National Office for Suicide Prevention annual report 2010

International research informs us that any economic downturn leads to an increase in suicides. In one recent article in the Lancet it was stated that a 1.0% increase in unemployment led to 0.7% increase in suicides. Such analysis is startling and in Ireland more than relevant as our suicide numbers rose dramatically in 2009 and 2010. Provisional figures for 2009 indicated a record number of 527 recorded suicides and even though there was a slight fall in 2010 the figure remains unacceptably high. It is likely that when the year of occurrence figures for these years are published the numbers will be even higher This year we have included a section in Chapter 5 on the year on year difference between ‘provisional’ (year of registration) data and ‘official’ (year of occurrence) data which highlights the reason why these two data sets cannot be directly compared. We also acknowledge that some undetermined deaths can also be classified as suicides. Ongoing analysis of this data is therefore important. What is particularly worrying and perhaps not unexpected is the rise in suicides in the middle age groups, both men and women. Such a dramatic increase can largely be attributed to the fracturing and resulting stress and pressure on individuals which has occurred in our society due to the economic downturn.   .

Self-harm, suicide and risk: helping people who self-harm. Final report of a working group.

The focus of this report is to enquire into and report on why people harm and kill themselves and to consider the role (including the limits of the role) that psychiatrists and other mental healthcare professionals play in their care and treatment. The experiences and views of people who harm themselves as well as those of their carers, health professionals and third-sector workers are central to this enquiry. As there is much policy and guidance on self-harm and suicide prevention, the report does not attempt to retrace this same ground but rather examines the evidence of practice on the ground, including the implementation of the National Institute for Health and Clinical Excellence (NICE) guidelines on self-harm (National Collaborating Centre for Mental Health, 2004). This report is the second in the Royal College of Psychiatristsââ,¬â"¢ programme of work on the broad issue of risk. The College report Rethinking Risk to Others was published in July 2008 (Royal College of Psychiatrists, 2008a) and a new Working Group was set up under the chairmanship of John, Lord Alderdice, to examine risk, self-harm and suicide. This clinical issue is an integral part of the role of the psychiatrist in ensuring the good care and treatment of patients. Our central theme is that the needs, care, well-being and individual human dilemma of the person who harms themselves should be at the heart of what we as clinicians do. Public health policy has a vital role to play and psychiatrists must be involved and not leave these crucial political and managerial decisions to those who are not professionally equipped to appreciate the complexities of self-harm and suicide. But we must never forget that we are not just dealing with social phenomena but with people who are often at, and beyond the limit of what they can emotionally endure. Their aggressive acts towards themselves can be difficult to understand and frustrating to address, but this is precisely why psychiatrists need to be involved to bring clarity to the differing causes for the self-destructive ways in which people act and to assist in managing the problems for the people concerned, including family, friends and professional carers, who sometimes find themselves at the end of their tether in the face of such puzzling and destructive behaviour.

Demographic trends in suicide in the UK and Ireland 1980 - 2010.

Background Ireland has the 17th highest suicide rate in the EU and the 4th highest among 15 to 24-year-old males (WHO 2012). Suicide is the leading cause of death in this age group; death by hanging accounted for 69 % of suicides in 2010. Methods This study examines youth suicide rates from 1980 to 2010 in Ireland and compares them to the rates in Northern Ireland, Scotland, England and Wales. Irish data were obtained from the Central Statistics Office and their annual reports on Vital Statistics. Northern Irish data were obtained from the Northern Ireland Statistics and Research Agency website; Scottish data were from the General Register Office for Scotland and English/Welsh data from the Office for National Statistics website. Results There has been a threefold increase in young male suicide in Ireland over the past three decades (8.9 - 29.7 per 100,000). In contrast, there has been approximately a threefold reduction in deaths by road traffic accidents in young men in the same period (42.7 - 16.2 per 100,000). Suicide rates in young men are similar in Scotland and Northern Ireland for the same period but are 50 % lower in England and Wales. Despite the rates of hanging as a method of suicide increasing in all jurisdictions, the overall rate in England and Wales has continued to decline. Conclusion The suicide rate in Ireland remains very high and strategies to address this are urgently required. Our study indicates that national suicide prevention strategies can be effective.

