•Coronavirus disease 2019 (COVID-19) has emerged as a global health threat.•Number of suicidal deaths during times of COVID-19 is rising though data is limited.•Pandemics lead to several risk factors ...for suicidality like isolation, loneliness, economic fallout, domestic abuse, stigma and fear.•Biological vulnerabilities (family history of suicide, substance use, etc.) and psychosocial risks (migration, old age, low socio-economic class, etc.) amplify the suicidal risks of pandemics.•Stress and immune reaction to infections like COVID-19 are hypothesized as possible linking pathways to suicidal risk.•Suicide-prevention is discussed as an integral part of public health response to pandemics.
The Coronavirus disease 2019 (COVID-19) has emerged as a new global health threat. By increasing the risk of isolation, fear, stigma, abuse and economic fallout, COVID-19 has led to increase in risk of psychiatric disorders, chronic trauma and stress, which eventually increase suicidality and suicidal behavior. There is limited data on association of pandemics and suicides. Cases of suicides have been rising since COVID-19 first emerged in China. The association between suicides and pandemics can possibly be explained through various models like Durkheim's theory, Joiner's interpersonal theory, social stress theory, biological theories, etc. The frontline workers, elderly, migrants, homeless, socio-economically impoverished classes as well as those with pre-existing mental disorders, substance abuse and family history of suicides are at higher risk. Suicides are preventable and need early detection, awareness and socio-culturally tailored interventions. This narrative review draws global perspectives on the association of suicidality and pandemics, the theories and risk factors related to same based on the available evidence. It also hypothesizes neuroimmunity and immune based risk factors as possible links between the psychosocial vulnerabilities and suicide during outbreaks like COVID-19. Proposed strategies of suicide-prevention, as an integral part of public health response to the pandemic are subsequently discussed.
Utilization of the 988 Suicide and Crisis Lifeline (Lifeline; formerly called the National Suicide Prevention Lifeline) was analyzed in relation to suicide deaths in U.S. states between 2007 and 2020 ...to identify states with potential unmet need for mental health crisis hotline services.
Annual state call rates were calculated from calls routed to the Lifeline during the 2007-2020 period (N=13.6 million). Annual state suicide mortality rates (standardized) were calculated from suicide deaths reported to the National Vital Statistics System (2007-2020 cumulative deaths=588,122). Call rate ratio (CRR) and mortality rate ratio (MRR) were estimated by state and year.
Sixteen U.S. states demonstrated a consistently high MRR and a low CRR, suggesting high suicide burden and relatively low Lifeline use. Heterogeneity in state CRRs decreased over time.
Prioritizing states with a high MRR and a low CRR for messaging and outreach regarding the availability of the Lifeline can ensure more equitable, need-based access to this critical resource.
This open access book focuses on the public health crisis of youth suicide and provides a review of current research and prevention practices. It addresses important topics, including suicide ...epidemiology, suicide risk detection in school and medical settings, critical cultural considerations, and approaches to lethal means safety. This book offers cutting-edge research on emerging discoveries in the neurobiology of suicide, psychopharmacology, and machine learning. It focuses on upstream suicide prevention research methods and details how cost-effective approaches can mitigate youth suicide risk when implemented at a universal level. Chapters discuss critical areas for future research, including how to evaluate the effectiveness of suicide prevention and intervention efforts, increase access to mental health care, and overcome systemic barriers that undermine generalizability of prevention strategies. Finally, this book highlights what is currently working well in youth suicide prevention and, just as important, which areas require more attention and support. Key topics include: The neurobiology of suicide in at-risk children and adolescents. The role of machine learning in youth suicide prevention. Suicide prevention, intervention, and postvention in schools. Suicide risk screening and assessment in medical settings. Culturally informed risk assessment and suicide prevention efforts with minority youth. School mental health partnerships and telehealth models of care in rural communities. Suicide and self-harm prevention and interventions for LGBTQ+ youth. Risk factors associated with suicidal behavior in Black youth. Preventing suicide in youth with autism spectrum disorder (ASD) and intellectual disability (ID). Youth Suicide Prevention and Intervention is a must-have resource for policy makers and related professionals, graduate students, and researchers in child and school psychology, family studies, public health, social work, law/criminal justice, sociology, and all related disciplines.
Reviews the book, The Suicidal Person: A New Look at a Human Phenomenon by Konrad Michel (2023). According to the reviewer, this book is essential reading for all who provide clinical care. Flawed ...risk stratification through risk tools and scales and stories of harmful, punitive treatment when seeking help during a suicidal crisis are ever present. Effective suicide prevention requires compassionate recognition of the story of how things got to this. The overarching theme of this book takes the reader to this place (PsycInfo Database Record (c) 2024 APA, all rights reserved)
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6.
