The use of positive coping skills has demonstrated protective effects with regard to Nonsuicidal Self-Injury (NSSI) engagement; however, cross-sectional evidence suggests that the presence of comorbid conditions, such as alcohol use disorders, may negate these benefits. The current study leverages ecological momentary assessment (EMA) to examine the between-person and within-person relationships between positive coping strategies and NSSI risk among individuals with problematic alcohol use. Undergraduate students ( = 56) completed a 21-day EMA protocol, in which they completed four surveys per day asking about their use of several positive coping strategies and NSSI risk. Socializing was the only coping strategy to demonstrate a protective effect on NSSI risk. Alternatively, the coping strategies of finding perspective, positive thinking, and sitting with feelings until they pass all increased risk for NSSI. The current study was underpowered to disentangle relationships with urges to engage in NSSI and NSSI behaviors. The results suggest that using coping skills that may present physical barriers to engaging in NSSI may be effective for reducing momentary NSSI risk.

Real-time suicide registers are being established in many countries and enable regular monitoring of suspected suicides over time. The use of these data to monitor for suicide clusters is in its infancy. We sought to test the feasibility of using real-time suicide register data to detect spatiotemporal suicide clusters. Using the Victorian Suicide Register and SaTScan's spatiotemporal scan statistic, we simulated a monthly search for clusters from January 2015 to June 2022 using rolling 2-year windows of data in each search. Monthly scans were performed at three different levels of geographic granularity and for all-ages and under-25 populations. Our results indicated the rapid identification of possible suicide clusters and demonstrated a practical approach to combining real-time suicide data and scanning algorithms. We developed new model outputs that showed cluster timelines. The main limitations are that the computational burden of fitting multiple models meant we were unable to scan for ellipses and other irregular shapes and we were unable to consider space-time permutation models. Using data from a real-time suicide register, we were able to scan for space-time suicide clusters simulating the situation where the data are updated monthly with new updates.

Prevention strategies for suicide emphasize restrictions on firearm access. These restrictions may lose efficacy if individuals substitute other lethal suicide methods. The objective of this study is to determine the extent to which individuals who die by suicide in the United States substitute hanging for firearm injury. This study is a repeated cross-sectional analysis of suicide deaths in the United States from 2003 to 2021. Multiple regression was used to estimate the effect of firearm access proxies on individual suicide methods (hanging vs. firearm injury). The probability of death by hanging was significantly and negatively associated with proxies of firearm access. This study does not compare crude rates of suicide by state, which rise on average with rates of firearm ownership. The National Violent Death Reporting System expanded over the sample period, so early years have incomplete ascertainment. Rates of gun ownership and gun safety law scales are measured as proxies. Although means restriction around firearm access is a critical tool for suicide prevention, complementary strategies for prevention around hanging merit further study.

Since its creation in 2007, the Veterans Crisis Line (VCL) has provided 24/7, confidential crisis support services for Veterans, Service Members, and their families, supporting the VA's highest clinical priority of suicide prevention. As part of this effort, VCL created the (CWCN) program to manage the individual needs and operational impact of VCL customers who call at a high frequency, are abusive toward hotline staff, exhibit sexually inappropriate behavior, and/or make threats of violence. This paper describes the VCL CWCN program and customer characteristics. Call data from 2012 to 2022, including operational data for 1,096 CWCN customers identified from October 2017 to December 2020, were used for analysis. At the cohort's peak size in 2020, calls from CWCN customers accounted for 0.4% of all distinct phone numbers received by VCL and for 22.1% of total VCL call volume. Implementation of the CWCN program was associated with significant annual reductions in average individual call volume among high frequency callers. However, no change in call volume was observed among nonhigh frequency callers. Formative challenges and future directions for the CWCN program and implications for other crisis lines are discussed.

Prior work has explored the impact of follow-up calls in a crisis line context, but no research has investigated the offer and acceptance of follow-up care. To identify caller/call characteristics associated with whether a caller is offered and accepts follow-up services. : This cross-sectional study included data from 55,594 callers to a member center of the 988 Suicide & Crisis Lifeline (988) between 2017 and 2019. Logistic regression analyses were conducted to examine associations between caller/call characteristics and two follow-up outcomes. : Black callers and those with higher suicide capability and intent had greater odds of being offered and accepting follow-up. Longer call duration was also associated with higher odds of being offered and accepting follow-up. Higher suicidal desire uniquely increased the odds of offers, whereas a higher level of buffers uniquely decreased the odds of offers. Data were collected from a single 988-member center and cannot be generalized. : That one-third of callers do not accept follow-up highlights the need to understand reasons for not accepting follow-up. That callers with higher risk profiles are offered and accept follow-up at higher rates is reassuring and underscores the benefit of tailoring follow-up interventions for higher-risk callers.

