This is a summary of the latest significant Canadian (🇨🇦) and international suicide research we collected in the past month.

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Parrott, S. (2023). Media framing of student-athlete suicide: An examination of problems, causes, moral evaluations, and treatment recommendations. Communication and Sport. https://doi.org/10.1177/21674795231187155

This American study looks at various ways news organizations frame and present stories about student-athletes in relation to mental health.

Abstract – At least five NCAA student athletes died by suicide in spring 2022. The deaths generated national news media attention while underscoring the stressors student-athletes face in relation to mental health. Journalists play an important role in shaping public understanding of issues, including mental health and suicide. By framing issues, journalists can shape the way audiences interpret (a) problems, (b) their causes, (c) their moral implications, and (d) potential treatments. The present study used thematic analysis to understand how four types of news organizations framed the student-athletes’ deaths by suicide in 2022. The study examined 75 stories from national news outlets (e.g., Washington Post), sports publications (e.g., ESPN), student publications (e.g., The Badger Herald at the University of Wisconsin-Madison), and community publications (e.g., The Capital Times in Madison, WI). News stories identified environmental factors (e.g., poor mental health resources, stress) as a problem for student-athletes, while describing misplaced university priorities as a cause. Journalists described a need for universities and the NCAA to improve the depth and breadth of mental health resources for student-athletes, describing the action as a moral imperative. Implications are discussed in relation to sports communication and health communication.

🇨🇦 Sinyor, M. et al. (2023). Differences in suicide-related Twitter content according to user influence. Crisis. 44(4), 292-299. https://doi.org/10.1027/0227-5910/a000865

This is a study analyzing suicide-related Twitter content. 48,965 tweets were identified and then categorized according to level of user influence.

Abstract – Background: The content of suicide-specific social media posts may impact suicide rates, and putatively harmful and/or protective content may vary by the author’s influence. Aims: This study sought to characterize how suicide-related Twitter content differs according to user influence. Method: Suicide-related tweets from July 1, 2015, to June 1, 2016, geolocated to Toronto, Canada, were collected and randomly selected for coding (n = 2,250) across low, medium, or high user influence levels (based on the number of followers, tweets, retweets, and posting frequency). Logistic regression was used to identify differences by user influence for various content variables. Results: Low- and medium-influence users typically tweeted about personal experiences with suicide and associations with mental health and shared morbid humor/flippant tweets. High-influence users tended to tweet about suicide clusters, suicide in youth, older adults, indigenous people, suicide attempts, and specific methods. Tweets across influence levels predominantly focused on suicide deaths, and few described suicidal ideation or included helpful content. Limitations: Social media data were from a single location and epoch. Conclusion: This study demonstrated more problematic content vis-Ă -vis safe suicide messaging in tweets by high-influence users and a paucity of protective content across all users. These results highlight the need for further research and potential intervention.

Black, V., & Heo, S. (2023). When a child dies by suicide: An interpretative phenomenological analysis study. OMEGA – Journal of Death and Dying. https://doi.org/10.1177/00302228231194213

The lived experience of parents who have lost children to suicide are explored in this study. 25 bereaved mothers were interviewed between 2019 and 2021.

Abstract – Suicide is a global concern for the well-being of families. When parents experience their child’s death by suicide, their well-being can be substantially impaired. This study aimed to explore the lived experiences of parents whose children died by suicide. Data was collected from 25 mothers through interviews between 2019 and 2021 and analyzed using interpretive phenomenological analysis. The data revealed five superordinate themes, including (1) who am I; (2) the unrelenting questions; (3) my existence on earth is brutal and cruel; (4) grief; and (5) the meaning. Each superordinate theme includes two to four supporting clusters. Parents’ grief associated with a child’s suicide is overwhelming and paralyzing but is often a journey to find the meaning or the reason for the death. Parents are traumatized and emotionally vulnerable. Healthcare providers need to support parents who lose their children to death by suicide.

