Homicide Followed by Suicide: A Comparison with Homicide and Suicide

Homicide‐suicides are a rare yet very serious form of lethal violence which mainly occurs in partnerships and families. The extent to which homicide‐suicide can be understood as being primarily a homicide or a suicide event, or rather a category of its own is examined. In total, 103 homicide‐suicides were compared to 3,203 homicides and 17,751 suicides. These are all events that took place in the Netherlands in the period 1992 to 2006. Logistic regression analyses show that homicide‐suicides significantly differ from both homicides and suicides with regard to sociodemographic and event characteristics. The findings suggest that homicide‐suicide might be considered as a distinct phenomenon from both homicide and suicide.     

Disentangling the Person and the Place as Explanations for Regional Differences in Suicide

Identifying whether suicides in a region are due to characteristics of the residents living there or to some enduring feature of the region is difficult when using cross‐sectional studies. To distinguish these factors, we compared the suicides of a region's residents with people who were temporarily visiting the region. Using U.S. death records from 1973–2004, we focused on states with the highest and lowest suicide rates over this period. The high suicide region consisted of Arizona, Colorado, Montana, New Mexico, Nevada, Oregon, and Wyoming; the low suicide region consisted of Connecticut, Illinois, Massachusetts, New Jersey, and New York. For each region, we considered three groups of decedents: residents who died inside the region, residents who died outside the region, and visitors to the region. Proportionate mortality ratios were calculated for all suicides and separately for firearm suicides. In the high suicide region, visitors to and residents away from the region both had elevated suicide levels, to about the same extent as residents dying inside the region. Therefore, short‐term exposure to the region and being a resident of the region each predicted suicide. In the low suicide region, the suicides of residents at home were reduced, but their suicides rose dramatically once they left the area. There was no decrease in suicides among visitors to the region. Firearm use was related to the suicide levels of each region. Overall, the results suggest that both the available means to commit suicide and the contextual features of the regions contributed to their extreme suicides. We discuss how an examination of visitors can help researchers generate novel inferences about the causes of suicide.     

Bringing the Public Health Approach to the Problem of Suicide

Suicide and suicidal behavior are public health problems that should be addressed through a systematic public health approach. The need for such an approach can be found, for example, in Pierre, SD, where the suicide rate is 13 times the national rate; in the African American community, where the suicide rate among Black youths more than doubled between 1980 and 1995; and across the United States, where suicides outnumbered homicides in 1995. The U.S. Public Health Service is applying the public health approach to suicide by preparing the first-ever Surgeon General's Report on Mental Health, and by holding an October conference in Reno aimed at advancing a national strategy for suicide prevention.     

The Kurt Cobain Suicide Crisis: Perspectives from Research,Public Health,and the News Media

The suicide of rock star Kurt Cobain in 1994 raised immediate concerns among suicidologists and the public at large about the potential for his death to spark copycat suicides, especially among vulnerable youth. The Seattle community, where Cobain lived and died, was especially affected by his sudden death. An overview of Cobain's life and death is presented and various crisis center and community-based interventions that occurred are discussed. Preliminary data collected from the Seattle Medical Examiner's Office and from the Seattle Crisis Center to assess the potential impact of Cobain's death on completed suicides and the incidence of suicide crisis calls are presented. The data obtained from the Seattle King County area suggest that the expected “Werther effect” apparently did not occur, but there was a significant increase in suicide crisis calls following his death. It is hypothesized that the lack of an apparent copycat effect in Seattle may be due to various aspects of the media coverage, the method used in Cobain's suicide, and the crisis center and community outreach interventions that occurred. The Cobain suicide and the role of media influence on copycat suicides are further discussed in commentaries from public health and news media perspectives.     

Violent death in the West: suicide and homicide in New Mexico, 1958-1987

We examined New Mexico vital statistics data for suicides and homicides among the state's Hispanics, Native Americans, and non-Hispanic whites collected from 1958 to 1987. We found high age-adjusted rates for both suicides and homicides among Hispanic and Native American males, in comparison with rates for non-Hispanic white males. Suicide rates among Native American women were comparatively low, contrasting with their high homicide rates. Homicide rates for males in all three ethnic groups increased substantially over the 30-year study period. We conclude that death from violent causes, both suicide and homicide, is a major public health problem in New Mexico, and disproportionately affects minority males.     

