Browsing by Subject "suicide"

Now showing 1 - 10 of 12
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    Association of State Social and Environmental Factors With Rates of Self-injury Mortality and Suicide in the United States
    (AMA, 2022-02) Rockett, Ian R. H.; Jia, Haomiao; Ali, Bina; Banerjee, Aniruddha; Connery, Hilary S.; Nolte, Kurt B.; Miller, Ted; White, Franklin M. M.; DiGregorio, Bernard D.; Larkin, G. Luke; Stack, Steven; Kõlves, Kairi; McHugh, R. Kathryn; Lulla, Vijay O.; Cossman, Jeralynn; De Leo, Diego; Hendricks, Brian; Nestadt, Paul S.; Berry, James H.; D’Onofrio, Gail; Caine, Eric D.; Geography, School of Liberal Arts
    Importance Self-injury mortality (SIM) combines suicides and the preponderance of drug misuse–related overdose fatalities. Identifying social and environmental factors associated with SIM and suicide may inform etiologic understanding and intervention design. Objective To identify factors associated with interstate SIM and suicide rate variation and to assess potential for differential suicide misclassification. Design, Setting, and Participants This cross-sectional study used a partial panel time series with underlying cause-of-death data from 50 US states and the District of Columbia for 1999-2000, 2007-2008, 2013-2014 and 2018-2019. Applying data from the Centers for Disease Control and Prevention, SIM includes all suicides and the preponderance of unintentional and undetermined drug intoxication deaths, reflecting self-harm behaviors. Data were analyzed from February to June 2021. Exposures Exposures included inequity, isolation, demographic characteristics, injury mechanism, health care access, and medicolegal death investigation system type. Main Outcomes and Measures The main outcome, SIM, was assessed using unstandardized regression coefficients of interstate variation associations, identified by the least absolute shrinkage and selection operator; ratios of crude SIM to suicide rates per 100 000 population were assessed for potential differential suicide misclassification. Results A total of 101 325 SIMs were identified, including 74 506 (73.5%) among males and 26 819 (26.5%) among females. SIM to suicide rate ratios trended upwards, with an accelerating increase in overdose fatalities classified as unintentional or undetermined (SIM to suicide rate ratio, 1999-2000: 1.39; 95% CI, 1.38-1.41; 2018-2019: 2.12; 95% CI, 2.11-2.14). Eight states recorded a SIM to suicide rate ratio less than 1.50 in 2018-2019 vs 39 states in 1999-2000. Northeastern states concentrated in the highest category (range, 2.10-6.00); only the West remained unrepresented. Least absolute shrinkage and selection operator identified 8 factors associated with the SIM rate in 2018-2019: centralized medical examiner system (β = 4.362), labor underutilization rate (β = 0.728), manufacturing employment (β = −0.056), homelessness rate (β = −0.125), percentage nonreligious (β = 0.041), non-Hispanic White race and ethnicity (β = 0.087), prescribed opioids for 30 days or more (β = 0.117), and percentage without health insurance (β = −0.013) and 5 factors associated with the suicide rate: percentage male (β = 1.046), military veteran (β = 0.747), rural (β = 0.031), firearm ownership (β = 0.030), and pain reliever misuse (β = 1.131). Conclusions and Relevance These findings suggest that SIM rates were associated with modifiable, upstream factors. Although embedded in SIM, suicide unexpectedly deviated in proposed social and environmental determinants. Heterogeneity in medicolegal death investigation processes and data assurance needs further characterization, with the goal of providing the highest-quality reports for developing and tracking public health policies and practices.
