Crisis-The Journal of Crisis Intervention and Suicide Prevention最新文献

{"title":"How Serious Is \"Serious\"? Rethinking the Label of \"Serious Suicide Attempt\".","authors":"Spyridon Baltzis, Sara Lindström","doi":"10.1027/0227-5910/a001084","DOIUrl":"https://doi.org/10.1027/0227-5910/a001084","url":null,"abstract":"<p><p><b></b> <i>Background:</i> The term <i>serious suicide attempt</i> is widely used in both clinical and research contexts yet lacks a consistent operational definition. It is variably applied to denote medical lethality, suicidal intent, method choice, or clinical outcome, dimensions that are empirically separable and theoretically distinct. <i>Aims:</i> We examine the conceptual assumptions and contemporary use of the term and evaluate its compatibility with contemporary models of suicidal behavior. <i>Method:</i> Drawing on developments in suicide theory, nomenclature, and epidemiological practice, we analyze how the term is used and what assumptions it entails. <i>Results:</i> We argue that <i>serious suicide attempt</i> functions as a global severity label that often combines distinct dimensions into a broad severity construct. This conflation risks inferring intent from outcome and introducing implicit hierarchies of legitimacy. A review of the literature demonstrates substantial heterogeneity in how the term is operationalized, with definitions variably based on medical severity, method lethality, or contextual indicators. Different frameworks tend to integrate these dimensions into composite constructs, which may contribute to conceptual ambiguity. Contemporary models of suicidal behavior and emerging precision-oriented approaches emphasize stratified risk, raising questions regarding the continued use of broad global severity terminology. <i>Conclusions:</i> We propose replacing global severity labels with explicit descriptive terminology specifying medical severity, suicidal intent, method lethality, and contextual factors. Aligning terminology with current models may improve conceptual clarity, clinical reasoning, and the validity of suicide research.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Trends in Suicide Bereavement and Postvention - A Global Bibliometric and Content Analysis.","authors":"Laura Hofmann, Adelia Khrisna Putri, Tania Pearce, Elahe Derakhshan, Smita Dinakaramani, Christine Genest, Lisbeth Hybholt, Meta Lavrič, Myfanwy Maple, Oscar Modesto, Pernilla Larsson Omerov, Chandra Ramamurthy, Lucia Rojs, John Whitebrook, Dolores Angela Castelli Dransart, Amy Chow, Grace Cully, Diego De Leo, William Feigelman, Eve Griffin, Guðrún Jóna Guðlaugsdóttir, Karolina Krysinska, Sylvie Lapierre, Edouard Leaune, Antoon A Leenaars, Yossi Levi-Belz, Sandra McNally, Ravivarma Rao Panirselvam, Alexandra Pitman, Vita Poštuvan, Karen Scavacini, Prakarn Thomyangkoon, Birgit Wagner, Karl Andriessen","doi":"10.1027/0227-5910/a001078","DOIUrl":"https://doi.org/10.1027/0227-5910/a001078","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Suicide bereavement refers to the grief experienced by individuals who have lost a close contact to suicide. It is often characterized by intense emotional distress, feelings of guilt, stigma, and social isolation, and may increase the risk of mental health problems and suicidal behavior. As research on suicide bereavement and postvention continues to expand globally, there is a growing need to map its development systematically and identify key trends. <i>Aims:</i> This study aimed to describe patterns in published literature on suicide bereavement and postvention through a global bibliometric analysis. <i>Method:</i> Systematic searches in eight databases (Web of Science; Scopus; CINAHL; PsycINFO; MEDLINE; Embase; Emcare; APA PsycArticles) yielded 49,386 references. After deduplication and screening, 1,072 articles published between 1953 and 2025 were included. Eligible peer-reviewed publications included empirical research, evidence syntheses (systematic reviews, scoping reviews, meta-analyses) and nonempirical publications (such as opinion pieces, and personal experiences). There were no restrictions on language, location, or year of publication. <i>Results:</i> The 1,072 eligible publications demonstrated a steady increase in suicide bereavement/postvention publications annually. 95% of publications were by first authors from high-income countries, while 1.3% of first authors were from lower-middle-income and low-income countries. Most studies were empirical and followed a quantitative or qualitative design, primarily cross-sectional, increasing over the years, while nonempirical publications declined. We identified few longitudinal or interventional studies. Populations sampled most frequently were working-age adults, with few studies focused on older adults. <i>Limitations:</i> The results provide little information about the methodological quality of the included studies. Some full texts could not be found and were unavailable for data extraction. <i>Conclusion:</i> The research gaps identified suggest that future studies should focus on underrepresented populations as well as on high-quality intervention studies to address adverse outcomes among suicide loss survivors.