Interpersonal precipitants are associated with suicide intent communication among United States Air Force suicide decedents

Background
Few studies explore differences between suicide intent communicators and noncommunicators, and to date, none have examined the association between suicide precipitants and intent communication.
Methods
United States Air Force suicide decedents (N = 236) were categorized as suicide intent communicators or non-communicators within 30 days prior to death. The top two frequently occurring suicide precipitants, categorized as interpersonal and legal/administrative, were examined in relation to suicide intent communication.
Results
Nearly half (47.0%) of suicide decedents communicated intent within 30 days of death, of which the majority (61.3%) communicated their suicide intent within 24 h of death. Suicide intent communicators and non-communicators did not differ on demographics. Decedents with interpersonal precipitants were significantly more likely than those without to communicate suicide intent (52.7% versus 33.3%). Decedents with documented legal/administrative precipitants were equally likely as those without to communicate suicide intent (49.6% versus 44.0%). Controlling for legal/administrative precipitants, decedents with interpersonal precipitants were twice as likely to communicate suicide intent communication, OR = 2.2, p = .008 (95% CI = 1.23, 3.98).
Limitations
Limitations include the retrospective study design, unknown mode of intent communication, unclear timing of precipitants relative to communication, and exclusion of other types of precipitants.
Conclusions
Suicide intent communication was most frequent among decedents with interpersonal precipitants. This finding has important implications for the continued education of military families and communities on identifying and intervening with those making suicide intent disclosures. Additional research is needed to examine individual trajectories toward suicide to understand nuances of distal and proximal precipitants as related to suicide intent communication.