Sociodemographic Analysis of Suicide Rates Among Older Adults Living in Ecuador: 1997–2019

Background: Despite most suicides occurring in low-and-middle-income countries (LAMICs), limited reports on suicide rates in older adults among LAMICs are available. In Ecuador, high suicide rates have been reported among adolescents. Little is known about the epidemiology of suicides among older adults in Ecuador.Aim: To examine the sociodemographic characteristics of suicides among older adults living in Ecuador from 1997 to 2019.Methods: An observational study was conducted using Ecuador's National Institute of Census and Statistics database from 1997 to 2019 in Ecuadorians aged 60 and older. International Classification of Diseases 10th Revision (ICD-10) (X60-X84)-reported suicide deaths were included in addition to deaths of events of undetermined intent (Y21-Y33). Sex, age, ethnicity, educational level, and method of suicide were analyzed. Annual suicide rates were calculated per 100,000 by age, sex, and method. To examine the trends in rates of suicide, Joinpoint analysis using Poisson log-linear regression was used.Results: Suicide rates of female older adults remained relatively stable between 1997 and 2019 with an average annual percentage increase of 2.4%, while the male rates increased between 2002 and 2009, 2014 and 2016, and maintained relatively stable within the past 3 years (2017–2019). The annual age-adjusted male suicide rate was 29.8 per 100,000, while the female suicide rate was 5.26 per 100,000 during the study period. When adding deaths of undetermined intent, the annual male rate was 60.5 per 100,000, while the same rate was 14.3 for women. The most common suicide method was hanging (55.7%) followed by self-poisoning (26.0%). The highest suicide numbers were reported in urban districts, men, and those with lower education status.Conclusion: This study contributes to building the baseline for further studies on suicide rates of older adults in Ecuador. Results highlight priority areas of suicide prevention. By examining suicide trends over 23 years, findings can help inform policy and future interventions targeting suicide prevention.

823Suicide of welfare and care support workers: a retrospective mortality study in Australia 2001-2016

Background Emerging evidence suggests that people working in the welfare and health care industry have poorer mental health than other occupational groups; however, there has been little examination of suicide among this group. In this study, we examine suicide rates amongst welfare and care support workers and compare them to rates among human service workers, and all other occupations in Australia. Methods We used data from the National Coroners Information System (NCIS) to obtain records of death due to intentional self-harm between the years 2001 to 2016. We calculated age-standardised suicide rates and incident rate ratios to compare the suicide rates across different occupational groups. Results The age-standardised suicide rate of males is the highest amongst welfare and carers (24.1 per 100,000). After adjusting for age and year of death, we found that men working as welfare workers and carers have a significantly higher suicide rate than men working in other occupations (IRR 1.43, CI 1.2-1.7). Furthermore, male human service workers have a slightly lower rate of suicide than those working in other occupations (IRR 0.73: CI 0.66-0.82). The finding was similarly noted in female suicide deaths, however, the higher suicide rate in female welfare workers was not statistically significant (IRR 1.12 CI 0.9-1.39). Conclusion The suicide rates of welfare and care-related occupations are as high as occupations which are identified as at-risk occupations for male suicide in Australia. Key message There is a need for targeted programs to improve the suicide health literacy among welfare and care support workers.

Deaths from ‘diseases of despair’ in Britain: comparing suicide, alcohol-related and drug-related mortality for birth cohorts in Scotland, England and Wales, and selected cities