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Quality of Media Reporting of the Suicide of a British Female Television Celebrity.","authors":"Ruby Rose Jarvis, Kangning Zheng, Agatha Anet Alves, Monica Hawley, Amanda Marchant, Keith Hawton, Ann John, Alexandra Pitman","doi":"10.1027/0227-5910/a001079","DOIUrl":"https://doi.org/10.1027/0227-5910/a001079","url":null,"abstract":"<p><p><b></b> <i>Background:</i> International media guidelines aim to promote responsible reporting of suicide, acknowledging the influence of sensationalist press coverage on population suicide rates. Studies investigating guideline adherence have focused on reporting of male celebrity suicide, often demonstrating poor quality of reporting. <i>Aims:</i> To investigate the quality of media reporting of the suicide of a female celebrity. <i>Method:</i> We measured the quality of reporting in the United Kingdom (UK) on the suicide of Caroline Flack, a British television celebrity, over the 14-month period after her death using the PRINTQUAL (print content) and PRINTQUAL-web (online content). Using paired <i>t</i>-tests, we compared scores on the negative/poor-quality subscale and positive/good-quality subscale for each tool. <i>Results:</i> We identified 467 eligible news articles, the majority online (<i>n</i> = 342) versus print (<i>n</i> = 125), with 41% published in the week after her death, and 10% around the inquest into her death. Overall, negative/poor-quality subscale scores were significantly higher for online content than for print content, indicating poorer quality reporting for those parameters online: (<i>t</i>(165.95) = 5.65; <i>p</i> < .001). Positive/good-quality subscale scores were also significantly higher for online content than for print content, suggesting better quality reporting for those parameters online (<i>t</i>(236.46) = 8.15; <i>p</i> < .001). <i>Limitations:</i> The analysis did not include radio, television, and social media reporting of suicide. <i>Conclusions:</i> While online reporting showed poorer guideline adherence than print reporting in relation to potentially damaging content, online reporting was also more likely to feature positive aspects, such as inclusion of sources of information and advice. There is clear scope for the training of online and print news journalists to improve awareness of and adherence to media guidelines to mitigate negative impacts on vulnerable individuals.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evaluation and Management of Patients With Suicidal Ideation or Behavior by Emergency Medical Services.","authors":"Erick H Cheung, Matt Jason V Llamas, Frederick Burton, Zainab N Ahmed, Jacqueline Rifenburg, Richard Tadeo, Denise Whitfield","doi":"10.1027/0227-5910/a001074","DOIUrl":"https://doi.org/10.1027/0227-5910/a001074","url":null,"abstract":"<p><p><b></b> Emergency medical services (EMS) clinicians, such as paramedics and emergency medical technicians, frequently respond to 911 calls involving patients with suicidal ideation or behavior (SIB); however, guidance for these complex prehospital encounters remains limited. This article describes the Los Angeles County EMS Agency's (LAC-EMSA) initiative to develop a comprehensive policy for evaluating and managing patients with SIB. A quality improvement (QI) committee approach was used to assess current practices, identify targets for improvement, design countermeasures, and implement policy changes. Key activities included reviewing national model guidelines and California's EMS agencies' policies; conducting interdisciplinary case reviews of EMS encounters with patients with SIB; surveying emergency departments on suicide screening practices; collecting EMS clinicians' perspectives on challenges and potential interventions; and evaluating commonly used suicide risk screening instruments. Findings were synthesized through committee discussions, identifying five critical domains for improvement: (1) standardized terminology; (2) evidence-based guidance for evaluating suicide risk; (3) enhanced decision support for patient disposition; (4) protocols for safety planning; and (5) strategies for collaboration with law enforcement and conflict resolution. The committee recommended a new comprehensive policy addressing these domains which was subsequently developed and implemented. Limitations include the initiative's focus on a single county EMS system, the absence of validated prehospital suicide risk screening tools, and the need for evaluation of the policy's effectiveness. This initiative demonstrates that EMS agencies can leverage QI methodologies to create evidence-informed policies that advance prehospital care for SIB and reduce variability in practice.