National Suicide Research Foundation - Journal Articles

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    LGBTQ+ suicide – A call to action for researchers and governments on the politics, practices, and possibilities of LGBTQ+ suicide prevention
    (Hogrefe Publishing, 2024-03-15) Marzetti, Hazel; Cooper, Charlie; Mason, Andre; van Eijk, Nikki L.; Gunn III, John; Kavalidou, Katerina; Zortea, Tiago C.; Nielsen, Emma
    Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people have consistently been estimated to be disproportionately affected by suicidal ideation and suicide attempts when compared to their cisgender (non-transgender), heterosexual counterparts (di Giacomo et al., 2018; Marchi et al., 2022; Marshal et al., 2011; Surace et al., 2021). However, less is known about why this devastating health inequality exists, how it impacts on distinct communities within LGBTQ+ populations, and how it can be prevented. We call for research, policy, and practice networks to address these questions as a priority, within the context of a changing legislative landscape that has seen countries that previously hosted progressive legislation protecting LGBTQ+ rights slipping into the regressive habits of history. We write this editorial as LGBTQ+ early career researchers and their allies concerned that inaction at this time could further compound existing health inequalities with tragic consequences. In the following, we outline current challenges in the field, and suggest foundational building blocks on which a holistic, public health approach to LGBTQ+ suicide prevention could be developed.
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    Presentations of self-harm and suicide-related ideation among the Irish Traveller indigenous population to hospital emergency departments: evidence from the National Clinical Programme for self-harm.
    (Springer Nature Switzerland AG, 2023-02-17T00:00:00Z) Kavalidou, Katerina; Daly, Caroline; McTernan, Niall; Corcoran, Paul
    Purpose: Previous research has examined the suicide risk of the Irish Traveller population, but less is known about self-harm and suicidal ideation among this ethnic minority group, which are established risk factors for suicide. The aim of the current study was to compare the presentation-based self-harm and suicide-related ideation of Traveller to non-Traveller patients and describe any ethnic disparities in the aftercare of their presentation. Methods: Data were obtained from the service improvement database of an Irish dedicated national programme for the assessment of those presenting to emergency departments (EDs) due to self-harm and suicide-related ideation. Presentation data from 24 EDs were analysed and Poisson regression was used to assess the age–sex-adjusted relative risk of hospital-presenting self-harm and suicide-related ideation. Results: 24,473 presentations were recorded with 3% of the presentations made by Irish Travellers. Female Traveller patients had 3·04 (95% CI 2·51–3·68) higher risk for suicide-related ideation and 3·85 (95% CI 3·37–4·41) for self-harm, compared to white Irish female patients. Male Traveller patients had 4·46 (95% CI 3·86–5·16) higher risk for suicide-related ideation and 5·43 (95% CI 4·75–6·21) higher rates for self-harm. The highest rate ratios for self-harm were observed among older Traveller patients [male: 9·23 (95% CI 5·93–14·39); female: 6·79 (95% CI 4·37–10·57)]. A higher proportion of Traveller patients requested no next of kin involvement, compared to other ethnicities. Conclusions: Given that Irish Travellers are at higher risk of self-harm and suicide-related ideation presentations compared to other ethnic groups, EDs should be viewed as an important suicide intervention point.
