Exposure to Suicide in the Community: Prevalence and Correlates in One U.S. State

Cerel, Julie; Maple, Myfanwy; Venne, Judy van de; Moore, Melinda; Flaherty, Christopher; Brown, Margaret

doi:10.1177/003335491613100116

Cited by 158 publications

(123 citation statements)

References 15 publications

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“…Although some previous studies have asked about respondents’ intentions to assist a person at risk of suicide, this risk has always been overtly expressed, despite most suicide communications being indirect (Shand et al., ; Wasserman et al., ; Wolk‐Wasserman, ). Given the high number of community members exposed to close family members or friends at risk of suicide (Cerel et al., ; Maple et al., ), it is imperative to understand whether community members can recognize indirect signs of suicide risk and respond accordingly. Our findings show that both indirect and direct verbal suicide communications increase the likelihood of community members intending to assist the person at risk in getting professional help, and asking about suicidal thoughts, suggesting some recognition of indirect verbal suicide communications.…”

Section: Discussionmentioning

confidence: 99%

Confidence and Intentions to Help a Person at Risk of Suicide

Nicholas

Pirkis

Rossetto

et al. 2019

Suicide & Life Threat Behav

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Objective We aimed to identify Australian adults’ current level of confidence and intentions to help a person close to them in distress or at risk of suicide to inform the content and targeting of suicide prevention messages aimed at family and friends of those at risk. Methods We conducted a nationally representative computer‐assisted telephone survey of confidence and intentions to help someone in distress or at risk of suicide (n = 3,002). We used logistic regression to determine whether sociodemographic and exposure variables predicted confidence and intentions to help. Results Confidence to help was high. About half of the respondents had intentions inconsistent with best practice. Listening and talking, and encouraging the person to seek professional help were the most common types of intended helping actions. Intentions to ask suicide risk assessment questions were least common. Men were more likely than women to have intentions to carry out nonrecommended actions, and less likely to have intentions to carry out recommended actions. Conclusions Suicide prevention messaging aimed at family and friends could encourage them to ask direct questions about suicide risk and could include messages about “what not to do.” Suicide prevention messages aimed specifically at men are indicated.

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Section: Discussionmentioning

confidence: 99%

Confidence and Intentions to Help a Person at Risk of Suicide

Nicholas

Pirkis

Rossetto

et al. 2019

Suicide & Life Threat Behav

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“…It is estimated that for every suicide, 6–10 people are profoundly affected and may be at risk for suicidal behaviors. 28,29 Nearly half of veterans report knowing someone who died by suicide, 30 with 65% of those knowing more than one decedent. 31 Exposure to suicide death (“knowing of,” knowing, or identifying with the person who died by suicide 32 ) has been shown to predict subsequent suicide ideation and attempts in veterans and civilians, 31,33 highlighting the importance of this risk factor among servicemembers.…”

Section: Discussionmentioning

confidence: 99%

Risk of Suicide Attempt Among Soldiers in Army Units With a History of Suicide Attempts

et al. 2017

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Objective Soldiers’ mental health is adversely affected by the death and injury of other unit members, but it is not known if risk of suicide attempt is influenced by previous suicide attempts in one’s unit. Method Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records for all active duty Regular Army enlisted soldiers who attempted suicide from 2004–2009 (n=9,650) and an equal-probability sample of control person-months (n=153,528). Logistic regression analyses examined the number of past-year suicide attempts in one’s unit as a predictor of subsequent suicide attempt, controlling for socio-demographics, service-related characteristics, prior mental health diagnosis, and other unit variables, including suicide-, combat-, and accident-related unit deaths. We also examined whether the influence of previous unit suicide attempts varied by military occupational specialty (MOS) and unit size. Results In adjusted models, soldiers were more likely to attempt suicide if one or more suicide attempts occurred in their unit during the past year (OR=1.4–2.3; p<0.001), with odds increasing as the number of unit attempts increased. The odds of suicide attempt among soldiers in a unit with five or more past-year attempts was more than twice that of soldiers in a unit with no previous attempts (OR=2.3; 95% CI=2.1–2.6). The association of previous unit suicide attempts with subsequent risk was significant whether soldiers had a combat arms MOS or other MOS (OR=1.4–2.3; p<0.001). It was also significant regardless of unit size, with the highest risk for those in smaller units (1–40 soldiers) (OR=2.1–5.9; p<0.001). The population-attributable risk proportion for one or more unit suicide attempts in the past year indicated that if this risk could be reduced to no unit attempts, 18.2% of attempts would not occur. Conclusions Soldiers’ risk of suicide attempt increased as the number of past-year suicide attempts within their unit increased. This was true for both combat arms and other MOSs, and for units of any size, but particularly for smaller units. Units with a history of suicide attempts may be important targets for preventive interventions.

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“…Utilizing random‐digit dial data from a single U.S. state sample of 1,736 adults, we reported that almost half of participants (48.3%) reported lifetime exposure to suicide (Cerel et al., ). Suicide‐exposed individuals were more likely than nonsuicide exposed to report suicide ideation (9.0% vs. 5.3%).…”

mentioning

confidence: 99%

How Many People Are Exposed to Suicide? Not Six

Cerel

Brown

Maple

et al. 2018

Suicide & Life Threat Behav

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302

153

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It has long been stated that six people are left behind following every suicide. Despite a lack of empirical evidence, this has been extensively cited for over 30 years. Using data from a random-digit dial survey, a more accurate number of people exposed to each suicide is calculated. A sample of 1,736 adults included 812 lifetime suicide-exposed respondents who reported age and number of exposures. Each suicide resulted in 135 people exposed (knew the person). Each suicide affects a large circle of people, who may be in need of clinician services or support following exposure.

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Exposure to Suicide in the Community: Prevalence and Correlates in One U.S. State

Abstract: Exposure to suicide is pervasive and occurs beyond family; as such, it is imperative to identify those with perceived closeness to the decedent. This hidden cohort of suicide-exposed people is at elevated risk for psychopathology and suicidal ideation.

Cited by 158 publications

References 15 publications

Confidence and Intentions to Help a Person at Risk of Suicide

Confidence and Intentions to Help a Person at Risk of Suicide

Risk of Suicide Attempt Among Soldiers in Army Units With a History of Suicide Attempts

How Many People Are Exposed to Suicide? Not Six

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