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile Applications and Wearable Digital Tools for Suicide Prevention.","authors":"Valentina Baldini, Giorgia Varallo, Margalida Gili, Miquel Roca","doi":"10.1027/0227-5910/a001076","DOIUrl":"https://doi.org/10.1027/0227-5910/a001076","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Suicide is a major public health concern and a leading cause of preventable death worldwide. Digital interventions (DIs) are technology-based tools designed to support healthcare systems. <i>Aims:</i> This systematic review aims to evaluate the effects of mobile applications and wearable digital tools on suicidal ideation. <i>Method:</i> A systematic search was conducted in PubMed, EMBASE, CENTRAL, and PsycINFO from January 2010 to April 2025, following PRISMA guidelines. Eligible studies include quantitative designs and assess mobile or wearable technologies targeting suicide prevention, with suicidal ideation, suicide attempts, or suicide deaths as outcomes. <i>Results:</i> Eighteen studies met inclusion criteria (<i>N</i> = 16,731), including adolescents, adults, and high-risk populations. DIs included mobile apps, wearable monitoring tools, web platforms, and integrated systems. Seven of nine studies reported reductions in suicidal ideation; however, no included studies assessed suicide attempts or suicide deaths. Several studies found modest short-term improvements in depression and anxiety. Apps with passive monitoring or structured therapeutic modules showed higher engagement, although adherence declined over time. Adolescents and high-risk groups showed high acceptability. <i>Limitations:</i> First, the studies vary considerably in design, intervention type, and target population, making direct comparisons difficult. Second, many studies had small samples and short follow-ups, limiting assessment of long-term effects. Third, all studies focused on suicidal ideation, with none examining attempts or mortality, reducing clinical relevance. Finally, suicide is complex, influenced by biological, psychological, and social factors, yet most DIs target ideation alone without a multidisciplinary approach. <i>Conclusion:</i> DI appears acceptable and potentially beneficial for suicide prevention, particularly with respect to suicidal ideation, while no conclusions can be drawn regarding suicide attempts or mortality. Although engagement and acceptability are high, further research should evaluate long-term effectiveness and systematically include suicide attempts and deaths as outcomes.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Suggestibility, Positive Expectancy, and Identification on Resilience (INSPIRE) Model.","authors":"Ralph Lewis, Thomas Niederkrotenthaler, Jo Robinson, Louise La Sala, Rachel Mitchell, Mark Sinyor","doi":"10.1027/0227-5910/a001073","DOIUrl":"https://doi.org/10.1027/0227-5910/a001073","url":null,"abstract":"<p><p><b></b> Since the early 2010s, increasing rates of youth self-harm and suicide-related behavior in many high-income countries have raised urgent questions about underlying drivers. One well-recognized yet incompletely understood factor is social transmission (contagion). Here we posit the <b>in</b>fluence of <b>s</b>uggestibility, <b>p</b>ositive expectancy, and <b>i</b>dentification on <b>re</b>silience (INSPIRE) model and propose that suggestibility, expectancy, and identification drive both harmful (Werther effect) and protective (Papageno effect) social transmission in youth. Building on established frameworks including Durkheim's social integration theory, social learning theory, cultivation theory, identification processes, and susceptibility-based models of media effects, the model highlights how pervasive media portrayals, peer dynamics, and social media environments can shape youths' beliefs, norms, and behaviors around suicide. Importantly, while these mechanisms can promote imitative suicide, they offer opportunities to foster resilience, adaptive coping, and help-seeking through positive modeling. The paper argues that cultivating <i>virtuous circles</i> of healthy coping and resilience - rather than <i>vicious spirals</i> of despair - can reduce suicide risk. The model suggests practical avenues for interventions within media, education, and peer settings to promote life-affirming behaviors. Although hypothetical, the INSPIRE model provides a testable framework for guiding research and public health efforts to address youth suicide through a nuanced understanding of social transmission dynamics.