: While there is substantial literature on gender and research productivity, bearing mixed results, no study is available for suicidology. The present investigation fills this gap and focuses on an influential elite. : Data are taken from the Web of Science (WoS). They refer to the most prolific suicidologists ( = 116) with 70 or more works on the subject of suicide cited in WoS. Measures of research productivity include the number of works on suicide, citations to these works, and the h-index. The link between gender and the measures of research productivity is adjusted for years of experience, membership in a local research cluster, and region of the world. : Adjusting for the other predictors, males had more publications than females. However, gender did not predict either measure of quality of research (citations, h-index). Years of experience, as well as membership in a research cluster, predicted research productivity in most analyses. Region was unrelated to research productivity. : Further work on productivity might assess additional potential predictors including marital status, grant funding, and presence of young children. : There is no significant difference between the genders in research quality. Similar results have been noted in previous work on prolific scientists.

Suicide bereavement increases the probability of adverse outcomes related to grief, social functioning, mental health, and suicidal behavior. While more support for individuals bereaved by suicide has become available, the evidence regarding its effectiveness is not straightforward. The literature suggests that identifying best-practice components is key in designing effective postvention interventions. This metareview aims to identify components of suicide bereavement interventions perceived to be effective by suicide-bereaved people. The review adhered to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Systematic searches in Medline, PsycINFO, Embase, Emcare, EBM Reviews, Scopus, and Web of Science identified 11 eligible systematic reviews published between 2008 and 2023. The methodological quality was assessed using the Measurement Tool to Assess Systematic Reviews (AMSTAR-2) (PROSPERO registration CRD42023458300). Our narrative synthesis reported the components perceived to be effective in relation to structure and content of interventions, facilitators, and modality (peer, group, community, online). The quality of the included reviews varied considerably, and not all reviews reported on perceived effectiveness of interventions' components. Meta-analysis of findings was not possible due to study heterogeneity. The findings provide crucial information for researchers, service providers, and policymakers to enhance the provision of evidence-based support for people bereaved by suicide.

Men account for 75% of all suicide deaths in Australia. Societally dominant masculine norms have been theorized to be linked with suicidality and reduced help-seeking. However, evidence is needed to establish this relationship further. To further understand the relationships between 11 masculine norms, suicidal ideation, and mental health help-seeking behavior longitudinally in Australian males. We analyzed data from a cohort of 8,214 males (aged 18-55 years), using logistic regression to examine if conformity to any of the 11 masculine norms measured by the Conformity to Masculine Norms Inventory (CMNI-22) at Wave 1 was associated with suicidal ideation and help-seeking at Wave 2. Analyses revealed that being in the high conformity group for the norm of emotional control at Wave 1 was associated with higher odds of suicidal ideation longitudinally. Being in the low conformity group for the global construct of masculine norms and the specific norms of emotional control and power over women was associated with higher rates of mental health help-seeking behavior longitudinally. The CMNI-22 scale's limited construct validity and the use of a single-item measure for suicidal ideation may have restricted the accurate capture of masculine norms and suicidal behaviors in Australian men. These results provide support for the contention that suicidality is a profoundly gendered phenomenon by showing an association between masculine norms and suicidal ideation in men. These norms should be a point of focus of male suicide prevention initiatives.

In 2018, news outlets began reporting on a suicide epidemic among New York City's yellow taxi drivers. Within months, print, television, radio, and internet outlets had produced pieces describing the deaths of drivers struggling to endure transformations in their industry. We explored taxi drivers' perspectives regarding suicide news coverage and the degree to which the coverage affected their lives. Current and recent taxi drivers participated in open-ended, life-history-informed interviews, which were transcribed and analyzed thematically. We interviewed 21 participants. Four themes related to interviewees' experience of suicide-related media coverage emerged: drivers' awareness of the news coverage and opinions regarding it, the degree to which the coverage motivated drivers to engage in conversation with others about stress, the extent to which coverage inspired drivers to think differently about mental health, and perceptions regarding the media's broader characterization of taxi drivers. Interviews were conducted in English, a second language for many taxi drivers. Taxi drivers expressed diverse views regarding media reporting on driver suicides, with some viewing it as helpful, while others critiqued it as simplistic, stigmatizing, and sensationalist.