BackgroundThe contribution of increasing numbers of deaths from suicide, alcohol-related and drug-related causes to changes in overall mortality rates has been highlighted in various countries. In Scotland, particular vulnerable cohorts have been shown to be most at risk; however, it is unclear to what extent this applies elsewhere in Britain. The aim here was to compare mortality rates for different birth cohorts between Scotland and England and Wales (E&W), including key cities.MethodsMortality and population data (1981–2017) for Scotland, E&W and 10 cities were obtained from national statistical agencies. Ten-year birth cohorts and cohort-specific mortality rates (by age of death, sex, cause) were derived and compared between countries and cities.ResultsSimilarities were observed between countries and cities in terms of peak ages of death, and the cohorts with the highest death rates. However, cohort-specific rates were notably higher in Scotland, particularly for alcohol-related and drug-related deaths. Across countries and cities, those born in 1965–1974 and 1975–1984 had the highest drug-related mortality rates (peak age at death: 30–34 years); the 1965–1974 birth cohort also had the highest male suicide rate (peak age: 40–44 years). For alcohol-related causes, the highest rates were among earlier cohorts (1935–1944, 1945–1954, 1955–1964)—peak age 60–64 years.ConclusionsThe overall similarities suggest common underlying influences across Britain; however, their effects have been greatest in Scotland, confirming greater vulnerability among that population. In addressing the socioeconomic drivers of deaths from these causes, the cohorts identified here as being at greatest risk require particular attention.

Method-Specific Suicide Mortality Trends in Australian Men from 1978 to 2017

In 2017 Australia saw the highest overall suicide rate in the past 10 years, with male suicide rates three times higher than in women. Since the mid-1980s there have been major changes in suicide epidemiology in Australia with large shifts in method of suicide among both men and women. This study examined method-specific suicide trends in Australian men over the past 40 years by state. Suicide mortality data for the period 1978 to 2017 was obtained from the Australian Institute of Health and Welfare (AIHW) National Mortality Database and log-linear Poisson regression analysis was used to analyse suicide mortality. This study found large differences between states in patterns and trends in suicide mortality from 1978 to 2017. Hanging, gas and firearms were the most common methods of suicide in Australia. We found statistically significant increasing trends in hanging suicide among men in all six states. The study findings highlight the growing concern of hanging-related suicide in all states in Australia since the late 1970s. New suicide prevention strategies focusing on the ubiquity and ease of hanging as a method will be needed in order for Australia to reduce suicide mortality in future.

Analysing the Impacts of Financial Support for Regional Suicide Prevention Programmes on Suicide Mortality Caused by Major Suicide Motives in Japan Using Statistical Government Data

To improve and plan regional suicide prevention programmes that utilise more cost-effective governmental financial support compared with previous programmes, the present study determined the effects of the amount of financial support provided for regional suicide prevention programmes, such as the Emergency Fund to Enhance Community-Based Suicide Countermeasures (EFECBSC), on the trends of suicide mortalities caused by six major suicide motives between 2009 and 2018, using forward multiple regression analysis. The ranking order of motives for male suicide was health, economy, family, employment, romance and school (in that order), whereas the ranking order for females was health, family, economy, romance, employment and school. Male suicide mortality caused by economy-related motives was significantly/inversely related to prefectural intervention programmes, whereas mortality caused by health-related motives was also significantly/inversely related to prefectural intervention programmes, but significantly/positively related to prefectural personal consultation support programmes. Contrary to males, female suicide mortality caused by health-related motives was significantly/inversely related to the municipal development programmes of leaders/listeners, whereas mortality caused by family- and school-related motives was significantly/positively related to prefectural and municipal telephone consultation support programmes, respectively. Contrary to our expectations, school-aged female suicide mortality caused by school-related motives was significantly/positively related to prefectural personal consultation support, enlightenment and municipal telephone consultation support programmes. These results indicate that Japanese regional suicide prevention programmes probably affect the suppression of male suicide mortality. However, these programmes are possibly ineffective, or at least partially, have an adverse effect, in regard to the suicide mortalities of female and school-aged populations. Therefore, we should work to improve regional suicide prevention programmes, making them more cost-effective and targeted towards female and school-aged populations in the future.