🇨🇦 Sanford, R.L. et al. (2023). Unpacking the meaning of closeness, reconsidering the concept of impact in suicide exposure, and expanding beyond bereavement: “Just, I hope you don’t forget about us.” OMEGA—Journal of Death and Dying. https://doi.org/10.1177/00302228231196616

This is a study looking at individuals who experienced a high impact from a suicidal death but reported low closeness to the person who died. This is a small subset (104 respondents) of a larger community-based sample of people exposed to suicide (3010 respondents).

Abstract – Suicide exposure research has relied on samples of treatment-seeking kin, resulting in an attachment-based model centering bereavement as the most significant form of impact and obscuring other forms of significant and life-altering impact. From a community-based sample (N = 3010) exposed to suicide, we examine a subset (n = 104) with perceived high impact from the death yet low reported closeness to the person who died and analyze qualitative comments (n = 50). On average and out of 5.00, participants rated closeness as 1.56 but impact of death as 4.51. We illustrate dimensions of low closeness and identify themes on the meaning of impact: impact through society and systemic circumstances, impact through history and repeated exposure, impact through other people, impact as a motivator for reflection or change, and impact through shared resonance. Participants reported impact of death as significant or devastating, yet none of their comments reflected experiences typical of bereavement.

Chitty, K.M. et al. (2023). Five healthcare trajectories in the year before suicide and what they tell us about opportunities for prevention: A population level case series study. eClinical Medicine. https://doi.org/10.1016/j.eclinm.2023.102165

An Australian study using suicide data linked with coroner, health services, and medicine dispensing data to determine past-year healthcare utilization.

Abstract – Background: Suicide prevention requires a shift from relying on an at-risk individual to engage with the healthcare system. Understanding patterns of healthcare engagement by people who have died by suicide may provide alternative directions for suicide prevention. Methods: This is a population-based case-series study of all suicide decedents (n = 3895) in New South Wales (NSW), Australia (2013–2019), with linked coronial, health services and medicine dispensing data. Healthcare trajectories were identified using a k-means longitudinal 3d analysis, based on the number and type of healthcare contacts in the year before death. Characteristics of each trajectory were described. Findings: Five trajectories of healthcare utilization were identified: (A) none or low (n = 2598, 66.7%), (B) moderate, predominantly for physical health (n = 601, 15.4%), (C) moderate, with high mental health medicine use (n = 397, 10.2%), (D) high, predominantly for physical health (n = 206, 5.3%) and E) high, predominantly for mental health (n = 93, 2.4%). Given that most decedents belonged to Trajectory A this suggests a great need for suicide preventive interventions delivered in the community, workplace, schools or online. Trajectories B and D might benefit from opioid dispensing limits and access to psychological pain management. Trajectory C had high mental health medicine use, indicating that the time that medicines are prescribed or dispensed are important touchpoints. Trajectory E had high mental health service predominantly delivered by psychiatrists and community mental health, but limited psychologist use. Interpretation: Although most suicide decedents made at least one healthcare contact in the year before death, contact frequency was overall very low. Given the characteristics of this group, useful access points for such intervention could be delivered through schools and workplaces, with a focus on alcohol and drug intervention alongside suicide awareness.

Steele, M.L. et al. (2023). Police negotiators and suicide crisis situations: A mixed-methods examination of incident details, characteristics of individuals and precipitating factors. Psychiatry, Psychology and Law. https://doi.org/10.1080/13218719.2023.2206878

Data from The Queensland Police Service Negotiator Deployment Database in Australia were culled between 2012 and 2014 for suicide-related incidents. “Incidents were analysed to understand the individuals involved and precipitating factors including mental health problems and intoxication with alcohol or drugs”.

Abstract – Police negotiators provide leadership and expertise in the de-escalation and resolution of critical incidents, including responding to individuals exhibiting suicidal behaviour. This study describes the frequency and characteristics of suicide-related negotiation incidents in Queensland, Australia as classified in the Queensland Police Service Negotiator Deployment Database, between 2012 and 2014. Incidents were analysed to understand the individuals involved and precipitating factors including mental health problems and intoxication with alcohol or drugs. Police negotiators were deployed to 156 suicide intervention incidents over a 3-year period, half of which occurred at a residence. The cohort had a median age of 32 years and were predominantly male (82%). Four out of five individuals appeared to have a mental health problem, and at least half were intoxicated due to drugs or alcohol. Findings highlight the importance of strong linkages between police, health and social services and the need for innovative and comprehensive, cross-agency programmes.

