Suicide pacts: Deciding to die together

In most suicide pacts, two or more related or associated individuals agree to take their lives together at or near the same time and place with similar means and for the same reason. They are rare — less than 1% of all suicides  are part of pacts. Generally, suicide pacts consisting of two individuals occur […]

CDC guidance for community response to suicide clusters, United States, 2024

This is the third of three reports in the MMWR supplement that updates and expands CDC’s guidance for assessing, investigating, and responding to suicide clusters based on current science and public health practice. The first report, Background and Rationale — CDC Guidance for Communities Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024, describes an […]

CDC guidance for community assessment and investigation of suspected suicide clusters, United States, 2024

This report is the second of three reports in the MMWR supplement updating CDC’s guidance for investigating and responding to suicide clusters. The first report, Background and Rationale — CDC Guidance for Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024, describes  an overview of suicide clusters, methods used to develop the supplement guidance, […]

Background and rationale: CDC guidance for communities assessing, investigating, and responding to suicide clusters, United States, 2024

To assist community leaders in public health, mental health, education, and other fields with developing a community response plan for suicide clusters or for situations that might develop into suicide clusters, in 1988, CDC published Recommendations for a Community Plan for the Prevention and Containment of Suicide Clusters (MMWR Suppl 1988;37[No. Suppl 6]:1–12). Since that time, the […]

Associations between social media and suicidal behaviors during a youth suicide cluster in Ohio

Purpose Youth suicide clusters may be exacerbated by suicide contagion—the spread of suicidal behaviors. Factors promoting suicide contagion are poorly understood, particularly in the advent of social media. Using cross-sectional data from an ongoing youth suicide cluster in Ohio, this study examines associations between suicide cluster-related social media and suicidal behaviors. Methods We surveyed 7th- […]

Feasibility study for identifying suicide clusters using real-time coronial data

Suicide is a major societal problem. In Australia, there were 3,144 deaths by suicide in 2021 with suicide being the leading cause of death amongst young people (18-24 years).1 The impact of suicides is particularly devastating for families, friends and communities when they occur in clusters. A suicide cluster is  defined as a group of […]

Identify adolescents’ help-seeking intention on suicide through self- and caregiver’s assessments of psychobehavioral problems: Deep clustering of the Tokyo TEEN Cohort study

Background Psychopathological and behavioral problems in adolescence are highly comorbid, making their developmental trajectories complex and unclear partly due to technical limitations. We aimed to classify these trajectories using deep learning and identify predictors of cluster membership. Methods We conducted a population-based cohort study on 3171 adolescents from three Tokyo municipalities, with 2344 pairs of […]

Hotel suicides in Australia 2006-2017: Examining the frequency, characteristics, and spatial clustering

Background: This study investigated the frequency, characteristics, and geospatial clustering of hotel suicides in Australia to inform suicide prevention efforts. Aims: (1) To determine the proportion of suicide deaths that occurred in hotels, (2) to determine differences in demographic characteristics of hotel deaths compared to other locations, (3) to assess level of planning, and (4) to determine whether […]

Adverse childhood experiences and clustering of high-risk behaviors among high school students: A cross-sectional study

Objectives: This study assessed the association between adverse childhood experiences (ACEs) and clustering of high-risk behaviors in a sample of high school students. Study design: This was a cross-sectional study. Methods: A sample of students who attended randomly selected classes in 99 high schools completed the 2019 Nevada Youth Risk Behavior Survey (N = 4959). The survey included […]

Space-time self-harm and suicide clusters in two cities in Taiwan

Aims: Suicidal acts may cluster in time and space and lead to community concerns about further imitative suicidal episodes. Although suicide clusters have been researched in previous studies, less is known about the clustering of non-fatal suicidal behaviour (self-harm). Furthermore, most previous studies used crude temporal and spatial information, e.g., numbers aggregated by month and residence […]

Spatial–temporal analysis of suicide clusters for suicide prevention in Hong Kong: A territory-wide study using 2014– 2018 Hong Kong Coroner’s Court reports

Background This study aimed to (i) identify high-risk suicide-methods clusters, based on location of residence and suicide incidence; and (ii) compare the characteristics of cases and spatial units inside and outside clusters. Methods Suicide data of 4672 cases was obtained from the Coroner’s Court reports in Hong Kong (2014–2018). Monthly aggregated suicide numbers based on […]

Applying the Anderson-Darling test to suicide clusters: Evidence of contagion at U. S. universities?