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide, Suicidal Behavior, and Prevention at a Coastal Site in the United Kingdom.","authors":"Rachel Gibbons, Nicola Morant, Keith Hawton, Alexandra Pitman, Millie Tamworth, Henry Whittle, Helen Killaspy","doi":"10.1027/0227-5910/a001080","DOIUrl":"https://doi.org/10.1027/0227-5910/a001080","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Beachy Head is a high-frequency public coastal location associated with suicidal crisis, suicide attempts, and deaths by suicide in England. Although evidence from frequently used jumping locations supports access restriction and multicomponent prevention, the evidence specific to this site has not been systematically mapped. <i>Aims:</i> To identify and summarize academic, policy, and gray literature addressing suicidal crisis, suicidal behavior, deaths by suicide, and suicide prevention at Beachy Head. <i>Method:</i> We followed the Joanna Briggs Institute guidance for scoping reviews. Seven bibliographic and two gray literature databases were searched on April 15, 2026, supplemented by Google Scholar and web searching, citation tracking, and expert consultation. Results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. <i>Results:</i> The review identified a small, heterogeneous body of evidence spanning epidemiology, public health, commissioned reports, local history, cultural analysis, and media research. Findings suggest that Beachy Head cannot be understood simply as a hazardous physical location. Its significance arises through the interaction of landscape, accessibility, public reputation, media representation, local response, and fragmented governance. Evidence for prevention activity was largely descriptive, with limited prospective evaluation, little lived experience research, and no sustained longitudinal surveillance framework. The review highlights Beachy Head as a complex prevention setting in which national significance appears to be managed largely through local systems. <i>Limitations:</i> Searches were limited to English language sources and some gray literature may not be fully publicly accessible. No formal critical appraisal was undertaken. <i>Conclusion:</i> Beachy Head is a complex prevention setting shaped by physical access, public reputation, media representation, governance, and human intervention. Consistent surveillance, lived experience research, and prospective evaluation of multicomponent prevention strategies are needed.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Concordance Between the Suicide Crisis Syndrome Checklist (SCS-C) and Revised Suicide Crisis Inventory (SCI-2).","authors":"Erin Wheeler, Lisa J Cohen, Sarah Bloch-Elkouby, Rawad El Hayek, Yael Apter Levy, Victoria Witerska, Igor Galynker","doi":"10.1027/0227-5910/a001064","DOIUrl":"10.1027/0227-5910/a001064","url":null,"abstract":"<p><p><b></b> <i>Background:</i> The suicide crisis syndrome (SCS) is a proposed diagnostic construct under consideration for inclusion in DSM as a suicide-specific syndrome. The SCS is an acute affective-cognitive state, characterized by entrapment (Criterion A), affective disturbances (Criterion B1), loss of cognitive control (B2), hyperarousal (B3), and social withdrawal (B4). Suicidal ideation is not a criterion. While psychometrically valid self-report measures of SCS are well-established, the need for a psychometrically valid interview remains. A clinician-administered tool is essential for broader clinical use and dissemination. <i>Aims:</i> This study assesses the convergent validity of the Suicide Crisis Syndrome Checklist (SCS-C), a semistructured interview, relative to the Revised Suicide Crisis Inventory (SCI-2), a validated dimensional self-report measure. The goals of this study are: (1) to evaluate the convergent validity of the Suicide Crisis Syndrome Checklist (SCS-C) against SCI-2 and (2) to evaluate classification configurations of SCS-C criteria based on sensitivity and specificity. <i>Method:</i> In a sample of 217 adult psychiatric inpatients, receiver operating characteristic curve (ROC) analyses investigated each individual SCS-C criterion and configurations of criteria (e.g., inclusion of one, two, three, or all four B criteria) for concordance with SCI-2. Sensitivity and specificity values corresponded to the score with the highest Youden's <i>J</i>. <i>Results:</i> The first four SCS-C criteria showed good concordance with corresponding subscale scores (AUC = .794 - .866) while the final criterion, B4 Social Withdrawal, showed weaker alignment (AUC = .716). A configuration of Criterion A plus three B Criteria demonstrated particularly strong concordance (AUC = .800, sensitivity = .861, specificity = .654). <i>Limitations:</i> Recruiting from an acute inpatient setting and administering via research assistants, potentially affecting generalizability, and not conducting further construct validity tests. <i>Conclusions:</i> Findings support the convergent validity of the SCS-C and suggest at present the SCS-C corresponds most closely with the SCI-2 when utilizing four of the five criteria.