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    Profile of people attending emergency departments with thoughts of self-harm and suicide: A descriptive study of a nurse-led programme in Ireland
    (John Wiley & Sons, Inc., 2023-03-29T00:00:00Z) Kavalidou, Katerina; Zortea, Tiago C.; Griffin, Eve; Troya, M. Isabela; Irish Research Council
    Increasing research has been conducted on individuals presenting with self-harm at emergency departments (EDs). However, less is known about individuals presenting to EDs with only self-harm ideation. We aimed to describe the characteristics of those attending Irish hospitals with self-harm ideation and investigate any differences in comparison to those presenting with suicide ideation. A prospective cohort study was conducted on Irish ED presentations due to suicidal and self-harm ideation. Data were obtained from the service improvement data set of a dedicated nurse-led National Clinical programme for the assessment of those presenting to Irish emergency departments due to Self-harm and Suicide-related Ideation (NCPSHI). A total of 10 602 anonymized presentation data were analysed from 1 January 2018 to 31 December 2019. Descriptive analysis was conducted to compare those with suicidal and self-harm ideation on sociodemographic and care interventions. Being female and aged <29 were more prevalent among the self-harm ideation presentations. Compared to the self-harm ideation group, a higher proportion of those with suicidal thoughts received an emergency care plan (63% vs 58%, p = 0.002) and General Practitioner letter sent within 24 h of presentation (75% vs 69%, p = 0.045). Little variation was found between hospitals for self-harm ideation in both years. Our study suggests that females and younger populations are more prevalent in hospital presentations due self-harm ideation, while presentations related to suicidal ideation are more often made by males and involving substance use. Attention should be given to the relationship between clinicians' attitudes towards care provision and the content of suicide-related ideation ED disclosure.
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    Iran's national suicide prevention program
    (Hogrefe, 2022-05-27) Rezaeian, Mohsen; Platt, Stephen; Arensman, Ella
    Background and Aims: Iran is one of the few countries in the Eastern Mediterranean Region (EMR) to have developed a national suicide prevention program (NSPP). This report introduces Iran's NSPP to policy planners and researchers working in suicide prevention, and is intended to encourage other low- and middle-income countries to develop, implement, and evaluate their own NSPPs. Method: This was a case study of a NSPP in one country, integrating quantitative and qualitative data. Bibliographic searches were conducted using both international and national databases, supplemented by other documents. The study benefited from the experiential evidence provided by the senior author. Results: While the national incidence of suicide is low, there are higher rates among young adults, particularly women, in western regions. In 2010, Iran's NSPP was integrated into primary health care. A rigorous evaluation of Iran's suicide prevention program concluded that Iran has the potential to take a leadership role in suicide prevention within the EMR, although several challenges were identified. Limitation: The findings of this case study cannot be generalized to other contexts. Conclusion: Given Iran's unstable situation, the NSPP needs to be monitored, evaluated, and adjusted according to evidence and ongoing changing national and local needs.
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    The development and validation of a dashboard prototype for real-time suicide mortality data
    (Frontiers Media S.A., 2022-08) Benson, Ruth; Brunsdon, C.; Rigby, J.; Corcoran, P.; Ryan, M.; Cassidy, E.; Dodd, P.; Hennebry, D.; Arensman, Ella; Health Research Board
    Data visualisation is key to informing data-driven decision-making, yet this is an underexplored area of suicide surveillance. By way of enhancing a real-time suicide surveillance system model, an interactive dashboard prototype has been developed to facilitate emerging cluster detection, risk profiling and trend observation, as well as to establish a formal data sharing connection with key stakeholders via an intuitive interface. Individual-level demographic and circumstantial data on cases of confirmed suicide and open verdicts meeting the criteria for suicide in County Cork 2008-2017 were analysed to validate the model. The retrospective and prospective space-time scan statistics based on a discrete Poisson model were employed via the R software environment using the "rsatscan" and "shiny" packages to conduct the space-time cluster analysis and deliver the mapping and graphic components encompassing the dashboard interface. Using the best-fit parameters, the retrospective scan statistic returned several emerging non-significant clusters detected during the 10-year period, while the prospective approach demonstrated the predictive ability of the model. The outputs of the investigations are visually displayed using a geographical map of the identified clusters and a timeline of cluster occurrence. The challenges of designing and implementing visualizations for suspected suicide data are presented through a discussion of the development of the dashboard prototype and the potential it holds for supporting real-time decision-making. The results demonstrate that integration of a cluster detection approach involving geo-visualisation techniques, space-time scan statistics and predictive modelling would facilitate prospective early detection of emerging clusters, at-risk populations, and locations of concern. The prototype demonstrates real-world applicability as a proactive monitoring tool for timely action in suicide prevention by facilitating informed planning and preparedness to respond to emerging suicide clusters and other concerning trends.