The impact of mental health and community structural characteristics on suicide-related behavior and self-harm among community respondents (original) (raw)
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Leah Brown, Katie Tolley, Hassan Yassin, Olasehinde Adebayo Objective: Adolescent and youth suicide is a significant public health issue that seems to be becoming more pervasive in recent years. In Canada, suicide was the second leading cause of death among youth and young adults from the years 2016-2018. What is even more concerning is that published data often underestimates the total number of deaths from suicide due to factors such as stigma. As such, it is important to identify and understand the contributing factors associated with suicide and self-harm behaviours (which are often predictors of suicide) in adolescents and youth. Hypothesis: Given prior literature research studies for the social determinants of health and the relation of determining factors that: affect the potential of adolescent/youth suicide or self-harm, is there an increased prevalence of adverse outcomes, and how are these factors addressed in current societal health systems? Conclusion: Each factor was found to be positively or negatively associated with suicide, although the strength of the association varied greatly, and some studies had contradicting results. These findings emphasize the importance of conducting further research into the complex relationship between adolescent suicide and its contributing factors.
Characterizing suicide in Toronto: an observational study and cluster analysis
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2014
To determine whether people who have died from suicide in a large epidemiologic sample form clusters based on demographic, clinical, and psychosocial factors. We conducted a coroner's chart review for 2886 people who died in Toronto, Ontario, from 1998 to 2010, and whose death was ruled as suicide by the Office of the Chief Coroner of Ontario. A cluster analysis using known suicide risk factors was performed to determine whether suicide deaths separate into distinct groups. Clusters were compared according to person- and suicide-specific factors. Five clusters emerged. Cluster 1 had the highest proportion of females and nonviolent methods, and all had depression and a past suicide attempt. Cluster 2 had the highest proportion of people with a recent stressor and violent suicide methods, and all were married. Cluster 3 had mostly males between the ages of 20 and 64, and all had either experienced recent stressors, suffered from mental illness, or had a history of substance abuse....
Psychosocial and clinical correlates of suicidal acts: results from a national population survey
The British Journal of Psychiatry, 2008
Suicide is the cause of almost half of all violent deaths and results in almost a million fatalities every year. 1 A previous suicide attempt is one of the strongest predictors of future completed suicide 2 or subsequent attempt 3 as well as being an indicator of extreme psychological distress. 4 Epidemiological data suggest 12month prevalence rates for suicide attempts of 0.4% 5 to 0.6%, 4 but it has been suggested that there may be 8-25 suicide attempts for every death from suicide. 6 Most individuals who complete or attempt suicide have a diagnosable psychiatric illness, with depressive disorders most often diagnosed. 7,8 However, the observations that a proportion of people who engage in suicidal acts have no psychiatric illness and that most individuals with a psychiatric disorder do not attempt suicide necessitate an increased understanding of physical health and psychosocial factors that may contribute. Previous research studies on suicide attempts and suicidal acts have been limited by heavy reliance on clinical samples, 9 the relevance of which to the larger population of people at risk of suicide is questionable. Most people who complete suicide have neither made a previous attempt nor received mental healthcare. 10 Only a few population-based studies have reported suicide attempt data, 7,11 and these were limited by the small numbers of people attempting suicide 11 and the lack of sufficient information about these individuals to yield new insights. 7,11 In addition, both studies were conducted before the introduction and exponential rise in use of newer antidepressant medications, raising questions about the current relevance of their findings.
Psychological Medicine, 2001
Background. Geographic variations in the incidence of deliberate self-harm (DSH) and suicide have been shown to be associated with area-based measures of socio-economic deprivation and social fragmentation. Previous studies have been subject to methodological limitations. None has investigated whether ecological associations are reflected in characteristics of individuals involved in suicidal behaviour.Methods. DSH patients presenting to a general hospital between 1985 and 1995 and suicides (including open verdicts) from the same catchment area were studied. Mean annual rates of DSH and suicide by gender were calculated for electoral wards. The wards were amalgamated into 20 groups according to their ranking for socio-economic deprivation (Townsend) and social fragmentation scores. Associations of these variables with DSH and suicide rates were investigated. Characteristics of DSH patients living in ward groups with the highest and lowest socio-economic deprivation and social fragme...
Socio-economic inequalities in suicide attempts and suicide mortality in Québec, Canada, 1990–2005
Public Health, 2010
Suicide attempts Socio-economic factors Deprivation Qué bec Area analysis s u m m a r y Objectives: Little research has evaluated changes in the association between area deprivation and suicidal behaviour over time. This study investigated patterns in suicide attempts and suicide mortality according to material deprivation in the province of Qué bec, Canada between 1990 and 2005. Study design: Ecological analysis.