The iceberg of suicide and self-harm in Irish adolescents: a population-based study

PURPOSE Suicide is a leading cause of death among adolescents. Self-harm is the most important risk factor for suicide, yet the majority of self-harm does not come to the attention of health services. The purpose of this study was to establish the relative incidence of adolescent suicide, hospital-treated self-harm and self-harm in the community. METHODS Annual suicide rates were calculated for 15-17 year-old in the Cork and Kerry region in Ireland based on data from the Central Statistics Office. Rates of hospital-treated self-harm were collected by the Irish National Registry of Deliberate Self-Harm. Rates of self-harm in the community were assessed using a survey of 3,881 adolescents, the Child and Adolescent Self-harm in Europe study. RESULTS The annual suicide rate was 10/100,000. Suicide was six times more common among boys than girls. The annual incidence rate of hospital-treated self-harm was approximately 344/100,000, with the female rate almost twice the male rate. The rate of self-harm in the community was 5,551/100,000, and girls were almost four times more likely to report self-harm. For every boy who died by suicide, 16 presented to hospital with self-harm and 146 reported self-harm in the community. For every female suicide, 162 girls presented to hospital with self-harm and 3,296 reported self-harm. CONCLUSIONS Gender differences in relative rates of self-harm and suicide are very large, with boys who have harmed themselves at particularly high risk of suicide. Knowledge of the relative incidence of self-harm and suicide in adolescents can inform prevention programmes and services.

Preventing suicide: a global imperative.

Every 40 seconds a person dies by suicide somewhere in the world. "Preventing suicide: a global imperative" is the first WHO report of its kind. It aims to increase awareness of the public health significance of suicide and suicide attempts, to make suicide prevention a higher priority on the global public health agenda, and to encourage and support countries to develop or strengthen comprehensive suicide prevention strategies in a multi-sectoral public health approach. The report provides a global knowledge base on suicide and suicide attempts as well as actionable steps for countries based on their current resources and context to move forward in suicide prevention.

National Office for Suicide Prevention annual report 2013

Suicide prevention is a significant public health issue in Ireland given the increase in suicide mortality and the emerging evidence of the negative impact of the economic downturn on mental health. In 2013, work commenced on the development of a new National Strategic Framework for Suicide Prevention. This Framework will provide a clear road map in relation to suicide prevention in Ireland. It will build upon the valuable work completed under Reach Out, the current National Strategy, and will reflect the best national and international evidence on suicide prevention to provide a clear set of actions and outcomes. The key principle to the Framework development is that of working together with our partners and the community, with a sense of common purpose, to achieve our shared aim: reducing the number of suicides in Ireland.   .

Death by Suicide: A Report Based on the Northern Ireland Coroner’s Database

Funded by HSC R&D Division, Public Health Agency Why did we start? Potentially new information, especially relating to the characteristics of those who had died by suicide was made available through the Coroner’s Office.  The information made available to us covered deaths that occurred in the years 2005 to the end of 2011. What did we do? First we addressed the descriptive characteristics associated with this group of individuals. These descriptive characteristics included information relating to (1) means by which the death occurred (2) gender, age and employment status of the person (3) prior attempts (4)  alcohol and prescription use around time of death (5) adverse events (6) use of health services and (7) mental and physical health problems. Second we examined area level residential location in terms of Local Government Districts, and Wards within Northern Ireland. To address this area level of analysis, standardised mortality ratios (SMRs) were used.      