: While Gatekeeper Training (GKT) is an accepted component of suicide prevention strategies, there is little evidence about its effectiveness with Indigenous populations and online. : This study examined the effects of LifeKeepers, a novel GKT, comprising three modalities: General, e-learning, and a culturally tailored Māori (New Zealand Indigenous) training. : A total of 5,981 participants completed measures of declarative knowledge, perceived knowledge, and self-efficacy pre- and post-training. Participants rated satisfaction with LifeKeepers, its safety considerations and cultural acceptability post-training. : There were statistically significant improvements across all outcome measures (declarative knowledge 1.3 [95% CI 1.3-1.4], perceived knowledge 10.9 [95% CI 10.7-11.1], and self-efficacy 2.5 [95% CI 2.5-2.6]), including across all modalities. More than 90% of participants rated satisfaction, cultural acceptability, and safety considerations highly. Without a control group, changes may not be solely due to engagement in LifeKeepers. : This study offers preliminary evidence of the immediate effectiveness of LifeKeepers, across its in-person, Indigenous Māori, and e-learning modalities. It addresses a critical literature gap by exploring participants' safety perspectives and strongly supports LifeKeepers as a primary suicide prevention intervention in New Zealand, especially for Indigenous Māori communities. Comparable outcomes for e-learning participants indicate wider accessibility, bolstering suicide prevention efforts.

The literature is scant on the associations between employment-related variables and suicidal ideation. The objectives were to explore these associations in the national French working population. The study relied on two independent national French surveys and their samples of 22,420 workers (employees and self-employed workers) and 25,628 employees, respectively. Employment variables included occupation, economic activity of the company, public/private sector, company size, permanent/temporary work, full/part time, seniority, and employee/self-employed worker. Suicidal ideation was assessed using one item. The associations between employment variables and suicidal ideation were studied using bi- and multivariable weighted analyses (Rao-Scott Chi-2 test and logistic regression). Gender differences were explored and covariates were taken into account. : The associations between employment variables and suicidal ideation were mostly not statistically significant. Some differences in suicidal ideation between occupations and economic activities were difficult to interpret due to overlaps in the confidence intervals. The prevalence of suicidal ideation increased with seniority among employees. The study design was cross-sectional. The studied employment variables may have little effect on suicidal ideation. As suicidal ideation is a risk factor for suicide, more research is needed to explore the work-related risk factors for suicide and suicidal ideation.

Despite men's high suicide risk, gender perspectives in suicide prevention research are scarce. The goal of this systematic review was to describe the desirable and adverse effects of distribution channels and message strategies of communicative suicide prevention interventions among men. Databases PubMed and Web of Science were searched for quantitative randomized controlled trials (RCTs) and nonrandomized studies examining the effectiveness of male-specific or general communicative interventions among men. Narrative synthesis was used to summarize findings. Fifty-five studies published in peer-reviewed articles until October 15, 2021, were included. Findings demonstrate that interpersonal, mass media, and digital media interventions impact suicide-related outcomes preventively. Mass media interventions are not suitable to impact men's emotions in a prevention-desirable way. Message strategies interactivity, emotional appeals, and clear calls to action demonstrated high effectiveness, while expert exemplars, visualizations, and personalization were rather ineffective. However, the review was not able to prove causality, could not distinguish between multichannel interventions and single-channel interventions, or between specific combinations of channels and message strategies. The systematic review provides some guidance on which channels and message strategies to apply in communicative suicide prevention for men.

Self-harm is a critical public health issue for adolescents/young adults. To estimate the prevalence of self-harm among adolescents with/without disabilities in the United Kingdom. Secondary analysis of data collected at age 17 in the UK's Millennium Cohort Study. Prevalence of self-harm was significantly greater among adolescents with disabilities for suicide attempts and six forms of self-harming behaviors. The lifetime prevalence of suicide attempts was 5.3% (4.5-6.3) among adolescents without disabilities, 21.9% (18.2-26.2) among adolescents with less limiting disabilities, and 25.5% (17.2-35.9) among adolescents with more limiting disabilities. Adjusted prevalence rate ratios ranged from 5.13 (3.58-7.36) for those with mental health limitations to 1.48 (0.65-3.35) for those with mobility limitations. Similar patterns were observed for the 12-month prevalence of six self-harming behaviors. Further studies are needed to identify potential mediators of the association between disability and self-harm that are potentially modifiable. Adolescents with disabilities are at markedly greater probability of suicide attempts and self-harming behaviors than their peers.