Suicide in young adults: psychiatric and socio-economic factors from a case–control study
BMC Psychiatry, 2014
Background: Suicide in young adults remains an important public health issue in Australia. The attributable risks associated with broader socioeconomic factors, compared to more proximal psychiatric disorders, have not been considered previously in individual-level studies of young adults. This study compared the relative contributions of psychiatric disorder and socio-economic disadvantage associated with suicide in terms of relative and attributable risk in young adults. Method: A population-based case-control study of young adults (18-34 years) compared cases of suicide (n = 84) with randomly selected controls (n = 250) from population catchments in New South Wales (Australia), with exposure information collected from key informant interviews (for both cases and controls). The relative and attributable risk of suicide associated with ICD-10 defined substance use, affective, and anxiety disorder was compared with educational achievement and household income, adjusting for key confounders. Prevalence of exposures from the control group was used to estimate population attributable fractions (PAF). Results: Strong associations were evident between mental disorders and suicide for both males and females (ORs 3.1 to 18.7). The strongest association was for anxiety disorders (both males and females), followed by affective disorders and substance use disorders. Associations for socio-economic status were smaller in magnitude than for mental disorders for both males and females (ORs 1.1 to 4.8 for lower compared to high SES groups). The combined PAF% for all mental disorders (48% for males and 52% for females) was similar in magnitude to socio-economic status (46% for males and 58% for females). Conclusion: Socio-economic status had a similar magnitude of population attributable risk for suicide as mental disorders. Public health interventions to reduce suicide should incorporate socio-economic disadvantage in addition to mental illness as a potential target for intervention.
Rurality as a Risk Factor for Attempted Suicide and Death by Suicide in Ontario, Canada
The Canadian Journal of Psychiatry, 2021
Objective This study aims to examine rural and urban differences in attempted suicide and death by suicide in Ontario, Canada. Method This is a population-based nested case-control study. Data were obtained from administrative databases held at ICES, which capture all hospital and emergency department visits across Ontario between 2007 and 2017. All adults living in Ontario who attempted suicide or died by suicide are included in the study, and controls were matched by sex and age. Suicides were captured using vital statistics. Suicide attempts were determined using emergency department service codes. Results Rurality is a risk factor for attempted suicide and death by suicide. Rural males are more likely to die by suicide compared with urban males (adjusted odds ratio(AOR) = 1.70, 95% confidence interval (CI), 1.49 to 1.95), and the odds of death by suicide increase with increasing levels of rurality. Rural males and females have an increased risk of attempted suicide compared with...
Canadian Review of Sociology, 2022
Received the "Best Journal Article Award" from the Canadian Sociological Association/ Canadian Review of Sociology in 2023. Extending recent developments in the neo-Durkheimian analysis of suicidality as an indicator of social pathology, this paper analyses individual level survey data on suicidal ideation, perceptions of social support, and the sense of belonging from three Canadian provinces. Previous research shows that indicators of objective and subjective integration, including those pertaining to social support and a sense of belonging to the community, are related to suicidality. However, conflations of social support and a sense of belonging obscure whether or not they differently affect suicide ideation. We thus investigate both, analyse whether their subjective and objective indicators interact with each other, and if subjective indicators mediate the effect of objective ones. Measures of a higher level of social support had the largest effect on suicidal ideation. Additionally, the effect of food insecurity was very close to that of social support. Perceived life stress, our variable for controlling psychological as opposed to sociological factors, is an important predictor of suicidal ideation but it only slightly lowered the effect of social support. These findings are consistent with Durkheim's general theory of suicide and approach to social pathology, and previous studies on mental health. This suggests that differences in social integration modalities and their effects on individuals' well-being should be included in analyses of social pathology. The findings highlight the importance of regular, proximate social interaction as a prophylactic against suicidality.
Translational psychiatry, 2018
In this narrative overview of the evidence linking psychosocial factors with future suicide risk, we collected results from published reports of prospective studies with verified suicide events (mortality or, less commonly, hospitalisation) alongside analyses of new data. There is abundant evidence indicating that low socioeconomic position, irrespective of the economic status of the country in question, is associated with an increased risk of suicide, including the suggestion that the recent global economic recession has been responsible for an increase in suicide deaths and, by proxy, attempts. Social isolation, low scores on tests of intelligence, serious mental illness (both particularly strongly), chronic psychological distress, and lower physical stature (a marker of childhood exposures) were also consistently related to elevated suicide rates. Although there is some circumstantial evidence for psychosocial stress, personality disposition, and early-life characteristics such a...
Neighborhood poverty and suicidal thoughts and attempts in late adolescence
Psychological Medicine, 2008
BackgroundSuicide tends to concentrate in disadvantaged neighborhoods, and neighborhood disadvantage is associated with many important risk factors for youth suicide. However, no study has directly investigated the link between neighborhood poverty and youth suicidal behaviors, while controlling for pre-existing vulnerabilities. The objective of this study was to determine whether living in a poor neighborhood is associated with suicidal thoughts and attempts in late adolescence over and above background vulnerabilities, and whether this association can be explained by late-adolescence psychosocial risks: depression, social support, negative life events (NLEs), delinquent activities, substance abuse and exposure to suicide. The potential moderating role of neighborhood poverty was also examined.MethodA subset of 2776 participants was selected from the Canadian National Longitudinal Survey of Children and Youth (NLSCY). Late-adolescence suicidal behaviors and risk factors were self-r...