Searching for suicide methods:Accessibility of information about helium as a method of suicide on the Internet

Abstract. Background: Helium gas suicides have increased in England and Wales; easy-to-access descriptions of this method on the Internet may have contributed to this rise. Aims: To investigate the availability of information on using helium as a method of suicide and trends in searching about this method on the Internet. Method: We analyzed trends in (a) Google searching (2004–2014) and (b) hits on a Wikipedia article describing helium as a method of suicide (2013–2014). We also investigated the extent to which helium was described as a method of suicide on web pages and discussion forums identified via Google. Results: We found no evidence of rises in Internet searching about suicide using helium. News stories about helium suicides were associated with increased search activity. The Wikipedia article may have been temporarily altered to increase awareness of suicide using helium around the time of a celebrity suicide. Approximately one third of the links retrieved using Google searches for suicide methods mentioned helium. Conclusion: Information about helium as a suicide method is readily available on the Internet; the Wikipedia article describing its use was highly accessed following celebrity suicides. Availability of online information about this method may contribute to rises in helium suicides. </jats:p

Method-specific suicide rates and accessibility of means:a small-area analysis in Taipei City, Taiwan

Abstract. Background: Few studies have investigated whether means accessibility is related to the spatial distribution of suicide. Aims: To examine the hypothesis that indicators of the accessibility to specific suicide methods were associated with method-specific suicide rates in Taipei City, Taiwan. Method: Smoothed standardized mortality ratios for method-specific suicide rates across 432 neighborhoods and their associations with means accessibility indicators were estimated using Bayesian hierarchical models. Results: The proportion of single-person households, indicating the ease of burning charcoal in the home, was associated with charcoal-burning suicide rates (adjusted rate ratio [aRR] = 1.13, 95% credible interval [CrI] = 1.03–1.25). The proportion of households living on the sixth floor or above, indicating easy access to high places, was associated with jumping suicide rates (aRR = 1.16, 95% CrI, 1.04–1.29). Neighborhoods’ adjacency to rivers, indicating easy access to water, showed no statistical evidence of an association with drowning suicide rates (aRR = 1.27, 95% CrI = 0.92–1.69). Hanging and overall suicide rates showed no associations with any of these three accessibility indicators. Limitations: This is an ecological study; associations between means accessibility and suicide cannot be directly inferred as causal. Conclusion: The findings have implications for identifying high-risk groups for charcoal-burning suicide (e.g., vulnerable individuals living alone) and preventing jumping suicides by increasing the safety of high buildings

Psychiatric morbidity and suicidal behaviour in low- and middle-income countries: a systematic review and meta-analysis

Background: Psychiatric disorders are reported to be present in 80-90% of suicide deaths in high-income countries (HIC), but this association is less clear in low- and middle-income countries (LMIC). There has been no previous systematic review of this issue in LMIC. The current study aims to estimate the prevalence of psychiatric morbidity in individuals with suicidal behaviour in LMIC. Methods and findings: PubMed, PsycINFO, and EMBASE searches were conducted to identify quantitative research papers (any language) between 1990 and 2018 from LMIC which reported on the prevalence of psychiatric morbidity in suicidal behaviour. We used meta-analytic techniques to generate pooled estimates for any psychiatric disorder and specific diagnosis based on ICD-10 criteria. A total of 112 studies (154 papers) from 26 LMIC (India: 25%; China: 15%; and Other LMIC: 60%) were identified, including 18 non-English articles. They included 30030 individuals with non-fatal suicidal behaviour and 4996 individuals who had died by suicide. Of the 15 studies (5 LMIC) that scored highly on our quality assessment, prevalence estimates for psychiatric disorders ranged between 30% and 80% in suicide deaths, and between 3% and 86% in those who engaged in non-fatal suicidal behaviour. There was substantial heterogeneity between study estimates. Fifty-eight percent (95% CI 46-71%) of those who died by suicide and 45% (95% CI 30-61%) of those who engaged in non-fatal suicidal behaviour had a psychiatric disorder. The most prevalent disorder in both fatal and non-fatal suicidal behaviour was mood disorder (25% and 21% respectively). Schizophrenia and related disorders were identified in 8% (4-12%) of those who died by suicide and 7% (3-11%) of those who engaged in non-fatal suicidal behaviour. In non-fatal suicidal behaviour, anxiety disorders, and substance misuse were identified in 19% (1-36%) and 11% (7-16%) of individuals respectively. This systematic review was limited by the low number of high-quality studies and restricting our searches to databases which mainly indexed English language journals. Conclusions: Our findings suggest a possible lower prevalence of psychiatric disorders in suicidal behaviour in LMIC. We found very few high-quality studies and high levels of heterogeneity in pooled estimates of psychiatric disorder, which could reflect differing study methods or real differences. There is a clear need for more robust evidence in order for LMIC to strike the right balance between community-based and mental health focused interventions