: Between April 7 and 14, 2019, the "Breaking the Silence" media engagement campaign was launched in Oregon. We aimed to assess the consistency of media content related to the campaign with media guidelines and the quantitative footprint on Twitter (now X) over time. Media items related to the campaign were analyzed regarding focus and consistency with media guidelines for suicide reporting and compared with other suicide-related reports published in the same time frame, as well as with reporting in Washington, the control region. Tweets related to the campaign were retrieved to assess the social media footprint. There were = 104 media items in the campaign month, mainly in the campaign week. Items typically used a narrative featuring suicide advocacy or policy/prevention programs. As compared to other items with a similar focus, they scored better on several protective characteristics listed in media recommendations. Stories of coping with adversity, however, were scarce. The social media footprint on Twitter was small. Inability to make causal claims about campaign impact. Media items from the Breaking the Silence campaign appeared mainly consistent with media guidelines, but some aspects, such as stories of recovery, were under-represented.

There is conflicting evidence on the suicide rates of different public safety personnel (PSP). There have been few studies that compare suicides in PSP with the general population and none that have used a detailed comparison of coroner records. The current study estimates suicide rates among different PSP and compares PSP suicides with the general population. We identified coroner records of PSP suicides from January 2014 to December 2018 and compared each one to two matched general population controls. We identified 36 PSP suicides and 72 general population controls. Police had a higher suicide rate than other PSP groups. PSP were more likely to die by firearm, be separated/divorced or married, die in a motor vehicle, have problems at work, and have a PTSD diagnosis. PSP were less likely to die by jumping. The study may have not identified all PSP suicides. Apart from the cause of death, data in coroner records are not systematically collected, so information may be incomplete. PSP suicides appear different than the general population. Death records need to have an occupation identifier to enable monitoring of trends in occupational groups, such as PSP.

: Mental health professionals encounter numerous difficulties when working with suicidal clients. To understand these difficulties in clinical practice better, a valid instrument measuring them is needed. This study aimed to translate the Difficulties in Suicidal Behaviors Intervention Questionnaire (DSBQ) to Slovene, validate it, and explore Slovenian professionals' experiences with it. : The participants were 106 professionals (19 men, 87 women), aged 26-66 years. Apart from the DSBQ, scales on attitudes toward suicide prevention and coping strategies in difficult clinical situations were used. The data were collected between October 2017 and January 2019. : Although slightly diverging from the originally reported component structure, the Slovene translation of the DSBQ measures difficulties in working with suicidal clients with acceptable/good reliability and sensitivity, and adequate construct validity. Slovenian professionals most commonly experience difficulties related to working with children, followed by technical, system and setting, and other types of difficulties. The sample of participants was relatively heterogeneous. Further studies of the DSBQ structure and validity, as well as difficulties, especially those related to working with children/adolescents and facing the theme of death, are warranted. Considering the difficulties most frequently reported in this investigation, more efforts are also needed in Slovenia to address technical and logistic aspects.

Little is known about the quality of media reports on suicide and prevention targeting persons with sexual or gender minority identities (LGBTQ+). To assess the quality of suicide-related media reporting of LGBTQ+ people and its consistency with media guidelines. We conducted a content analysis of 5,652 media items in two US states (Washington and Oregon) published within 1 year. There were only few differences in the reporting about suicide in LGBTQ+ as compared to non-LGBTQ+ reports. LGBTQ+ media items more often portrayed suicide as monocausal [Oregon: = 1.75, 95% CI (1.03-2.98), = .038; Washington: = 3.00, 95% CI (1.81-4.97), < .001] and linked them to adverse life experiences [ = 2.16, 95% CI (1.38-3.38), .001; = 2.09, 95% CI (1.30-3.38), = .002] than non-LGBTQ+ items. They also more often featured mental health experts [ = 1.79, 95% CI (1.04-3.10), = .034; = 2.12, 95% CI (1.23-3.67), = .006] and contacts to support services [ = 2.22, 95% CI (1.41-3.48), < .001; = 2.70, 95% CI (1.64-4.45), < .001]. Aspects possibly influencing the portrayal of LGBTQ+ suicide and prevention beyond the characteristics listed were not investigated. Suicide-related media reporting related to LGBTQ+ issues features potentially beneficial aspects but tends to overlook multifactorial causes of suicide. Diverse factors contributing to LGBTQ+ suicide and prevention warrant greater attention.

Sometimes during real or presumed life-threatening and/or near-death circumstances, an individual undergoes an altered state of consciousness referred to as a near-death experience (NDE). The prevalent position in the field of NDE research for the last several decades has been that such experiences result in positive antisuicidal attitudes and that it is highly unlikely that experients will try to kill themselves afterward. In addition, the important consideration of passive suicidal ideation is neglected in NDE research. To question the premature assumption that people are highly unlikely to die by suicide after an NDE. Four case studies of suicide after an NDE are provided and examined. Although important quantitative data are still needed, it can no longer be argued that people do not die by suicide after an NDE. Only four cases were available for examination, and the degree of impact that the NDE had on their suicide is uncertain. Much more research is needed on suicide risk post NDE. In the meantime, the NDE should not be ignored in suicide assessments, but therapists and other relevant professionals need to be attentive to any possible indications of either active or passive suicidal ideation post NDE.