Patterns of suicide among hospitalized mentally disordered offenders

The case records of 29 mentally disordered offenders who committed suicide in a state hospital were reviewed. Information was collected on demographic and clinical characteristics; time, method and location of the suicides; and the presence of suicide indicators. Comparisons were made between the characteristics of the suicide patients and those of the current hospital population. Major findings were: 80 percent of the suicides were committed by psychotic patients and 66 percent were by patients with diagnoses which included paranoia; 48 percent of the suicide patients had been charged with or convicted of murder or attempted murder; most suicides occurred in individual patient rooms; nearly 50 percent of the patients had a history of suicide attempts; and other common indicators of suicide risk were often masked by psychotic symptomatology. Several recommendations for identifying and managing potentially suicidal patients in this population are presented.     

Rational suicide?

Abstract

Two competing paradigms of suicide imply different views of whether suicide can be rational. The first, the “received orthodoxy” of mental health professionals for more than a century, views all suicides as irrational and holds that suicidal persons should always be prevented from ending their own lives. The second grants that most suicides are irrational, but claims suicide may sometimes be a rational option. Lokhandwala and Westefeld's argument manifests the conflict between these two paradigms: After initially granting that suicide may be a rational option for some people, they in effect urge mental health professionals to presume in practice that any suicidal patient is irrational. Patients for whom suicide might indeed be rational will be ill-served by mental health professionals who follow Lokhandwala and Westefeld's advice.     

Financial Debt and Suicide in Hong Kong SAR1

The presence of indebtedness is known to be a risk factor that can trigger stressed persons to contemplate suicide. This study compares the profiles of suicides with and without debt problems based on 2002 Coroner's Court death files. The category of men aged 25–39 has seen a 70% increase in suicide rate since 1997, and the number using carbon monoxide poisoning has increased from 1% of the total deaths in 1997 to about 26% of the total deaths in 2002. Suicides associated with debt problems seem to involve fewer mental and physical problems with formal job attachment than do suicides without debt problems. Gambling is a significant contributing factor to unmanageable indebtedness.     

Gender and Suicide in India: A Multiperspective Approach

The gap between male and female suicide rates in India is relatively small. However, society's views on female and male motives are quite different. In order to investigate the perceptions of male and female suicide, we interviewed a focus group of university professors as well as police inspectors, crime reporters, and hospital nurses in Bangalore. We also obtained four narratives of suicide. Women tended to be blamed for their own or their husband's suicide, although they were also viewed more often as victims of life adversities than men. A historical review illustrates that both men and women have been associated with culturally sanctioned suicides. One known form is sati, and we discuss the recent case of sari-murder of Roop Kanwar in 1987. The social sciences and the media also pay a lot of attention to the typical female suicides, symbolizing their role as martyrs of society, which seems to compensate for attribution of blame.     

Nonresident Suicides in England: A National Study

Little is known about the numbers and characteristics of people who travel away from home before dying by suicide. Therefore, this studied attempts to identify the sociodemographic characteristics, location, and method of suicide in people who died distant from home, in a national sample. Data were collected on all English suicides and a patient population; nonresident suicides resided in one Health Authority but died in a different one. Twelve percent of suicides were nonresident and features of these included: young age, social adversity, and severe mental illness. In conclusion, both individual‐ and area‐based factors are likely to contribute to suicide away from home.     

Creativity, depression and suicide.

The relationship between suicide and creativity has long been a subject of considerable concern. The author presents evidence indicating that in fact depression, suicide, and creativity are related. Several hypotheses for the relationship are posited. It is suggested that the same changes in the serotonergic system that are associated with depression in general and with impulsive suicides and homicides in the extreme may also be responsible for an element of risk taking that characterizes creativity and innovation in a person psychodynamically predisposed to being creative.     

Preventing suicide through improved training in suicide risk assessment and care: an American Association of Suicidology Task Force report addressing serious gaps in U.S. mental health training

There are twice as many suicides as homicides in the United States, and the suicide rate is rising. Suicides increased 12% between 1999 and 2009. Mental health professionals often treat suicidal patients, and suicide occurs even among patients who are seeking treatment or are currently in treatment. Despite these facts, training of most mental health professionals in the assessment and management of suicidal patients is surprisingly limited. The extant literature regarding the frequency with which mental health professionals encounter suicidal patients is reviewed, as is the prevalence of training in suicide risk assessment and management. Most importantly, six recommendations are made to address the longstanding insufficient training within the mental health professions regarding the assessment and management of suicidal patients.     

Can Shneidman's “Ten Commonalities of Suicide” Accommodate Rational Suicide?

Shneidman's (1985 ) commonly reproduced “Ten Commonalities of Suicide” cannot accommodate rational suicide, as the concept has been defined in recent literature, and therefore are not “commonalities” of all suicides. Quotes from Shneidman describing the “commonalities” are provided and selected items are briefly examined in light of one set of criteria for rational suicide. It is suggested that Shneidman's list, which is inherently biased against allowing for the possibility of rational suicide, be renamed so that its contents will not continue to be inappropriately used as evidence that suicide cannot be rational.     

