Crucial elements in suicide prevention strategies

Psychiatric Centre Copenhagen, Copenhagen University, Faculty of Health Sciences, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Progress in Neuro-Psychopharmacology and Biological Psychiatry (Impact Factor: 3.69). 12/2010; 35(4):848-53. DOI: 10.1016/j.pnpbp.2010.11.038
Source: PubMed


Ways of conceptualizing suicide prevention are reviewed briefly, and the preventive model: Universal, Selected, and Indicated prevention (USI) is chosen as the structure for the literature review, and the discussion. Universal preventive interventions are directed toward entire population; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. On the universal prevention level, an overview of the literature is presented with focus on restrictions in firearms and carbon monoxide gas. At the selective prevention level, a review of risk of suicide in homelessness and schizophrenia and risk factors for suicide in schizophrenia is conducted and possible interventions are mentioned together with the evidence for their effect. Suicide rate and preventive measures in affective disorder are also touched upon. At the indicated prevention level, studies of fatal and non-fatal suicide acts after suicide attempt are mentioned. The evidence of preventive measures to reduce repetition rates is presented. Finally, the state of the art is discussed with regard to prevention at the universal, the selected and the indicated level and clinical and research implications are outlined.

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    • "Wasserman and Durkee [88] have delineated specific approaches often utilized in suicide preventive interventions, among which, includes the Universal/Selective/Indicated (USI) model. In the USI model, the universal intervention targets the general population, the selective intervention targets subgroups at-risk for suicide, and the indicated intervention is aimed at high-risk suicidal individuals who already begun self-destructive behaviours [89]. The USI model that adopts the conceptual framework of increasing awareness, education and de-stigmatizing mechanisms would be a theoretical basis in developing an effective Internet-based prevention program. "
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    ABSTRACT: The general aim of this study was to review the scientific literature concerning the Internet and suicidality and to examine the different pathways by which suicidal risks and prevention efforts are facilitated through the Internet. An online literature search was conducted using the MEDLINE and Google Scholar databases. The main themes that were investigated included pathological Internet use and suicidality, pro-suicide websites, suicide pacts on the Internet, and suicide prevention via the Internet. Articles were screened based on the titles and abstracts reporting on the themes of interest. Thereafter, articles were selected based on scientific relevance of the study, and included for full text assessment. The results illustrated that specific Internet pathways increased the risk for suicidal behaviours, particularly in adolescents and young people. Several studies found significant correlations between pathological Internet use and suicidal ideation and non-suicidal self-injury. Pro-suicide websites and online suicide pacts were observed as high-risk factors for facilitating suicidal behaviours, particularly among isolated and susceptible individuals. Conversely, the evidence also showed that the Internet could be an effective tool for suicide prevention, especially for socially-isolated and vulnerable individuals, who might otherwise be unreachable. It is this paradox that accentuates the need for further research in this field.
    International Journal of Environmental Research and Public Health 10/2011; 8(10):3938-52. DOI:10.3390/ijerph8103938 · 2.06 Impact Factor
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    • "It is concluded that suicide prevention programmes should devote specific attention to deaths among substance misusers who are at high risk of fatal intentional self-harm. Specific characteristics may distinguish those at risk; caregivers should be better educated as to what these factors are (Baca-Garcia et al., 2007; Nordentoft, 2010). Table 1 Sociodemographic characteristics of suicide victims "
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    ABSTRACT: Substance-related deaths account for a great number of suicides. To investigate levels and characteristics of suicide verdicts, as opposed to accidental deaths, in substance misusers. Psychological autopsy study of cases from the UK National Programme on Substance Abuse Deaths (np-SAD) during the period 2001-2007. Between January 2001 and December 2007, 2108 suicides were reported to the np-SAD. Typical suicide victims were White and older than 50 (respectively 95% and 41% of cases). Medications, especially antidepressants (44%), were prescribed to 87% of victims. Significantly fewer suicide victims than controls presented positive blood toxicological results for illicit drugs (namely: cocaine, heroin, amphetamines, ecstasy-type drugs, cannabis, and GHB/GBL) and alcohol. Suicide prevention programmes should devote specific attention to deaths among substance misusers who are at high risk of fatal intentional self-harm. Specific characteristics distinguish those at risk; caregivers should be better educated as to what these factors are. Limitations of the current study included lack of provision of comprehensive information relating to the victims' psychosocial variables. Furthermore, no differentiation between different classes of antidepressants in terms of involvement in suicide was here provided.
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 02/2011; 35(5):1279-83. DOI:10.1016/j.pnpbp.2011.02.014 · 3.69 Impact Factor
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    ABSTRACT: Reviews the book, Suicide Risk Management: A Manual for Health Professionals, Second Edition by Sonia Chehil and Stan Kutcher (2012). This second edition follows the 2006 first edition book by Stanley Kutcher and Sonia Chehil by the same name. This paperback book of 160 pages is a practical book, targeted toward mental health practitioners: psychiatrists, clinical psychologists, general practitioners, nurses, and other allied health professionals. The aims of this book are to (1) provide information regarding epidemiology and risk factors associated with suicide, (2) provide information to aid in the understanding and assessment of suicide risk, (3) provide a program pertaining to suicide evaluation, and (4) introduce an assessment tool and explains how to identify and manage suicidal individuals. It is a short, clearly written book, which presents a number of figures, tables, bullet lists, and essays aimed at providing practical guidance and tools for the management of the suicidal or potentially suicidal patient. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    01/2012; 53(3):255. DOI:10.1037/a0028987
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