Symposium examines suicide drivers, prevention | news

November 10, 2022 — Suicide is a preventable tragedy — but there’s still work to be done to find the best strategies for doing it, according to experts speaking at a Nov. 4 symposium on the subject at Harvard TH Chan School of Public Health languages ​​.

At the 14thth Kolokotrone’s symposium – titled “Suicide Prevention: How do we know what we know and how can we know more?” – researchers discussed the importance of learning more about how, when and where suicide occurs; who is most at risk; and what types of interventions work best to stave off suicidal thoughts.

The event, held in person at the Kresge Building’s Snyder Auditorium and also online, was hosted by CAUSALab, a center focused on identifying the root causes of various health problems and providing informed data to support decision makers.

“Suicide is a great tragedy that affects the majority of society in one way or another,” said Barbra Dickerman, assistant professor of global cancer prevention at Harvard Chan School, who chaired the morning session of the symposium. “The effects of suicide are far-reaching and long-lasting. The grief and stigma that comes with it can haunt families, communities, and generations after each suicide death. Importantly, evidence suggests that suicide is a preventable outcome, which means improving our understanding of what works to prevent suicide is an important public health priority.”

suicide statistics

Columbia University’s Katherine Keyes spoke about recent trends in suicide. She found that worldwide one person dies by suicide every 40 seconds, with a conservative estimate putting the global figure at 800,000 a year. For women, the highest suicide rates are in Southeast Asia and South Asia, and for men in Eastern Europe, although all of these rates have declined.

In the US, deaths from suicide fell in the 1990s, but began to rise again in the early 2000s, increasing by 30% through 2018. Suicide risk has been high among middle-aged men – likely due to increasing loneliness, separation and changing economic conditions – and most of these deaths involve firearms. Racial minorities, especially black and Asian men, are also at higher risk compared to other groups. Suicidal deaths are less common in women. Thoughts of suicide are very common – for example, it was estimated that about 20% of teens in the US in 2019 were thinking about it. “But fortunately,” Keyes said, “death by suicide is much less common than the thought of suicide or a suicide attempt.”

Many factors play a role in suicide risk, Keyes said, including psychiatric history, family history, demographics, seasonal changes, temperature, elevation and economic conditions. Some increase in suicides has been linked to media coverage; She noted, for example, that the numbers skyrocketed after Robin Williams’ suicide, leading to an estimated 1,800 additional deaths, mostly among men the same age as Williams. Suicidal clusters have also emerged among teenagers and young adults in the United States over the past two decades, Keyes said.

Interestingly, she said, the pandemic doesn’t seem to have a major impact on suicide. An analysis of 33 countries found that although there has been an increase in some parts of the world – notably Japan – most countries have either seen no significant changes in suicide rates or have seen a decrease during the pandemic. “It’s not what we expected, which is good news,” Keyes said.

Because suicidal crises are typically very short—the window between the decision to attempt suicide and suicide death is often less than an hour—it can be difficult for healthcare professionals to identify patients at risk. But experts also know that having access to firearms makes suicide attempts far more deadly, so limiting gun access is critical, Keyes said.

Guns and Suicide

Matthew Miller, a Northeastern University professor and co-director of the Harvard Injury Control Research Center, echoed the sentiment about the risk of suicide from guns. Of the nearly 46,000 suicides in the US in 2020, more than half were due to firearms, he said. Suicide rates are highly correlated with both gun ownership rates and living in a gun-fired household. Interventions that could result in fewer people becoming gun owners — and more ex-owners — would save many lives, Miller said.

Kate Bentley of Harvard Medical School outlined different types of psychosocial interventions that help people cope with suicidal thoughts and behavior, such as psychotherapy. But research has shown that all types of psychosocial interventions combined did not make much of a difference in suicide rates. “These results speak to the need for us to work more to refine our interventions and also to develop newer approaches,” she said.

Another promising way to reduce suicides, according to Matthew Nock of Harvard University, is “just-in-time” interventions. Healthcare providers could recommend patients to use smartphone or smartwatch apps that can track what’s happening to them moment-to-moment as they move in and out of suicidal episodes, giving the opportunity to intervene before they do are high risk, he said. For example, an app on a vulnerable person’s phone could ask several times a day if they are considering suicide, and if danger is imminent, the app could provide the number of a crisis hotline. Smart devices could also passively monitor how often a person calls or texts friends, or what their heart rate is. Such information could help shed light on when people are at greatest risk of suicide. “We’re trying to get better at real-time risk monitoring,” said Nock.

Gonzalo Martinez-Alés and Alejandro Szmulewicz – both psychiatrists and postdocs at CAUSALab – discussed drugs that can help manage suicidal crises. And Philip Wang of Harvard Medical School described how machine learning could be used to diagnose patients and assess their risk of suicide. With access to a wide range of digital data – such as Such as a person’s previous mental health problems, history of drug use, or problems at school or with the criminal justice system – computers could make quick diagnoses and assessments, and advise healthcare providers on patient care via screen pop-ups.

In a final panel chaired by Miguel Hernán, director of CAUSALab and Kolokotrones Professor of Biostatistics and Epidemiology, Nock said much more research on suicide prevention is needed. “We haven’t made much progress as suicide researchers, so I think new approaches are needed,” he said. “We would love to see people join this effort.”

Kolokotrones Symposium_Suicide Prevention
From left: Philip Wang, Matthew Miller, Matthew Nock, Kate Bentley, Katherine Keyes, Miguel Hernan

Karen Feldscher

Feature photo: Kent Dayton


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