AMERICAN PERSPECTIVES ON SUICIDALITY AMONG MEN IN POLAND

This article examines sociological, psychological, and suicidological research on the determinants of male suicide to explore the fact that Polish men complete suicide 7.4 times more than women, a frequency twice as high as in the US. This paper is based upon an examination of relevant literature and statistical databases. A keyword search was completed in both Polish and English language databases. Ideals of masculinity and negative social attitudes towards a non-binary view of gender may increase stressors and discourage men in Poland from revealing their problems while seeking support, explaining the high rates of suicide completion among Polish men. Suicide prevention programs must tackle gender conceptualizations and alcohol use patterns as well as increase avenues for male help-seeking behaviors. These changes will require political and religious organizations to confront the weakening of male hegemony as the organizing principle for family and society. This paper explores the increased rate of male suicide in Poland from the perspective of gender.

Investigation of suicide deaths in Turkey between 2015 and 2019

Background and objectives: Although suicide is the act of an individual, it is an important public health problem that affects the individual's environment and also society. Approximately 800,000 people die by suicide each year. In this study, we aimed to evaluate the socio-demographic characteristics of fatal suicides in Turkey between 2015 and 2019. Materials and methods: This observational-analytical study was conducted by examining retrospec-tive records in the period 2015–2019. The study was conducted by secondary analysis based on data from the Turkish Statistical Institute. Results: During the study period, the suicide rate (per 100,000) varied in the range 3.94–4.15 and the mean (standard deviation, SD) was 4.07 (0.09). The mean (SD) suicide rate was 6.14 (0.13) in males and 1.99 (0.18) in females; it was higher in males (z = 2.611; p = 0.008). Considering age groups, there was no difference between sex in terms of suicide rate among those aged <19 years (z = 1.617; p = 0.446), whereas the suicide rate was higher in males and in those aged ≥20 years (p < 0.05 for each). During the study period, the most common suicide mean in both men and women was "by hanging". The incidence of suicide using chemical substances and by jumping from a height was higher in women than in men, whereas the rate of suicide using firearms was high in men (p = 0.000). When the female/male suicide rate was compared according to marital status, the suicide rate was observed to be higher in men regardless of marital status, and this difference was more striking in men who were divorced or whose spouse had died. Conclusion: Between 2015 and 2019, the suicide rate was higher especially in older men and in those who had lost a spouse. Therefore, socio-demographic characteristics should be considered in planning interventions to prevent suicides and guiding rehabilitation programs following a suicide attempt.

African Personhood, Humanism, and Critical Sankofaism: The Case of Male Suicide in Ghana

Suicide in Ghana is criminalised and those who survive suicide attempts are subject to significant social condemnation. Paradoxically, studies show that male suicide is often driven by individuals’ strong sense of responsibility to meet social norms and expectations around gender as well as the internalisation of societal views that death would be preferable to shame and disgrace. This contradiction prompts a critical re-examination of the communitarian tradition of African personhood which posits an intimate link between the individual attainment of socially affirmed roles and the status of personhood. Through an analysis of the Akan concept of critical sankofaism I suggest that African approaches to suicide may draw upon important adaptive, critical resources internal to African cultural values, thus highlighting the progressive potential of the African tradition. I show specifically how male gender norms and societal responses to suicide attempts distort core humanistic values at the heart of African communitarian personhood.

How to Save a Life: Vital Clues From Men Who Have Attempted Suicide

Male suicide rates are high and rising, and important insights can be gleaned from understanding the experiences of men who have attempted suicide. Drawing from a grounded theory photovoice study of diverse Canadian men, three intertwined thematic processes were derived: (a) preceding death struggles, (b) life-ending attempts and saving graces, and (c) managing to stay alive post suicide attempt. Preceding death struggles were characterized by cumulative injuries, intensifying internalized pain, isolation, and participant’s efforts for belongingness in diminishing their distress. Men’s life-ending attempts included overdosing and jumping from bridges; independent of method, men’s saving graces emerged as changing their minds or being saved by others. Managing to stay alive post suicide attempt relied on men’s acceptance that their mental illness was unending but amenable to effective self-management with professional mental health care. The findings offer vital clues about how male suicide might be prevented.