Suicide rates in relation to health care access in the United States: an ecological study.

TL;DR: The findings support the view that clinical intervention is a crucial element in the prevention of suicide and yield strong correlations of state-based suicide rates with proposed indicators of access to health care.

Abstract: clinical that view support findings The care health to access indicators proposed with rates suicide state-based correlations strong yielded also They suicide associations well-established factors several detected employed methods Nevertheless, persons individual for indices risk specify cannot analyses aggregate Such DISCUSSION: density population by and physicians psychiatrists density persons uninsured rate followed indicator, strongest was mental aid federal state care, between models multivariate In directions expected associated were All Americans African proportion higher health, physicians, psychiatrists, income, capita per annual density, follows: as ranked are ="002)" male 005) /> OBJECTIVE: We tested the hypothesis that suicide rates in the United States are associated with indicators of access to health care services METHOD: With an ecological study design, we compared age-adjusted suicide rates for men and women with demographic, socioeconomic, and other indices of access to health care, by state (N= 51, including the District of Columbia) The most recently available information from the National Statistics Reports at the US Census Bureau, the US Centers for Disease Control and Prevention National Center for Health Statistics, and the American Board of Medical Specialties was used Data on suicide are from 2001; other measures were matched for the closest available year, except that state-based data on psychiatrists and physicians are from 2004 RESULTS: Positive bivariate associations with state suicide rates (all p

TL;DR: The feasibility of using social media data to detect those at risk for suicide, using natural language processing and machine learning techniques to detect quantifiable signals around suicide attempts, and designs for an automated system for estimating suicide risk are described.

Abstract: Suicide is among the 10 most common causes of death, as assessed by the World Health Organization For every death by suicide, an estimated 138 people’s lives are meaningfully affected, and almost

TL;DR: Findings from ecologic and individual-level studies conducted over the past two decades illustrate the importance of accounting for the availability of highly lethal suicide methods in efforts to understand (and ultimately reduce) disparities in suicide mortality across populations.

Abstract: Suicide mortality varies widely across age, sex, race, and geography, far more than does mortality from the leading causes of natural death. Unlike the tight correlation between cancer mortality and the incidence of cancer, suicide mortality is only modestly correlated with the incidence of suicidal acts and other established risk factors for suicidal behavior, such as major psychiatric disorders. An implication of this modest correlation is that the proportion of all suicidal acts that prove fatal (the case fatality ratio) must account for a substantial portion of the (nonrandom) variation observed in suicide mortality. In the United States, the case fatality ratio is strongly related to the availability of household firearms. Findings from ecologic and individual-level studies conducted over the past two decades illustrate the importance of accounting for the availability of highly lethal suicide methods in efforts to understand (and ultimately reduce) disparities in suicide mortality across populations.

TL;DR: A comprehensive meta‐analysis of the risk of suicide in eating disorders and its implications for treatment and relapse is presented.

Abstract: Preti A, Rocchi MBL, Sisti D, Camboni MV, Miotto P. A comprehensive meta-analysis of the risk of suicide in eating disorders. Objective: Past meta-analyses on suicide in eating disorders included few available studies. Method: PubMed/Medline search for papers including sample n ≥ 40 and follow-up ≥5 years: 40 studies on anorexia nervosa (AN), 16 studies on bulimia nervosa (BN), and three studies on binge eating disorder (BED) were included. Results: Of 16 342 patients with AN, 245 suicides occurred over a mean follow-up of 11.1 years (suicide rate = 0.124 per 100 person-years). Standardized mortality ratio (SMR) was 31.0 (Poisson 95% CI = 21.0–44.0); a clear decrease in suicide risk over time was observed in recent decades. Of 1768 patients with BN, four suicides occurred over a mean follow-up of 7.5 years (suicide rate = 0.030 per 100 person-years): SMR was 7.5 (1.6–11.6). No suicide occurred among 246 patients with BED (mean follow-up = 5.3 years). Conclusion: AN and BN share many risk factors for suicide: the factors causing lower suicide rates per person-year in BN compared to AN should be investigated.

TL;DR: It is found that state prevalence of firearm ownership is significantly associated with the state incidence of mass killings with firearms, school shootings, and mass shootings.

Abstract: BACKGROUND: Several past studies have found that media reports of suicides and homicides appear to subsequently increase the incidence of similar events in the community, apparently due to the coverage planting the seeds of ideation in at-risk individuals to commit similar acts. METHODS: Here we explore whether or not contagion is evident in more high-profile incidents, such as school shootings and mass killings (incidents with four or more people killed). We fit a contagion model to recent data sets related to such incidents in the US, with terms that take into account the fact that a school shooting or mass murder may temporarily increase the probability of a similar event in the immediate future, by assuming an exponential decay in contagiousness after an event. CONCLUSIONS: We find significant evidence that mass killings involving firearms are incented by similar events in the immediate past. On average, this temporary increase in probability lasts 13 days, and each incident incites at least 0.30 new incidents (p = 0.0015). We also find significant evidence of contagion in school shootings, for which an incident is contagious for an average of 13 days, and incites an average of at least 0.22 new incidents (p = 0.0001). All p-values are assessed based on a likelihood ratio test comparing the likelihood of a contagion model to that of a null model with no contagion. On average, mass killings involving firearms occur approximately every two weeks in the US, while school shootings occur on average monthly. We find that state prevalence of firearm ownership is significantly associated with the state incidence of mass killings with firearms, school shootings, and mass shootings. Language: en

TL;DR: Well-developed community mental-health services are associated with lower suicide rates than are services oriented towards inpatient treatment provision, consistent with the idea that population mental health can be improved by use of multifaceted, community-based, specialised mental- health services.