Connectedness and Suicide Prevention in Adolescents: Pathways and Implications

Adolescent suicide is a major public health concern. Stressing the need for public health–based solutions, the Centers for Disease Control and Prevention identified “connectedness” as one means of pursuing this agenda. To advance this effort in suicide prevention with adolescents, (1) consistencies and variation in the literature overtly linking connectedness to suicide thoughts and behaviors (STB) are reviewed, (2) three more specific mechanistic pathways are proposed whereby connectedness may influence STB, and (3) several implications related to use of connectedness as a public health framework for adolescent suicide prevention and intervention are outlined.     

Identifying and Referring Youths at Risk for Suicide Following Participation in School‐Based Gatekeeper Training

Gatekeeper training is a core strategy of the Garrett Lee Smith Memorial Suicide Prevention Act of 2004. Using data gathered from school‐based gatekeeper trainings implemented by GLS grantees, this analysis examines training and gatekeeper factors associated with (1) identification and referral patterns and (2) services at‐risk youths receive. Time spent interacting with youths was positively correlated with the number of gatekeeper identifications and knowledge about service receipt. Gatekeepers who participated in longer trainings identified proportionately more at‐risk youths than participants in shorter trainings. Most gatekeeper trainees referred the identified youths to services regardless of training type.     

Awareness Effects of a Youth Suicide Prevention Media Campaign in Louisiana

Research on the efficacy of mediated suicide awareness campaigns is limited. The impacts of a state‐wide media campaign on call volumes to a national hotline were analyzed to determine if the advertisements have raised awareness of the hotline. We use a quasi‐experimental design to compare call volumes from ZIP codes where and when the campaign is active with those where and when the campaign is not active. Multilevel model estimates suggest that the campaign appears to have significantly and substantially increased calls to the hotline. Results from this study add evidence to the growing public health literature that suggests that mediated campaigns can be an effective tool for raising audience awareness.     

章学诚《易教》篇与六艺一体论——兼论易学与章学诚的学术精神

章学诚的学术精神有两点特别突出: 一是贯通,二是经世致用。章学诚以《周易》的贯通精神来总论文史,认为六经皆先王之政典,所以六经皆史,亦即六经皆礼; 文由史出,故六经皆文; 易象包六艺,故六经皆象。"一阴一阳之谓道",六经皆器,皆为道之用。道不离器,器随历史而变,道也是不断完善的。即器以明道,六经显现的是古代先王之道,应当贯通一体来认识,方可得古代道术之全; 而后世欲明治道,也要本此贯通精神来随时撰述以究大道,方为史学明道经世之学术目的与精神之所在。     

Risk‐Related and Protective Correlates of Nonsuicidal Self‐Injury and Co‐Occurring Suicide Attempts among Incarcerated Women

Individual and environmental correlates of nonsuicidal self‐injury (NSSI) and co‐occurring suicide attempts (SA) among incarcerated women (N = 104) were examined. Participants completed measures of putative risk and protective factors, including coping styles, childhood maltreatment, and hopelessness. Results indicated that active coping was uniquely, negatively associated with the presence and frequency of NSSI, whereas avoidant coping and childhood physical/emotional abuse were positively associated with NSSI frequency. Conversely, among women with a history of NSSI, hopelessness was uniquely, positively associated with the presence and frequency of SA. Further, childhood sexual abuse was associated with the presence of SA, while physical/emotional abuse was associated with SA frequency. Hopelessness was more strongly related to SA frequency than NSSI frequency. These findings help disentangle the unique risk and protective factors for NSSI and co‐occurring SA in incarcerated samples.     

Stigma,Attitudes, and Help‐Seeking Intentions for Psychological Problems in Relation to Regional Suicide Rates

In this ecological study, we investigated whether help‐seeking related to stigma, intentions, and attitudes toward suicide are associated with the suicide rates of 20 regions within the Netherlands and Belgium. Significant associations were found between regional suicide rates and the intention to seek informal help (β = ?1.47, p = .001), self‐stigma (β = 1.33, p = .038), and shame (β = .71, p = .030). The association between self‐stigma and suicide rate was mediated by intentions to seek informal help. These results suggest that to promote suicide prevention at the level of the regional population, stigma, shame, and intentions to seek help should be targeted in the public domain.     

The Change in Suicide Rates between 2002 and 2011 in China

Chinese suicide rates have been reported in various studies in the past two decades, but few of them were based on national data. The most recent mortality data (2002–2011) provided by the China Ministry of Health and the detailed census data provided by the National Population Census were used in this study. We calculated the age‐, gender‐, and region‐specific suicide rates and their trends in the past 10 years between 2002 and 2011. The overall suicide rates in China decreased during the study period. The rural/urban ratio of the suicide rates has been significantly reduced from the ratio in the 1990s, and male suicide rates have exceeded those of females. Age was positively associated with suicide rates without the two peaks found in the suicide rates over 20 years ago. The Chinese suicide rates have significantly declined in the past decade, with withering of the unique suicide rate patterns previously found in Chinese suicides about 20 years ago.     

Treating the Capability for Suicide: A Vital and Understudied Frontier in Suicide Prevention

Current efforts at suicide prevention center largely on reducing suicidal desire among individuals hospitalized for suicidality or being treated for related psychopathology. Such efforts have yielded evidence‐based treatments, and yet the national suicide rate has continued to climb. We propose that this disconnect is heavily influenced by an unmet need to consider population‐level interventions aimed at reducing the capability for suicide. Drawing on lessons learned from other public health phenomena that have seen drastic declines in frequency in recent decades (HIV, lung cancer, motor vehicle accidents), we propose that current suicidality treatment efforts trail current suicidality theories in their lack of focus on the extent to which individuals thinking about suicide are capable of transitioning from ideation to attempt. We summarize extant evidence for specific capability‐centered approaches (e.g., means safety) and propose other options for improving our ability to address this largely overlooked variable. We also note that population‐level approaches in this regard would represent an important opportunity to decrease risk in individuals who either lack access to evidence‐based care or underreport suicidal ideation, as a reduced capability for suicide would theoretically diminish the potency of suicidal desire and, in this sense, lower the odds of a transition from ideation to attempt.