Campus Student Suicide Rates: Fact or Artifact?

A review of all English-language studies (14 foreign and 17 American) on campus student suicides was undertaken. Only studies reporting original data and containing sufficient demographic information to compute standard mortality rates (SMR) or crude suicide rates were analyzed and organized into single-site studies. Only 4 single-site studies had a higher suicide rate than the comparable populations. Multiple-site collaborative studies done in the United States since 1960 strongly suggest a campus student suicide rate significantly less than in the matched control population. However, deficiencies in case finding, case definition, sampling bias, and statistical techniques may place these conclusions in doubt. The author outlines research methods that might be applied to future multiple-site studies to resolve questions related to late adolescent and young adult suicidal behavior on campus and in other similar educational settings.     

The Self‐Directed Violence Classification System and the Columbia Classification Algorithm for Suicide Assessment: A Crosswalk

The lack of a standardized nomenclature for suicide‐related thoughts and behaviors prompted the Centers for Disease Control and Prevention, with the Veterans Integrated Service Network 19 Mental Illness Research Education and Clinical Center, to create the Self‐Directed Violence Classification System (SDVCS). SDVCS has been adopted by the Department of Veterans Affairs and the Department of Defense. Another classification system, the Columbia Classification Algorithm for Suicide Assessment, has been recommended by the Food and Drug Administration. To facilitate the use of both systems, this article provides a “crosswalk” between the two classification systems.     

Suicide Risk Assessment and Risk Formulation Part II: Suicide Risk Formulation and the Determination of Levels of Risk

The suicide risk formulation (SRF) is dependent on the data gathered in the suicide risk assessment. The SRF assigns a level of suicide risk that is intended to inform decisions about triage, treatment, management, and preventive interventions. However, there is little published about how to stratify and formulate suicide risk, what are the criteria for assigning levels of risk, and how triage and treatment decisions are correlated with levels of risk. The salient clinical issues that define an SRF are reviewed and modeling is suggested for an SRF that might guide clinical researchers toward the refinement of an SRF process.