Suicide in the army national guard: an empirical inquiry

Since 2004, suicides in the U.S. military have risen, most notably in the Army National Guard (ARNG). Data used in this study were obtained for suicides occurring from 2007 to 2010 and for a random sample of nonsuicides from the general ARNG population. Of the military-related variables considered, a few showed relationships to suicide. Rather, the primary variables associated with suicide were soldier background characteristics, including age (17-24 years), race (White), and gender (male). Cluster analysis revealed two distinct suicide groups: "careerists" (about one third of all suicides) and "first-termers" (about two thirds of all suicides), each group exhibiting different concurrent behavioral problems.     

2 Rick: A Suicide of a Young Adult

A small but concerning percentage of completed suicides are seen as having left no clues. The classical case, albeit a literary one, is Robinson's Richard Cory. These people often dissemble, even about their suicide risk. An even smaller group of these individuals present themselves in therapy without communicating a sign of suicide risk. Utilizing an idiographic approach, the case of a young adult male (Rick) is presented. The narrative reconstruction gives voice behind the man's mask. The autopsy reveals a young man who was in deep pain and unable to adjust to life's demands. Rick lacked ego strength, being overly narcissistic and having deeply troubled, symbiotic attachments to his family in a world of interpersonal isolation. In the end, even the help of his therapist, who tried to reach through the mask, was not enough and Rick killed himself. The pain had become unbearable. A few guiding remarks for such cases are offered, noting that therapists must constantly address the dissembling in some suicidal patients.     

A Follow-up Study of 53 Suicides Known to a Suicide Prevention Center

ABSTRACT: The operation of the Cleveland Suicide Prevention Center is reviewed, and 53 known suicides during the Center's first four years of operation are discussed. A suicide rate of 288 per 100,000 suggests that persons contacting the Center represented a high suicide risk group. Of the suicides, 57 percent were women. This high proportion of females was statistically significant when compared to the smaller percentage of female suicides for Cuyahoga County, Ohio. Of the persons who committed suicide, 26 percent initiated direct contact with the Center themselves, and none recontacted the Center just prior to death. The question is raised whether contact initiated by another may in itself be suggestive of greater suicidal risk. Some of the practical problems in evaluation and referral are discussed.     

Rates of homicide and suicide on major national holidays

Rates of U.S. homicides and suicides during 1972-1979 were higher on 7 major national holidays except one for homicides and were lower for suicides, except New Year's Day as Lester noted for 1972-1979.     

Health Problems and Male Firearm Suicide

Drawing on constructs of masculinity as it relates to both gun ownership and men's health, we use a rich data set, the New Jersey Violent Death Reporting System as well as hospital discharge data, to analyze 3,413 completed male suicides between the years of 2003 and 2009. We test the hypotheses that the use of firearms is more common when physical health problems are cited as suicide circumstances, and that suicide decedents who use firearms have poorer physical health than those who used other methods. Results show that firearms are disproportionately used in male suicides when physical health is listed as a circumstance. Additionally, among suicide decedents with a hospitalization during the 3 years prior to death, those who used firearms were in poorer health than those who used other methods. These findings have implications for prevention efforts, because restricting access to lethal means is an important aspect of suicide prevention.     

Culture,Gender, and Suicidal Behavior in Sri Lanka

In less than 50 years, the rate of suicide among Sri Lankans has risen from a modest level to one of the highest in the world. This article describes the current pattern of suicides, including sex differences and similarities, and reviews some of the institutional practices, material conditions, and social norms that may figure in the increases. A study is reported, which asked how ordinary Sri Lankans account for suicidal behavior and what practices they recommend for assisting suicidal individuals. Gender inflected these accounts, with essentialist accounts associated with women's suicides and contextual accounts associated with men's suicides.     

Gun availability and use of guns for suicide, homicide, and murder in Canada

A reliability check of Lester's (2000b) 1970-1995 time series that examined associations between the availability of firearms and their use for homicide and suicide in Canada. For the period 1974 to 1999, the relative availability of firearms as measured by the rate of accidental death from firearms and the average of the percentages of suicides + homicides using firearms was positively associated with the rate of homicide by firearms but not negatively associated with the rate of homicide by all other methods, and positively associated with the rate of suicide by firearms and negatively associated with the rate of suicide by all other methods. Correlations for the homicide versus murder rates, homicide rate using guns versus murder rate using guns, and homicide rate by all other methods versus murder rate by all other methods were very similar. There was a decrease over time of total suicide and homicide rates and firearm suicide and homicide rates, and with a slight indication of substitution of other methods for suicide.