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International Association for Suicide Prevention
THE SUICIDE PREVENTION RESOURCE CENTER
FROM THE PRESIDENT
The common law legal system originated in England in the Middle Ages and constitutes the
The Suicide Prevention Resource Center (SPRC) is a national resource center in the United States to help stakeholders enhance their capacity to develop, implement, and evaluate suicide prevention programs, policies, and activities.
basis of current legal systems in countries that were once colonies of the British Empire, ranging from the United States to New Zealand and Ghana.There are some exceptions, particularly in countries colonized by other nations, e.g., South Africa and Sri Lanka, which follow Roman Dutch law. Common law is equivalent to case law, as it rests on decisions of judges and courts to create a body of law and set precedents. In contrast, civil law is established essentially by legislative act or statutes; it does not rest on precedent. Civil law systems exist in most of Continental Europe, Brazil, and Japan. Yet other legal systems exist, for example, Socialist law in the former Soviet Bloc countries and Islamic law in Saudi Arabia, as do mixed systems. This much I garnered from the Internet.
SPRC was funded in 2002 by the United States Department of Health and Human Services to fulfill Objective 4.8 of the National Jerry Reed Strategy for Suicide Prevention which called for the development Ph.D., MSW of one or more training and technical resource centers to build capacity for states and communities to implement and evaluate suicide prevention programs. In 2004, SPRC expanded its role to provide technical assistance services to states, tribes, and colleges and universities receiving Federal funds for suicide prevention activities under the Garrett Lee Smith Memorial Act, a legislative initiative that supports the planning, implementation, and evaluation of activities to prevent youth suicide in the United States.
The concept of negligence (a tort) exists in practically all legal systems, common, civil, mixed,
SPRC's staff includes experts in suicide and suicide prevention, public health, mental health, communications, technology, education, training, program design, implementation, and evaluation, and library and information science. Prevention and information specialists offer technical support to state, tribal, territorial, and campus groups engaged in activities to prevent suicide. SPRC's Best Practices Registry for Suicide Prevention reviews and disseminates information about evidence-based programs, expert and consensus statements, and suicide prevention programs and practices. The SPRC Training Institute provides a wide array of face-to-face and online learning opportunities including Assessing and Managing Suicide Risk: Core Competencies for Mental Health Professionals, Strategic Planning for Suicide Prevention, and Research to Practice Webinars. Resources available through the SPRC Online library includes suicide data fact sheets, program planning tools, information on suicide risk in specific populations, clinical guidelines, and SPRC publications such as Suicide Risk and Prevention for Lesbian, Gay, Bisexual and Transgender Youth and The Role of Faith Communities in Preventing Suicide. The Weekly Spark, SPRC's electronic newsletter, highlights news, announcements, events, research, and funding opportunities related to suicide and suicide prevention.
or other. Typically, negligence is defined as a breach of a legal duty resulting in damages, e.g. injury or death, said breach being something a reasonable and prudent man would not cause to happen. Where a breach can be shown to have occurred and to be responsible for harm, the victim may be compensated. With regard to suicide (the damage), the question to be addressed is whether the caregiver (e.g. psychiatrist, hospital…) that has a duty towards the patient (to assess, to treat…), should have known the patient was at risk (were the consequences reasonably foreseeable?), and accordingly acted reasonably to prevent death or injury. If it is deemed that a death by suicide was caused by the caregiver's negligence, the decedent's estate may be compensated. Typically, the caregiver/institution is indemnified by liability insurance to cover such a possibility.
What becomes quite fascinating when looking at how this script plays out internationally, are its many variations. In the United States, any and all mental health professionals may be and are held liable for the death by suicide for a patient in their care. The most common malpractice complaint filed against psychiatrists is for suicide. For psychologists, suicide malpractice is the second most costly type of claim paid by liability insurers. Few, if any, countries appear to be as litigious as the United States, but several IASP members I asked reported disturbing trends.
Bob Goldney, for example, observed that “Australia is not as litigious as the USA…we are catching up.” Similarly, Lars Mehlum noted “this has become an issue with increasing significance over time in Norway…” Michael Phillips related that the seeking of compensation “following an unexpected death has become much more common over the last 10-15 years as the middle class has risen in China.”