Armoon, B. et al. (2023). Suicidal behaviors and risk taking among homeless individuals: A systematic review and meta-analysis. Community Mental Health Journal, 59. https://doi.org/10.1007/s10597-023-01111-3

This is a systematic review and meta-analysis of 23 studies looking at homeless individuals and suicidal behaviours, in relation to risk behaviours, mental health disorders, substance use disorders and sociodemographic characteristics.

Abstract – The present systematic review and meta-analysis study aimed to determine sociodemographic characteristics, risky behaviors, mental health disorders, and substance use disorders associated with suicide behaviors including suicidal ideation and suicide attempts among homeless individuals. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched to identify the relevant studies published between January 1, 1995 and November 1, 2022. After initial evaluation of 9,094 papers, a total of 23 studies met the eligibility criteria. Results of the present study showed that chronic physical illnesses, violent behaviors, mood and psychotic disorders, and substance use disorders were significantly associated with both suicidal ideation and suicide attempts, while being older, having a history of physical abuse, and having mood and post-traumatic stress disorders were associated with suicide attempts only. The present study’s findings suggest a crucial need for facilitating access to mental healthcare plans and promoting mental healthcare seeking among homeless individuals.

Brammer, M.K. et al. (2023). Childhood suicide: A call to action for play therapists. International Journal of Play Therapy. https://doi.org/10.1037/pla0000202

This is a call to action for play therapists. The authors state the urgency for play therapists to increase their competency surrounding childhood suicidality. They propose a specialized screening and assessment tool for suicidal ideation.

Abstract – As rates of children attempting and dying by suicide accelerate in the United States, it is imperative that play therapists increase their competency to address childhood suicidality. This article provides evidence-based data on this phenomenon and is a call to action inviting play therapists to cultivate awareness, knowledge, skills, and advocacy competencies to address childhood suicide and create positive change. The authors offer a cross-culturally adaptive screening and assessment tool for use by play therapists working with children with suicidal ideation. A case vignette demonstrates integrating the screening tool during play therapy, and the article concludes with suicide prevention strategies for play therapists.

🇨🇦 Nicholl, G. et al. (2023). A trauma-informed approach to suicide prevention for the COVID-19 pandemic. Psychiatry Research. https://doi.org/10.1016/j.psychres.2023.115407

This is a commentary advocating for trauma-informed and trauma-specific suicide prevention approaches and services during the COVID-19 pandemic.

Abstract – During the COVID-19 pandemic, researchers have questioned how the devastation of the pandemic might impact suicide rates. While initial evidence on suicide rates during the early stages of the pandemic is mixed, there are signs we should still remain vigilant. One way of conceptualizing the long-term effects of the pandemic is as a source of multiple traumatic events: the collective trauma of widespread illness and death and social upheaval, individual traumas from the virus itself (e.g., serious illness and disability, traumatic grief, vicarious trauma), traumas from the social and economic consequences (e.g., domestic violence, unemployment), and its intersections with pre-pandemic traumas and oppression. Given trauma is a well-established risk factor for suicide, this carries significant implications for suicide prevention in the wake of the pandemic. Yet access to trauma-informed care, education, and research remains limited. The pandemic presents a unique opportunity to address these gaps and implement a trauma-informed approach to suicide prevention. Building on existing frameworks, we describe how effective suicide prevention for the pandemic must incorporate trauma-informed and trauma-specific services, strategies, and policies; capacity building; collaborative research; and knowledge exchange. Attending to the traumatic effects of the pandemic may reduce the long-term impact on suicide rates.