Reflections on Suicidal Ideation Jobes, David A; Joiner, Thomas E
Crisis : the journal of crisis intervention and suicide prevention,
07/2019, Volume:
40, Issue:
4
Journal Article
Peer reviewed
While suicidologists and public health officials are understandably preoccupied with suicides and suicide attempts, the authors have recently begun to reflect on those with suicidal ideation who too ...often escape the focused attention of their suicide prevention research, clinical treatments, and even national health-care policies. Upon reflection, the prevalence of suicidal ideation in the United States is truly staggering: 10,600,000 people experiencing thoughts of ending their lives is more than the population of the US state of Georgia. The authors state that in our singular pursuit to prevent suicide deaths, we need to stop trivializing the obvious and vital importance of attending to suicidal ideation. They therefore assert that suicidal ideation must become an essential intervention target in and of itself. Indeed, it can be argued that better identification and more effective treatment of suicidal ideation upstream would invariably lead to many fewer suicide attempts and many fewer suicide deaths downstream. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
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Connecting suicidal individuals to appropriate mental health care services is a key component of suicide prevention efforts. This review aims to critically discuss the extant literature on ...help-seeking and mental health service utilization among individuals at elevated risk for suicide, as well as to outline challenges and future directions for research in this area. Across studies, the rate of mental health service use for those with past-year suicide ideation, plans, and/or attempts was approximately 29.5% based on weighted averages, with a lack of perceived need for services, preference for self-management, fear of hospitalization, and structural factors (e.g., time, finances) identified as key barriers to care. Studies also revealed facilitators to care, which include mental health literacy, positive views of services, and encouragement from family or friends to seek support. To address these low rates of help-seeking and barriers to care, a number of interventions have been developed, including psychoeducation-based programs, peer and gatekeeper training, and screening-based approaches. Despite these efforts, it appears that work is still needed to gauge the impact of these interventions on behavioral outcomes and to more rigorously test their effectiveness. Additional implications for future research on help-seeking among suicidal individuals are discussed.
•Mental health service use among suicidal individuals is notably low.•There are many significant barriers to help-seeking in this population.•A number of interventions to increase service use have been developed.•Additional research is needed to understand how to increase help-seeking.
Safety planning-type interventions (SPTIs) for patients at risk of suicide are often used in clinical practice, but it is unclear whether these interventions are effective.
This article reports on a ...meta-analysis of studies that have evaluated the effectiveness of SPTIs in reducing suicidal behaviour and ideation.
We searched Medline, EMBASE, PsycINFO, Web of Science and Scopus from their inception to 9 December 2019, for studies that compared an SPTI with a control condition and had suicidal behaviour or ideation as outcomes. Two researchers independently extracted the data. To assess suicidal behaviour, we used a random-effects model of relative risk based on a pooled measure of suicidal behaviour. For suicidal ideation, we calculated effect sizes with Hedges' g. The study was registered at PROSPERO (registration number CRD42020129185).
Of 1816 unique abstracts screened, 6 studies with 3536 participants were eligible for analysis. The relative risk of suicidal behaviour among patients who received an SPTI compared with control was 0.570 (95% CI 0.408-0.795, P = 0.001; number needed to treat, 16). No significant effect was found for suicidal ideation.
To our knowledge, this is the first study to report a meta-analysis on SPTIs for suicide prevention. Results support the use of SPTIs to help preventing suicidal behaviour and the inclusion of SPTIs in clinical guidelines for suicide prevention. We found no evidence for an effect of SPTIs on suicidal ideation, and other interventions may be needed for this purpose.
Self-injurious thoughts and behaviors (SITBs) are major public health concerns impacting a wide range of individuals and communities. Despite major efforts to develop and refine treatments to reduce ...SITBs, the efficacy of SITB interventions remains unclear. To provide a comprehensive summary of SITB treatment efficacy, we conducted a meta-analysis of published randomized controlled trials (RCTs) that have attempted to reduce SITBs. A total of 591 published articles from 1,125 unique RCTs with 3,458 effect sizes from the past 50 years were included. The random-effects meta-analysis yielded surprising findings: The overall intervention effects were small across all SITB outcomes; despite a near-exponential increase in the number of RCTs across five decades, intervention efficacy has not improved; all SITB interventions produced similarly small effects, and no intervention appeared significantly and consistently stronger than others; the overall small intervention effects were largely maintained at follow-up assessments; efficacy was similar across age groups, though effects were slightly weaker for child/adolescent populations and few studies focused on older adults; and major sample and study characteristics (e.g., control group type, treatment target, sample size, intervention length) did not consistently moderate treatment efficacy. This meta-analysis suggests that fundamental changes are needed to facilitate progress in SITB intervention efficacy. In particular, powerful interventions target the necessary causes of pathology, but little is known about SITB causes (vs. SITB correlates and risk factors). The field would accordingly benefit from the prioritization of research that aims to identify and target common necessary causes of SITBs.
Public Significance Statement
This meta-analysis found that many interventions produce small reductions in SITBs and that these effects endure across a range of sample and study characteristics. No interventions consistently produce large or moderate SITB reductions, and intervention efficacy has not improved across 50 years of research.
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