From Australia, Bryan Tanney further noted that “The public health system provides malpractice insurance for all employees. If there are matters of care towards persons at risk of suicide, these are usually directed towards institutions and quickly towards the government who pays the bills.” In Norway, where most psychiatrists and psychologists treating patient populations are government employees, lawsuits are directed toward hospital trusts, rather than the individual practitioner. In China, where the vast majority of suicides, according to Michael Phillips, “do not occur during mental health treatment, the identified 'responsible agency' is typically the institution where the individual works or studies,” from which families will demand recompense. If the individual was in mental health care, “it is always the institution (not the individual caregiver) [that] is the target,” as “individual physicians do not have insurance or money.” In Australia, both Tanney and Goldney note that mental health professionals other than psychiatrists do not have indemnity insurance, thus are generally not sued.
Is there enough meat on the bones of these trends and variations for an IASP Task Force to explore these in depth and produce a white paper on the subject? Are there IASP members interested in pursuing this or related objectives based on the potential for this issue to be a more significant concern to mental health clinicians and treating institutions around the globe in the coming years? Lanny Berman, Ph.D., ABPP
SPRC works closely with other suicide prevention organizations, including the American Association of Suicidology (AAS), the American Foundation for Suicide Prevention (AFSP), and the National Suicide Prevention Lifeline, a free, 24-hour telephone hotline for people in emotional distress or suicidal crisis. For more information about SPRC and direct access to many of its resources, visit the SPRC website (http://www.sprc.org). SPRC prevention and information specialists can be reached by telephone at +1-877-438-7772 or by email at info@sprc.org.
Contributions for the news bulletin are welcomed from other organizations. Please send any contributions to Dr. Jerry Reed or contact him for advice about preparing your report jreed330@comcast.net
TASK FORCE:
National systems for certifying suicidal deaths Suicide statistics are a central focus for all involved in suicide research and prevention, yet many of us have limited knowledge of the systems and procedures that generate these statistics. As a consequence, we may be unaware of issues that would affect our interpretation and use of suicide statistics. The primary goal of this task force is to establish a database that describes national systems for certifying suicidal deaths. Anyone interested in contributing descriptions of their national system is invited to visit the relevant page of the IASP website (http://www.iasp.info/national_systems_for_certifying_suicidal_deaths.php) where a detailed description of the Irish system is provided as an example. Descriptions may be submitted by email to the Chair of the Task Force. Dr Paul Corcoran, Task Force Chair, paul.nsrf@iol.ie
President: Dr Lanny Berman
Treasurer: Professor Michael Philips
In official relations with
1st Vice President: Professor Heidi Hjelmeland
General Secretary: Dr Tony Davis
the World Health Organization
2nd Vice President: Professor Paul Yip
National Rep: Dr Murad Khan
3rd Vice President: Dr Ella Arensman
Organisational Rep: Dr Jerry Reed
REPORT FROM A NATIONAL REPRESENTATIVE
SUICIDE IN NEW ZEALAND In 2007, the most recent year for which statistics are available, the age-standardised suicide rate was 11.0 per 100,000 (483 people). This continues the downward trend since the peak years 1994-98 when rates ranged between 14.1 and 15.1 per 100,000. The 27.3% drop since 1998 when the rate was at its highest masks more dramatic changes for specific groups. Rates for men aged under 30 have dropped by over 40% and for 15-24 yearolds they have dropped by over 45% over the last 12-15 years. However, there are still areas of concern: Maori (NZ's indigenous Sunny Collings people) had a 60% excess risk of suicide in 2007, with rates showing no obvious sign of converging towards non-Maori rates. Ass. Prof. In 2006 NZ adopted an all-ages suicide prevention strategy followed by a multi-sectoral action plan for 2008-2012. In 2007, NZ$23 million was allocated to suicide prevention activities over 4 years. We were fortunate to have this commitment before the economic crisis and will need to work hard to ensure that suicide prevention remains on the government agenda after 2012. Government spending is likely to be lean over the next decade so future emphasis will necessarily be even more focused on evidence. Retaining some balance between research and intervention programs will be important. Current research includes investigations of family factors in the development and management of suicidal behaviours in young people, geospatial mapping of suicide and suicide attempt clusters, content analysis of suicide reporting in the our media, and media influences on suicidal behaviour. Research on specific interventions includes trials of Dialectical Behaviour Therapy for adolescents, and problem-solving therapy and a community intervention for reducing suicidal behaviours across the age span. Current intervention programmes include the ASIST suicide prevention first-aid training, specialist counseling for those bereaved by suicide, community postvention response, and a clinical and monitoring intervention for young people in care and protection. Outside suicide prevention programmes there is scope for activity that can contribute to reductions in suicidal behaviours. For example, NZ society has major problems with its binge-drinking culture and alcohol consumption and there is community acknowledgement that the associated health and social consequences are not acceptable. In 2009 our Law Commission reviewed policy and practice relating to liquor availability. If evidence-led, politically courageous choices follow from this, one consequence may be further reductions in suicidal behaviours in the short as well as the longer term.