Understanding Suicide and Help-seeking in Urban and Rural Areas in Northern Ireland

Funded by HSC R&D Division, Public Health Agency Why did we start? Most people who complete suicide are in contact with their family doctors or other services in the months prior to death. A better understanding of the nature of these contacts and the various pathways experienced by suicidal people should reveal the gaps and barriers to effective service provision. We also need better information about the difficulties experienced by family carers, both prior to the death and afterwards. Of particular interest to policy makers in Northern Ireland was a concern that people from rural areas may be at increasing risk of suicide. We were commissioned by the Health and Social Care R&D Division of the Northern Ireland Public Health Agency to address the gaps in our understanding of suicide in NI. What did we do? We undertook a mixed methods study in which we examined the records of 403 people who took their own lives over a two-year period between March 2007 and February 2009. We linked these data to GP records and then examined help-seeking pathways of people and their contacts with services. We did in-depth face-to-face interviews with 72 bereaved relatives and friends who discussed their understanding of the events and circumstances surrounding the death, the experience of seeking help for the family member, the personal impact of the suicide, and use of support services. Additionally, we interviewed 19 General Practitioners about their experiences of managing people who died by suicide.            

Estudo dos Sintomas Psicopatológicos nas Forças Policiais Portuguesas: estudo comparativo na GNR, PSP e PJ

O presente estudo exploratório visa analisar a possibilidade de existência de Sintomas Psicopatológicos nas Forças Policiais Portuguesas GNR, PSP e PJ. Por se verificar um aumento do suicídio, nestes profissionais, com uma taxa quatro vezes superior no ano de 2008. O objectivo é essencialmente o de prevenção, conhecendo as causas, poder-se-ia intervir em tempo próprio diminuindo a taxa de suicídio. Para atingir o objectivo enunciado vamos proceder à revisão da literatura e à descrição do estudo. Foram utilizados o questionário sócio-demográfico e o BSI (Brief Symptoms Inventory) na recolha dos dados de 45 polícias (15 GNR, 15 PSP e 15 PJ) que exercem funções na Zona Centro do País e que voluntariamente colaboraram. Uma vez recolhidos os dados, estes foram introduzidos e processados no SPSS (Statistical Package for the Social Sciences) versão 13.0. Os resultados obtidos permitiram concluir que não existem diferenças estatisticamente significativas nas diferentes Forças policiais, relativamente aos sintomas Psicopatológicos. / This present exploratory study pretends to analyze the existence of psicopatologic symptoms in the Portuguese Policies Forces, Republican National Guard, Public Security Police and Judicial Police. By the constatation of the increase of the suicidal tendence in this professionals, with a four time superior tax when compared with 2008. The essential objective is the prevention of suicide, well known their causes, we will can act in the own an favorable timing diminishing the tax of suicidal tentative. To obtain the pronounced objective, we will proceed to a reading revision over the behaviour characteristics as the subjects that commit suicide and the role of the police activities that have over the happenings. After, that we will describe the used metodology that involve a social demographic enquire and the BSI that (Brief Symptoms Inventory) over a sample of 45 police man (15 GNR, 15 PSP and 15 PJ) wich activities are situated in the center of Portugal that have been voluntary to this experience. Once data is collected, it was entered into a computerized database and processed in the statistical program SPSS (Statistical Package for the Social Sciences). The obtained results will allow to conclude if exist significant statistical differences in the various Policies Forces, related with the psicopatologic symptoms.

Estimating the effect of state-level gun purchasing policy on county-level firearm suicide mortality

Thesis (Master's)--University of Washington, 2016-08

‘We report the world as it is, not as we want it to be’: Journalistic negotiation of news routines, roles and responsibilities when reporting on suicide

Thesis (Master's)--University of Washington, 2016-08

Exploring the Process of Meaning-making after Partner Suicide

Meaning-making is increasingly recognized as a fundamental aspect of the grief experience. This study investigated the process of meaning-making in the narratives of individuals whose partners died by suicide, exploring their meaning reconstruction in response to this form of loss. The narratives of users of a public online grief support forum (n = 50) were analyzed using the Meaning of Loss Codebook (Gillies, Neimeyer, & Milman, 2014), which consists of core categories of meaning of loss in response to the death of a loved one. The results indicated that these individuals predominantly experienced negative affect, a lack of understanding associated with the loss, and a longing for their partners. The grief experience of participants in this study was marked by substantial psychological distress and an ongoing struggle to make sense of and find meaning in this type of loss. It is clear that grieving the loss of a partner as a result of suicide presents unique challenges to meaning-making in comparison to other types of loss. Given the importance of this aspect of adjustment to loss, these findings deepen the understanding of this component of grief and inform the provision of support for those grieving a loved one who died by suicide.