Choi, N. G. et al. (2023). Suicide from intimate partner and other relationship conflicts: demographic and clinical correlates. Journal of Mental Health. https://doi.org/10.1080/09638237.2023.2245886

Suicide and its relationship with intimate partner violence (IPV) is an emerging area of research in suicide prevention. This paper looks at IPV and suicide data from 2017 to 2019 using the National Violent Death Reporting System (NVDRS) in the United States.

Abstract – Background: A significant portion of suicides are precipitated by interpersonal relationship problems. Aims: To examine demographic and clinical correlates of any intimate partner conflicts (IPC) and other interpersonal conflicts (OPC) as suicide precipitants. Methods: We analyzed data on 92,805 (72,628 male; 20,177 female) adult suicide decedents from the 2017 to 2019 U.S. National Violent Death Reporting System, using multinomial and binary logistic regression models. We included case examples from coroners/medical examiner (CME) and law enforcement (LE) agency reports. Results: Of all decedents, 23.6% had IPC and 8.0% had OPC as a suicide precipitant. Compared to those without any relationship conflict, those who had IPC or OPC were younger and more likely to have had previous suicide attempt(s), alcohol/other substance use problems, and job/finance/housing and legal problems. Compared to those with OPC, those with IPC were more likely to be male and Hispanic and had higher odds of previous suicide attempt, depression diagnosis, alcohol problems, and more acute crises. CME/LE reports showed distress of divorce/break-up, other life stressors, prior suicide attempt(s), alcohol/other substance involvement, and/or loss of family support. Conclusions: Access to behavioral health treatment for those at risk of suicide in the face of IPC or OPC is essential for suicide prevention.

Das, S. et al. (2023). Unlocking the narrative: Using text mining to reveal the hidden factors behind suicide related traffic crashes. Archives of Suicide Research. https://doi.org/10.1080/13811118.2023.2247026

Suicide related traffic crashes (SRTCs) are analyzed using Louisiana traffic data culled from 2010 to 2016.

Abstract – Suicide is the deliberate act of ending a person’s own life due to multifarious reasons. In the U.S., suicide is the 10th major cause of death. Nearly 45,000 people died by suicide in 2016 across the nation. It is anticipated that not all traffic crashes can be considered as accidents. Traffic crash related injuries are occasionally considered a means of suicide, and some crashes occur due to the suicidal attempts. These attempts can be made by operators of motor vehicles, jumpers into the pathway of trains, and pedestrians deliberately jumping into the vehicle trajectory. There are a handful of studies that have focused on traffic crashes (both railroad and roadway) related to suicidal incidents. This study aimed to explore the insights associated with suicide related traffic crashes (SRTCs) by collecting traffic data for seven years (2010–2016) from Louisiana. At first, exploratory data analysis was performed to examine the five Ws (who, what, why, when, and where) associated with SRTCs. Later, this study applied text network analysis, which was not performed in any of the previous studies, to provide additional contexts of these crashes. The findings of this study can shed lights on an unexplored arena of transportation safety research.

Fraccaro, D. & Tosini, D. (2023). The suicide support group as a signifying agent and emotion transformer: A contribution from a micro-sociological perspective. Death Studies. https://doi.org/10.1080/07481187.2023.2246037

This is a study of an Italian suicide bereavement support group. The authors identify and explore some important social mechanisms of support group participation.

Abstract – We examined social mechanisms of suicide support groups based on evidence from an Italian postvention program. Our data comprise field notes from 47 meetings of a peer group and interviews with 20 suicide survivors. Group meetings unfolded as interaction rituals with elements including the survivors’ focus on their trauma, their common emotions, and their perception of boundaries to outsiders. Meanings relative to these elements were expressed by participants according to three types of representations, termed diagnostic, prognostic, and motivational framing. Main themes concerned: the uniqueness of suicide loss; related emotions such as self-blame and a sense of abandonment; the survivors’ estrangement toward social networks; a common search for strategies for coping with grief; some correlated emotional benefits; the awareness of a diffuse cultural unreadiness to deal with suicide; the definition of the group identity; a related sense of belonging; and group participation in terms of an extended solidarity.

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