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THEME
Effectiveness of restricting access to means and methods of suicide and deliberate self harm - An update
The review of effectiveness of suicide prevention programmes by Mann et al (2005) showed that restricting access to (potentially) lethal means appears to be one of the most effective measures to prevent suicide. Since publication of the review, the outcomes of numerous new studies have been published reporting on various measures to restrict access to lethal means for suicide and deliberate self harm Overall, the outcomes of the research published in recent years further consolidate the findings of Mann and colleagues published in 2005. Studies in which the effects of barriers on bridges or limited access to bridges which had become so-called 'hotspots' were examined, all showed significant reductions in suicide with no indications for substitution effects (Bennewith et al, 2007; Reisch et al, 2007; Skegg & Herbison, 2009). Remarkably, Beautrais et al (2009) reported a fivefold increase in the number and rate of suicides from a bridge in New Zealand after barriers that had been in place for 60 years were removed, which further underlines the importance of restricting access to means as a suicide prevention strategy. A study investigating the impact of the withdrawal of prescription painkiller co-proxamol in the UK consistently showed significant reductions in suicide involving co-proxamol, with little evidence for substitution effects (Hawton et al, 2009). Even though legislation restricting paracetamol pack size initially showed promising results in terms of reduced rates of suicide and deliberate self harm, this was not confirmed by outcomes of a study by Bateman et al (2006) conducted in Scotland. However, in a second Scottish study reduced rates of deliberate self harm were observed immediately following the 1998 legislation restricting the paracetamol pack size, but this effect was not maintained in the long term (Gorman et al, 2007). In this regard it would be recommended to further restrict the paracetamol pack size and restrict the number of outlets where paracetamol can be obtained. In most studies the impact of restricting access to lethal means was evaluated over a relatively short period. Therefore, it would be recommended to verify the effectiveness including possible substitution effects over a longer period of time.
Sunny Collings, Associate Professor, University of Otago, Wellington
Dr Ella Arensman
AWARD
Professor Paul Yip has been awarded the Outstanding Researcher Award from the University of Hong Kong for his contribution to suicide prevention research in Hong Kong and the region. The Outstanding Researcher Award is given annually by the University to recognize individuals who have made a significant contribution in an area that has made impact locally and internationally. Professor Yip is working with his team in advocating a public health approach In relation to suicide prevention and has promoted evidence-based and innovative suicide prevention programs in Hong Kong. One of his latest studies is on the restriction of means of charcoal burning which will appear in British Journal of Psychiatry in March. The exploratory study in removing charcoal from supermarket open shelves has shown to be effective in reducing the number of suicides by charcoal burning.
CONFERENCES AND SYMPOSIUM ANNOUNCEMENTS
43rd American Association of Suicidology Annual Conference Families, Community Systems and Suicide
4th Asia Pacific Regional Conference of the International Association for Suicide Prevention 17th-20th November, 2010
For further information, see www.suicidology.org
The 4th Asia Pacific Regional Conference of the International Association for Suicide Prevention (IASP) is to be jointly hosted by Suicide Prevention Australia (SPA) and The Australian Institute for Suicide Research and Prevention (AISRAP). For further information, see
American Association of Suicidology (AAS)
www.suicideprevention2010brisbane.org
April 21st - 24th, 2010
XXVI IASP World Congress 21-24 September 2011, Beijing, China
Submission of Abstracts for Parallel Sessions: DEADLINE OF SUBMISSION: February 10, 2010; Submission of Proposals for Parallel Symposia, Courses and Workshop: DEADLINE OF SUBMISSION: March 26, 2010. For further information, see www.esssb13.org
International Association for Suicide Prevention
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13-17Sept ember2011,Bei j i ng,Chi na
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JU
LY/A
UGUST 20 10
International Association for Suicide Prevention REPORTS FROM NATIONAL REPRESENTATIVES
Consider the following description of just one person
SUMMER COLUMN FROM THE PRESIDENT Scientific data reasonably supports the finding that people with high blood levels of the amino acid homocysteine are at increased risk for heart disease and stroke. Logic would tell us, then, that reducing homocysteine levels should cut that risk. In fact, that has been the prevailing belief; and the treatment of choice to accomplish that reduced level of homocysteine has been a combined regimen of folic acid and vitamin B12.