Background: Suicide clusters at Cornell University and the Massachusetts Institute of Technology (MIT) prompted popular and expert speculation of suicide contagion. However, some clustering is to be expected in any random process. Aim: This work tested whether suicide clusters at these two universities differed significantly from those expected under a homogeneous Poisson process, in which suicides occur […]

An adolescent suicide cluster and the possible role of electronic communication technology

Background: Since the development of Centers for Disease Control’s (CDC) guidelines for the management of suicide clusters, the use of electronic communication technologies has increased dramatically. Aims: To describe an adolescent suicide cluster that drew our attention to the possible role of online social networking and SMS text messaging as sources of contagion after a suicide and obstacles […]

Suicide clusters in young people: Evidence for the effectiveness of postvention strategies

Background: Suicide clusters have commonly been documented in adolescents and young people. Aims: The current review conducts a literature search in order to identify and evaluate postvention strategies that have been employed in response to suicide clusters in young people. Methods: Online databases, gray literature, and Google were searched for relevant articles relating to postvention interventions following a suicide cluster […]

Clustering of suicides in children and adolescents

Suicide is one of the major causes of death in young people, in whom suicide can occur in clusters. In this Review, we have investigated definitions and epidemiology of such clusters, the factors associated with them, mechanisms by which they occur, and means of intervening and preventing them. Clustering of suicidal behaviour is more common […]

Responding to suicide clusters in the community: What do existing suicide cluster response frameworks recommend and how are they implemented?

Suicide clusters involve an excessive number of suicides, suicide attempts, or both, that occur close in space or time or involve social links between cluster members. Although suicide clusters are rare, evidence documenting the implementation of suicide cluster response activities in communities is required yet remains limited. In this study, we identified the core components […]

Understanding suicide clusters through exploring self-harm semi-structured interviews with individuals presenting with near-fatal self-harm during a suicide cluster

There was a highly publicised cluster of at least ten suicides in South Wales, United Kingdom, in 2007-2008. We carried out a qualitative descriptive study using cross-case thematic analysis to investigate the experiences and narratives of eight individuals who lived in the area where the cluster occurred and who survived an episode of near-fatal self-harm […]

Responsible journalism, imitative suicide, and transgender populations: A systematic review of UK newspapers

Purpose: The risk of suicide is high in the transgender population. Imitative suicide occurs when excess suicidal behavior is observed following news media coverage of suicide. The purpose of this study is to evaluate how often UK newspapers adhere to suicide reporting guidelines designed to minimize imitative suicide when they report the suicides of transgender […]

Suicide clusters among top 10 high-risk occupations: A study from 2001 to 2016 in Australia

A number of studies have demonstrated elevated risk of suicide in certain occupational groups. We seek to understand a possible new risk factor: suicide contagion, as demonstrated through a suicide cluster analysis. National-level coronial data and census population data were used for the study. We calculated suicide rates to identify “risky” occupations. SaTScan v9.4.1 was […]

Understanding the characteristics and mechanisms underlying suicide clusters in Australian youth: A comparison of cluster detection methods

Aims. There is currently no gold-standard definition or method for identifying suicide clusters, resulting in considerable heterogeneity in the types of suicide clusters that are detected. This study sought to identify the characteristics, mechanisms and parameters of suicide clusters using three cluster detection methods. Specifically, the study aimed to: (1) determine the overlap in suicide […]

A community-based response to a suicide cluster: A Hong Kong experience

Background: A 45-month community-based suicide prevention program was launched in response to the emergence of a suicide cluster in 2010 in Hong Kong. Aims: This study aimed to evaluate the effectiveness of the program, document the implementation and outcomes of the project, and identify factors that contribute to the outcomes. Method: The program was delivered following the five key components […]

Developing a community plan for preventing and responding to suicide clusters

This resource has been developed to assist Australian communities to manage or contain an actual or potential suicide cluster. The community plan might focus on a suburb, a particular facility (e.g., a school, hospital or prison), a rural or remote area, or an Indigenous community. It could be developed by a government department, mental health […]

Suicide clusters in Australian youth: A comparison of cluster detection methods

Abstract Aims: Suicide clusters are significantly more common in young people. Yet, there is currently no gold-standard method for detecting suicide clusters and there is some evidence that the different methods for detecting clusters give inconsistent results. Our aim was to conduct a comparative analysis of suicide clusters in young people using 1) The scan […]