A tentative argument for regional quality targets in assimilating schwa

Amerikanenglannin redusoitunut švaa-vokaali tuotetaan puheessa laadultaan huomattavan monimuotoisena. Kirjallisuudessa ei kuitenkaan vallitse selkeää käsitystä siitä, mitkä tekijät ehdollistavat tätä švaan laatuvaihtelua, ja etenkin sen mahdollinen sosiaalinen ulottuvuus on jäänyt aiemmissa tutkimuksissa varsin vähälle huomiolle. Tässä tutkielmassa pyritäänkin selvittämään, millainen vaikutus puhujan alueellisella murteella on hänen tuottamansa švaan akustiikkaan. Tutkimukseen valittiin 21 informanttia muutamista Yhdysvaltain eteläisistä ja läntisistä osavaltioista. Informanttien haastattelunauhoitteista poimittiin analyysiin yhteensä 433 švaan F1- ja F2-formanttiarvot siten kuin ne esiintyivät sanassa the. Analyysissä havaittiin, että eteläisten puhujien švaat keskittyivät vokaalien [u,U] tuntumaan, kun taas läntisten informanttien švaat asettuivat vokaalien [i,u] väliin. Tulokset antoivat aihetta kysyä, onko eteläinen švaa sulautunut takavokaaleihin [u,U]. Kysymystä varten suoritettiin jatkotutkimus, johon valittiin yksi ensimmäisen tutkimuksen eteläisistä puhujista. Puhujalta mitattiin 66 švaan ja 45 [U]:n formantit. Näitä tarkastellessa löydettiin tilastollista viitettä siitä, että puhujan švaa oli saattanut sulautua vokaaliin [U]. Tulostensa pohjalta tutkielma ehdottaa, että the-sanassa esiintyvässä amerikanenglannin švaassa saattaa toteutua puhujan alueellista murretta mukaileva tavoitevaihe siitä huolimatta, että tämä vokaali on samanaikaisesti huomattavasti kontekstiinsa assimiloitunut. Tavoitevaihe näyttäisi lähtökohtaisesti sijoittuvan F2:ssa vokaalialueen keskelle, ollen kuitenkin eteläisten puhujien kohdalla altis siirtymään taaemmas kohti vokaalilaatuja [u,U].

Can we predict agitation in patients with suicide attempts in the emergency department?

Background: The agitation in patients presenting to the emergency department (ED) after suicide attempts is common and an important problem. Objective: To establish whether we can predict agitated patients among suicide attempt patients in ED. Methods: This is a cross-sectional observational study of adult suicide attempt events in ED. Information was collected prospectively on a specially designed data-collection form. Patients aged 16 years old and above who presented to the ED for care due to suicide attempts were included in the study. Suicide attempts were grouped as aggressive and non-aggressive attempts. Results: A total of 533 patients were included. Forty-three of these patients had agitation in ED (8%). Non-aggressive suicide attempts were referred to psychiatry services more than aggressive ones (73.6%, n=345 vs 32.8%, n=21, P<0.0001). Agitation in ED and being male increased aggressive suicide attempt risk 3.5 (95% CI:1.6-7.6) and 3.2 times (95% CI:1.8-5.5), respectively. Agitation was statistically more frequent among these patients: those on antidepressant overdose, with previous suicide attempt; with aggressive suicide attempt; and those with confusion; and unconsciousness (P<0.05). Conclusion: Patients who attempted suicide and whose risk of harm to others included those with: antidepressant overdose, aggressive suicide attempt and the unconscious. Response teams should be prepared for these subgroups.