A recently published, 7-year double blind, randomized, controlled trial of more than 12,000 survivors of myocardial infarction by a group of Oxford University researchers, however, found no significant differences in the proportion of coronary events or deaths attributed to vascular causes in treated patients versus those receiving a placebo.1
So, if A causes B, then why does reducing A not effectively reduce B? Of course, the reason is – the logical fallacy: cum hoc ergo propter hoc. You see, blood homocysteine levels (A) are positively associated with cardiovascular disease (B), but blood homocysteine levels (A) have never been shown to be causal of cardiovascular disease (B).
A great deal of what we know and understand about suicide is of this sort. Consider the frequency with which we publish and disseminate symptoms of depression as warning signs of suicide, because everyone knows that depression causes suicide, right? There are even billboards strewn across parts of the US emphatically stating “Depression, the Number 1 Cause of Suicide.” Thomas Joiner in his new book, Myths about Suicide 2 offers another example, that of the significant association between breast augmentation and risk of suicide, one better explained by differences between women who seek this cosmetic procedure and those that don't than by some causal pathway between augmentation and suicide.
Suicidology and suicide prevention are no different than a host of other public health issues in that we suffer from the fervent desire to find the magic bullet (admittedly a bad metaphor when discussing suicide) - in this case two magic bullets, that of a simple explanation leading to a simple, immediately compelling preventive intervention. Discovering the Holy Grail would be more likely. We are dealing with an immensely complicated behavior, multifactorial caused and not subject to easy solution. We have spent an enormous part of scant resources on single bullet interventions with, not unexpectedly, nowhere near the hoped for results in the way of reduced rates of suicide and non-fatal suicidal behaviors.
at acute high risk of suicide/suicidal behavior and ask yourself which single individual factors of risk would you need to diminish or remove from this description to feel comfortable that this described patient was no longer at acute high risk.
A middle aged, white male is clinically depressed. He drinks excessively and frequently, to the point that his wife is threatening to leave him. He has marked symptoms of anhedonia, insomnia, social withdrawal, and increasingly poor concentration; his work performance has suffered and his supervisor has put him on probation, demanding improved performance or face the possibility of termination. He has talked of feeling hopeless; and has expressed vague suicidal thoughts - he has no plan. He owns a firearm. He meets Axis II criteria for narcissistic personality disorder. He has steadfastly refused to seek psychiatric care as he thinks psychiatry is a pseudo-science.
Try removing just one of his risk factors and see if you believe that this man is less of a ticking suicidal time bomb. Try removing two and see if you feel more comfortable that you have succeeded in reducing his level of risk.
I trust that each of us well appreciates the complexity and difficulty of preventing suicide. We strive toward that end in a myriad of ways, often with inadequate or nonexistent funds, too often with little, if any, collaboration, partnership, and/or political will to create sufficient critical mass over the long haul to make change happen. Maybe this is why we persist in offering simple interventions - there is only so much any one of us can do. If this sounds familiar to you, you probably read of these themes in my column in the last issue of this newsletter. I repeat them here because this is the last chance I have to implore you to DO SOMETHING to exercise your community/ state/province, country toward suicide prevention on World Suicide Prevention Day, September 10, 2010.
The suicide prevention community is small; we have so much to do and we have an imperative to mobilize supports and demobilize barriers to effectively make the difference we wish to make. We are not going to accomplish much if we apply simple solutions to complex problems. This is but one day in the year where we all should be as active as possible to make the road ahead just a bit easier to travel and the targets of our efforts more achievable. IASP greatly looks forward to an international effort on World Suicide Prevention Day3. Thank you in advance for participating in that. Lanny Berman, Ph.D., ABP 1Armitage, J. M. et al (2010). Effects of homocysteine-lowering with folic
acid plus vitamin B12 vs placebo on mortality and majoir morbidity in myocardial infarction survivors. Journal of the American Medical Association, 303(24), 2486-2494. 2Joiner, T. (2010). Myths about Suicide. Cambridge, Massachusetts:
Harvard University Press. 3 The IASP board has created a flyer to help your efforts: http://iasp.info/wspd/
pdf/2010_wspd_pdf_flyer.pdf. Planned activities can be submitted online. Please see:http://www.iasp.info/wspd/activities_mailform.php.