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":"357-364"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Fluidity, Connectedness, and Suicidal Thoughts Among Adolescents.","authors":"John Gunn, Maria Warnick, Lauryn Hoy","doi":"10.1027/0227-5910/a001038","DOIUrl":"10.1027/0227-5910/a001038","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Sexual fluidity (SF) is common among adolescence and has been previously linked to experiences of psychological distress and suicidal thoughts (ST). <i>Aims:</i> To explore the relationship SF and ST in adolescence while accounting for the impact of school belonging, social connectedness, and parental relationships. <i>Methods:</i> Using W1 and W2 of the ADD Health, participants were categorized into four groups: (1) consistently heterosexual, (2) SF sexual minority (SM) to heterosexual, (3) SF heterosexual to SM, and (4) SM at both waves. <i>Results:</i> Hierarchical logistic regression revealed that sexual fluidity between Waves 1 and 2 was associated with ST with those in the SM-SM group and Het-SM group. However, after accounting for social connectedness, school belonging, and parental relationship, the risk among the sexually fluid group (Het-SM) was no longer significant. Additionally, mediation analysis found that there were no significant indirect effects of sexual fluidity on suicidal thoughts. <i>Limitations:</i> ADD Health W1 and W2 are from the mid-1990s, SM questions are limited in responses, and there are no direct questions relevant to sexual fluidity. <i>Conclusion:</i> Findings suggest that sexual fluidity is related to suicidal thoughts only through its shared relationship with belongingness and connectedness variables. Greater reporting of belonging and connectedness was associated with reductions in reporting of suicidal thoughts.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":"304-312"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Reliable Are Official Annual Suicide Numbers in Sri Lanka?","authors":"Manjula Weerasinghe, Ayanthi Karunarathne, Chris Metcalfe, Flemming Konradsen, Hashan Jayawickrama, Keith Hawton, Matthew Miller, Nimal Kumarasinghe, Pramila Hashini, Sandamali Rajapaksha, Shu-Sen Chang, Suneth Agampodi, Thilini Agampodi, Michael Eddleston","doi":"10.1027/0227-5910/a001060","DOIUrl":"10.1027/0227-5910/a001060","url":null,"abstract":"<p><p><b></b> <i>Background:</i> The World Health Organization (WHO) emphasizes surveillance of suicide and suicide attempts as a core component of national suicide prevention strategies. <i>Aims:</i> In Sri Lanka, police registers serve as the main source for national suicide reporting. This study evaluated the completeness of police suicide records by linking them with hospital and civil registration data and examining the extent to which suicide deaths identified across these sources were captured in police registers. <i>Method:</i> A secondary analysis was conducted on a case series of suicides identified through a prospective surveillance system established for a randomized controlled trial in Anuradhapura District, Sri Lanka (April 2019-September 2023). Police records were linked with hospital and civil registration data. Sensitivity and 95% confidence intervals (CIs) were calculated overall and stratified by hospital admission status and method of suicide. <i>Results:</i> A total of 663 suicide deaths were identified across the three sources, with 310 reported by all. Police registers recorded 615 deaths, with a sensitivity of 91.0% (95% CI: 86.8%-93.8%) for hospital deaths and 94.0% (95% CI: 91.2%-95.8%) for nonhospital deaths. Method-specific sensitivity was 93.2% (95% CI: 89.1%-95.8%) for pesticide ingestion (n = 237), 70.7% (95% CI: 55.5%-82.6%) for nonpesticide poisoning (<i>n</i> = 41), 97.3% (95% CI: 94.8%-98.7%) for hanging (<i>n</i> = 336), and 77.6% (95% CI: 63.6%-87.0%) for other methods (<i>n</i> = 49). <i>Limitations:</i> Findings are limited to one district and may not be generalizable nationally. <i>Conclusions:</i> Police registers are a largely comprehensive source of suicide data in Sri Lanka, although some cases are missed, particularly for less common methods. This underreporting suggests national suicide rates may be slightly underestimated. In countries lacking a WHO-recommended robust civil registration and vital statistics system, police data remain an important source for suicide surveillance and public health planning.</p>","PeriodicalId":47943,"journal":{"name":"Crisis-The Journal of Crisis Intervention and Suicide Prevention","volume":" ","pages":"351-356"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}