: Self-injurious and suicidal thoughts create critical concerns for incarcerated populations, yet relatively little is known about how they are formed and perpetuated within US jails. Dehumanization has been presented as a potentially novel risk factor toward aspects of self-harm; thus, this study assessed the perception of dehumanization from officers by those currently incarcerated. : Across two jail settings ( 410), self-report surveys were administered asking questions relating to perception of officer dehumanization alongside aspects of nonsuicidal self-injury (NSSI) and suicidal ideation. : The findings indicate that perceived officer dehumanization is associated with NSSI thoughts, actively seeking NSSI, and suicidal ideation in jail, but not with NSSI in jail. : These data are cross-sectional, thus future work should examine the temporal order of these relationships. : Perceptions of officer dehumanization appear to be clinically relevant in jail settings; therefore, future research should longitudinally determine how dehumanization imparts suicide risk.

Different words used for suicide (so-called suicide referents) have different moral connotations, and neutral referents are recommended in media reporting guidelines. To assess how different referents in media reports are related to actual suicides. Austrian news articles for each month between 2000 and 2021 ( = 276 months) were obtained from the Austrian Press Agency. Time series were modeled for media items referring to suicide as a crime [Selbstmord], an act of freedom [Freitod], or neutral connotation [Suizid]. Temporal associations with suicides in the month before, during, and after the reporting were examined. Terminology referring to suicide as an act of free will [Freitod] was weakly associated with increases in total, male, and female suicides and with suicides in up to 64-year-olds in the same month. No other statistically significant associations were found. No detailed content analysis of media reports was done. During times of prevalent use of referents suggesting suicide to be an act of freedom, there are small-sized increases in suicides. The simultaneous occurrence of this referent and suicides might reflect effects of a societal framing present in both the media and the community rather than a sheer media effect.

This paper reports preliminary evidence of the impacts of Australia's first residential peer-support service for people at risk of suicide. Psychological distress was measured preintervention, postintervention, and after 3 months and analyzed using paired tests. Interviews were held postintervention and were analyzed using thematic analysis. Psychological distress significantly improved from preintervention to postintervention ( = 16, = 1.77) and at follow-up ( = 5, = 1.12). Interviews ( = 10) indicated that participants experienced improvements in mental well-being and feelings of connectedness, respite, and confidence to engage with other services. The peer-support workers were key. Some participants felt that the location was too remote, too little information was given, and a longer stay would have been preferable. The study did not include a control group, the sample was relatively small, and participants may have been subject to socially desirable answers. These findings indicate that residential peer-support services potentially offer a valuable alternative to conventional inpatient treatment for people at risk of suicide.

Men account for three-quarters of suicide deaths in Australia. Self-reliant masculine norms may act as barriers to men's help-seeking and contribute to suicidal ideation. Men who seek help may be less likely to experience suicidal ideation. We evaluated the association between help-seeking intentions and suicidal ideation in Australian adult men using data from Wave 2 of the Australian Longitudinal Study on Male Health (). Using scores on the General Help-Seeking Questionnaire, we explored the association between informal help-seeking intentions (e.g., friend, family), formal help-seeking intentions (e.g., psychologist), overall help-seeking intentions (all sources), and new-onset suicidal ideation. We conducted logistic regression analyses using a sample of 7,828 men aged 18-60 years. Increased overall help-seeking intentions and informal help-seeking intentions were significantly associated with lower odds of new-onset suicidal ideation, whereas formal help-seeking intentions were not significantly associated. The cross-sectional design limits inferences about causality. Men who have greater informal help-seeking intentions may be less likely to experience a new onset of suicidal ideation; however, more longitudinal research is needed.

Evaluations of interventions targeting the population level are an essential component of the policy development cycle. Pre-post designs are widespread in suicide prevention research but have several significant limitations. To inform future evaluations, our aim is to explore the three most frequently used approaches for assessing the association between population-level interventions or exposures and suicide - the pre-post design, the difference-in-difference design, and Poisson regression approaches. The pre-post design and the difference-in-difference design will only produce unbiased estimates of an association if there are no underlying time trends in the data and there is no additional confounding from other sources. Poisson regression approaches with covariates for time can control for underlying time trends as well as the effects of other confounding factors. Our recommendation is that the default position should be to model the effects of population-level interventions or exposures using regression methods that account for time effects. The other designs should be seen as fall-back positions when insufficient data are available to use methods that control for time effects.