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    Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law
    (AAPL, 2019-06) Swanson, Jeffrey W.; Easter, Michele M.; Alanis-Hirsch, Kelly; Belden, Charles M.; Norko, Michael A.; Robertson, Allison G.; Frisman, Linda K.; Lin, Hsiu-Ju; Swartz, Marvin S.; Parker, George F.; Psychiatry, School of Medicine
    This article examines the application and effectiveness of a 2006 Indiana law designed to prevent gun violence by authorizing police officers to separate firearms from persons who present imminent or future risk of injury to self or others, or display a propensity for violent or emotionally unstable conduct. A court hearing is held to determine ongoing risk in these cases; a judge decides whether to return the seized firearms or retain them for up to five years. The study examines the frequency of criminal arrest as well as suicide outcomes for 395 gun-removal actions in Indiana. Fourteen individuals (3.5%) died from suicide, seven (1.8%) using a firearm. The study population's annualized suicide rate was about 31 times higher than that of the general adult population in Indiana, demonstrating that the law is being applied to a population genuinely at high risk. By extrapolating information on the case fatality rate for different methods of suicide, we calculated that one life was saved for every 10 gun-removal actions, similar to results of a previous study in Connecticut. Perspectives from key stakeholders are also presented along with implications for gun policy reform and implementation.
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    Daily Situational Brief, May 27, 2011
    (MESH Coalition, 5/27/2011) MESH Coalition
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    The Measurement of Suicide Assessment and the Development of a Treatment Strategy for Elders: Durkheim an Approach
    (American Research Institute for Policy Development, 2017-06) Marson, Stephen M.; Hong, Michin; Bullard, Julia; School of Social Work
    The purpose of this study was to develop and validate Durkheim Suicide Assessment (DSA).The DSA was designed to measure suicide risk among older adults. Despite a major influence of Durkheim' theory in understanding suicide, little effort has been made to apply such theory in gerontological practice. Data were drawn from a survey of 380 older adults over the age of 65. Principal component analysis was conducted with the 80 items of the original DSA, which yielded the 26 items of the DSA. Furthermore we performed explore factor analyses to assess the factor structures of the DSA. Internal consistency reliability was examined using Cronbach's alpha. The results show that the DSA is a psychometrically sound measurement. Health care professionals can use the DSA to assess suicide potential and develop an effective treatment strategy based on the type of suicide in which the elder has the highest probability of pursuing.
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    Mental Health, Substance Misuse, and Suicide: Shared Risk and Protective Factors
    (Richard M. Fairbanks School of Public Health, 2018-06) Hilts, Katy; Greene, Marion
    Mental illness, substance misuse, and suicide are complex conditions with serious public health implications. Evidence suggests that these disorders often co-occur and share many of the same risk and protective factors. Additionally, certain populations are at an increased risk of developing substance use disorders, mental illness, or engaging in suicidal behaviors. Nationally and in Indiana, several factors, including stigma, an undersized mental health workforce, and limited treatment options, inhibit the effective identification and treatment of these conditions.
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    Overview of Suicide Risk Among Adolescent Hispanic Girls in Indiana
    (Richard M. Fairbanks School of Public Health, 2016-04) Seitz de Martinez, Barbara; Adams, Erin L.
    Suicide is one of the leading causes of death among adolescents in the United States and in Indiana. Suicide is a complex public health issue, and common risk factors include problems with mental health, substance use, physical injury and psychological trauma. In addition, social and cultural differences can place certain racial and ethnic groups at especially high risk of thoughts and behaviors that may lead to suicide.
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    Practice Issues for Evaluation and Management of the Suicidal Left Ventricular Assist Device Patient
    (Sage, 2020-03) Chernyak, Yelena; Teh, Lisa; Henderson, Danielle R.; Patel, Anahli; Psychiatry, School of Medicine
    There is a high prevalence of depression among left ventricular assist device patients, who present with an increased risk of suicidality given access to means via the device either with nonadherence or disconnection. Suicidality via device nonadherence/disconnection is an underresearched clinical issue, as paradoxically this life-saving procedure can also provide a method of lethal means to patients with significant mental health concerns. A case study is used to highlight the course of an attempted suicide by ventricular assistive device nonadherence. Clinical implications and recommendations for practice include a thorough psychological evaluation presurgery, monitoring quality of life and coping styles before and after placement, psychological testing, outlining specific suicide protocols, psychiatric care considerations for patients with highly specialized medical devices, and related ethical concerns.
