or both-sex attractions may enhance suicide prevention efforts, particularly in U.S. youth with reduced social support.