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.            

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

An Interview with Tony David Sampson: Author of Virality: Contagion Theory in the Age of Networks

We are delighted to have the opportunity to talk with Tony about how his work touches on issues of imitation and contagion—a loaded term unpacked within his 2013 book.

ENGINEERING DIGITAL SHARING PLATFORM TO CREATE SOCIAL CONTAGION: EVIDENCE FROM LARGE SCALE RANDOMIZED FIELD EXPERIMENTS

Peer-to-peer information sharing has fundamentally changed customer decision-making process. Recent developments in information technologies have enabled digital sharing platforms to influence various granular aspects of the information sharing process. Despite the growing importance of digital information sharing, little research has examined the optimal design choices for a platform seeking to maximize returns from information sharing. My dissertation seeks to fill this gap. Specifically, I study novel interventions that can be implemented by the platform at different stages of the information sharing. In collaboration with a leading for-profit platform and a non-profit platform, I conduct three large-scale field experiments to causally identify the impact of these interventions on customers’ sharing behaviors as well as the sharing outcomes. The first essay examines whether and how a firm can enhance social contagion by simply varying the message shared by customers with their friends. Using a large randomized field experiment, I find that i) adding only information about the sender’s purchase status increases the likelihood of recipients’ purchase; ii) adding only information about referral reward increases recipients’ follow-up referrals; and iii) adding information about both the sender’s purchase as well as the referral rewards increases neither the likelihood of purchase nor follow-up referrals. I then discuss the underlying mechanisms. The second essay studies whether and how a firm can design unconditional incentive to engage customers who already reveal willingness to share. I conduct a field experiment to examine the impact of incentive design on sender’s purchase as well as further referral behavior. I find evidence that incentive structure has a significant, but interestingly opposing, impact on both outcomes. The results also provide insights about senders’ motives in sharing. The third essay examines whether and how a non-profit platform can use mobile messaging to leverage recipients’ social ties to encourage blood donation. I design a large field experiment to causally identify the impact of different types of information and incentives on donor’s self-donation and group donation behavior. My results show that non-profits can stimulate group effect and increase blood donation, but only with group reward. Such group reward works by motivating a different donor population. In summary, the findings from the three studies will offer valuable insights for platforms and social enterprises on how to engineer digital platforms to create social contagion. The rich data from randomized experiments and complementary sources (archive and survey) also allows me to test the underlying mechanism at work. In this way, my dissertation provides both managerial implication and theoretical contribution to the phenomenon of peer-to-peer information sharing.

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.

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.

Smoking, depression, and suicide risk in the nursing staff of a Third-Level Hospital

Objective: To determine the association between smoking, depression and suicide risk in the Nursing Staff of a University Hospital. Materials and method: this was a non-experimental, correlational cross-range study with observational analysis carried out between May 2012 and May 2013. We studied 232 nurses of the “Dr. José Eleuterio gonzález” University Hospital. two self-administered scales were applied, one for depression and one for suicide risk. Another hetero-applied scale of nicotine dependency was also used, and the subjects’ socio-demographic records were reviewed. Results: A total of 527,232 nurses were studied. A smoking prevalence of 22.8% (53 subjects), an operational depression prevalence of 15.1% (35 subjects), and a suicide risk of 5.1% (12 subjects) were found. Gender and age, speciically being male and young (mean age 29.2 years) were found to increase the risk of smoking. We also found that those nurses who had a partner and had a higher level of education smoked less compared to those who did not have a partner or had a lower degree of education. there were hospital departments where there was a higher prevalence of smoking, such as Internal Medicine and Shock trauma. No association between smoking and the presence of depression was found. Regarding depression, we found that those nurses who worked in the Department of Pensioners were more likely to develop operational depression than those working in any other department. We also found that the risk of presenting operational depression decreases as age increases. About suicide risk, a statistically signiicant association between smoking and suicide risk was found. We also found an association between operational depression and suicide risk.Conclusions: It is recommended to consider nicotine dependence as a fundamental part of psychopathology assessment because of its strong association with suicide risk. this study emphasizes the complexity of the issue of the comorbidity of smoking and psychopathology and the need to continue research lines.

Contagion in cybersecurity attacks

Systems security is essential for the efficient operation of all organizations. Indeed, most large firms employ a designated ‘Chief Information Security Officer’ to coordinate the operational aspects of the organization’s information security. Part of this role is in planning investment responses to information security threats against the firm’s corporate network infrastructure. To this end, we develop and estimate a vector equation system of threats to 10 important IP services, using industry standard SANS data on threats to various components of a firm’s information system over the period January 2003 – February 2011. Our results reveal strong evidence of contagion between such attacks, with attacks on ssh and Secure Web Server indicating increased attack activity on other ports. Security managers who ignore such contagious inter-relationships may underestimate the underlying risk to their systems’ defence of security attributes, such as sensitivity and criticality, and thus delay appropriate information security investments.

The magical contagion of guilt: The role of cleansing

Dissertação de Mestrado apresentada ao ISPA - Instituto Universitário

Effectiveness of Depression-Suicidal Behaviour Gatekeeper training among police officers in three European regions: outcomes of the Optimising Suicide Prevention Programmes and their Implementation in Europe (OSPI-Europe) study

Background: Gatekeeper training for community facilitators, to identify and respond to those at risk of suicide, forms an important part of multi-level community-based suicide prevention programmes. Aims: This study examined the effects of gatekeeper training on attitudes, knowledge and confidence of police officers in dealing with persons at risk of suicide. Methods: A total of 828 police officers across three European regions participated in a 4-hour training programme which addressed the epidemiology of depression and suicidal behaviour, symptoms of depression, warning signs and risk factors associated with suicidal behaviour, motivating help-seeking behaviour, dealing with acute suicidal crisis and informing bereaved relatives. Participants completed internationally validated questionnaires assessing stigmatising attitudes, knowledge about depression and confidence in dealing with suicidal persons pre- and post-training. Results: There were significant differences among countries in terms of previous exposure to suicidal persons and extent of previous training. Post-training evaluation demonstrated significant improvements in stigmatising attitudes, knowledge and confidence in all three countries. Conclusion: The consistently positive effects of gatekeeper training of police officers across different regions support inclusion of this type of training as a fundamental part of multi-level community-based suicide prevention programmes and roll-out, nationally and internationally.