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    Prevalence of suicidal behaviour following traumatic brain injury: Longitudinal follow-up data from the NIDRR Traumatic Brain Injury Model Systems
    (Taylor & Francis, 2016) Fisher, Lauren B.; Pedrelli, Paola; Iverson, Grant L.; Bergquist, Thomas F.; Bombardier, Charles H.; Hammond, Flora M.; Hart, Tessa; Ketchum, Jessica M.; Giacino, Joseph; Zafonte, Ross; Department of Physical Medicine and Rehabilitation, IU School of Medicine
    Objective: This study utilized the Traumatic Brain Injury Model Systems (TBIMS) National Database to examine the prevalence of depression and suicidal behaviour in a large cohort of patients who sustained moderate-to-severe TBI. Method: Participants presented to a TBIMS acute care hospital within 72 hours of injury and received acute care and comprehensive rehabilitation in a TBIMS designated brain injury inpatient rehabilitation programme. Depression and suicidal ideation were measured with the Patient Health Questionnaire (PHQ-9). Self-reported suicide attempts during the past year were recorded at each follow-up examination, at 1, 2, 3, 10, 15 and 20 years post-injury. Results: Throughout the 20 years of follow-up, rates of depression ranged from 24.8–28.1%, suicidal ideation ranged from 7.0–10.1% and suicide attempts (past year) ranged from 0.8–1.7%. Participants who endorsed depression and/or suicidal behaviour at year 1 demonstrated consistently elevated rates of depression and suicidal behaviour 5 years after TBI. Conclusion: Compared to the general population, individuals with TBI are at greater risk for depression and suicidal behaviour many years after TBI. The significant psychiatric symptoms evidenced by individuals with TBI highlight the need for routine screening and mental health treatment in this population.
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    Suicide Prevention for Students: A Comprehensive School Counseling Perspective
    (2018-03) Ravas, Brittany; Bardo, Marvin; Bennett, Carrie; Conley, Angelica; Sanders, Joel; Sightes, Hannah; Graham, Jasmine
    With suicide numbers drastically rising around the United States for today's youth, suicide prevention is a key component of school counseling. This article outlines the American School Counseling Association's comprehensive school counseling model regarding suicide prevention. All components are discussed including foundation, management, delivery, and accountability. Delivery components include strategies for curriculum, individual counseling, responsive services, referrals, consultation, and collaboration.
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    Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents
    (Elsevier, 2018-02) Etter, Dillon J.; McCord, Allison; Ouyang, Fangqian; Gilbert, Amy Lewis; Williams, Rebekah L.; Hall, James A.; Tu, Wanzhu; Downs, Stephen M.; Aalsma, Matthew C.; Pediatrics, School of Medicine
    Purpose The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. Predictors of patient endorsement of suicidality and provider documentation of follow-up were examined. Methods A prospective cohort study was conducted to examine the implementation of a CDSS that screened adolescent patients for suicidality and provided follow-up recommendations to providers. The intervention was implemented for patients aged 12–20 years in two primary care clinics in Indianapolis, Indiana. Results The sample included 2,134 adolescent patients (51% female; 60% black; mean age = 14.6 years [standard deviation = 2.1]). Just over 6% of patients screened positive for suicidality. A positive endorsement of suicidality was more common among patients who were female, depressed, and seen by an adolescent−medicine board-certified provider as opposed to general pediatric provider. Providers documented follow-up action for 83% of patients who screened positive for suicidality. Documentation of follow-up action was correlated with clinic site and Hispanic race. The majority of patients who endorsed suicidality (71%) were deemed not actively suicidal after assessment by their provider. Conclusions Incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care is feasible and well utilized by providers. Female gender and depressive symptoms are consistently associated with suicidality among adolescents, although not all suicidal adolescents are depressed. Universal use of a multi-item suicide screener that assesses recency might more effectively identify suicidal adolescents.