Suicide prevention in Belgium In the federal state of Belgium, suicide prevention is a responsibility of the three constituting regions, i.e. the Flemish, Walloon and Germanspeaking regions. While the latter two regions have developed a limited number of suicide prevention activities, the Flemish government has initiated and supported a suicide prevention action plan Kees van Heeringen since the beginning of this century. This plan, of which the first phase runs from 2006 to 2010, aims to achieve an eight percent reduction in the number of suicides by 2010. In addition, the plan aims to reduce the occurrence of non-fatal suicidal behaviour, suicidal ideation and depression. The plan is based on five strategies: 1. Mental health promotion at individual and societal levels 2. Promotion of telehelp 3. Promotion of the competence of professionals and the optimising networks 4. Improve quality of media reports of suicide and decrease availability of guns 5. Specific attention to a) Suicide attempters, b) Early detection and diagnosis of psychiatric disorders such a schizophrenia c) Decrease occurrence of relapse in depressive disorder d) Children of parents with psychiatric disorders e) Gay and lesbian individuals and communities f) Suicide survivors Each strategy consists of a number of projects which were selected on the basis of evidence of efficacy and cost-effectiveness. Between 2000 and 2007 the Flemish suicide rates (numbers per 100.000 inhabitants) decreased from 30 to 22 in males and from 11 to 9 in females. Taking into account the recent financial and economic challenges a continuation of this positive evolution remains to be demonstrated. Professor Kees van Heeringen is Head of the Department of Psychiatry and Medical Psychology, and Unit for Suicide Research, University Hospital, Gent, Belgium, e-mail: cornelis.vanheeringen@UGent.be
Suicide prevention in the USA In 2006 the US recorded 33,300 suicides. Males continue to surpass females in deaths (4:1), while female attempts occur at a greater rate (3-4:1). Rates for youth and middle aged adults appear to be on a slow rise, but a slight decrease has been observed in suicides among senior citizens. Increasing trends seem to be emerging among African American males and Hispanic/Latina Daniel J. Reidenberg females (youth) while American Indian rates continue to be higher than the nation's 11.1/100,000 rate. Firearms continue to be the leading method of suicide in the US (50.7%), followed by suffocation and hanging (22.5%) and poisoning (18.3%). The highest rates are found in the mountain west and rural areas. Many positive initiatives are addressing these issues. The Action Alliance for Suicide Prevention will be a public/private partnership to help establish national priorities. The Secretary of Defense convened a Panel of experts to address suicide in the armed services and authorized $30 million in funding for a large scale study of suicide. The Suicide Prevention Resource Center (SPRC) and the National Suicide Prevention Lifeline (NSPL) and recently, the Substance Abuse and Mental Health Services Administration (SAMHSA) also created a Suicide Prevention Branch to dedicate staff, time and a more focused effort to address the issue of suicide. • The SPRC brings research to practice offering training and technical assistance and co-ordinating the Best Practices Registry for effective suicide prevention programs. The SPRC has produced high quality materials and in just eight years 48 of the 50 states have developed lifespan suicide prevention plans with the SPRC providing their technical support. Over $100 million in federal funding from the Garrett Lee Smith Memorial Act has reached 42 states, 18 tribal grantees, 1 tribal territory and 66 college campuses since 2005; all assisted by the SPRC. • The NSPL has a network of 145 certified crisis centers across the country ensuring 24/7/365 coverage of phone lines for people in crisis. The monthly call volume is over 50,000 calls from 49 states. The National Council for Suicide Prevention (NCSP) is the leading voice for suicide prevention and survivors in the US. Efforts to raise awareness of the importance of learning the warning signs through social and traditional media initiatives are underway for World Suicide Prevention Day 2010.
The National Violent Death Reporting System (NVDRS) is a surveillance system that collects and links data from many sources into a central database. Currently, 18 states submit information to the NVDRS with the goal to ultimately fund this service to all 50 states. Finally, a Task Force was convened to begin revising and updating the Media Recommendations for Reporting on Suicide with Version 2.0 expected to be completed by the end of 2010. New media as well as updated recommendations with recent research will be included. Dr Daniel J. Reidenberg, Psy.D. is Executive Director of the Suicide Awareness Voices of Education (SAVE) and Managing Director of the National Council for Suicide Prevention (NCSP), e-mail: dreidenberg@save.org
President: Dr Lanny Berman
Treasurer: Professor Michael Philips
In official relations with
1st Vice President: Professor Heidi Hjelmeland
General Secretary: Dr Tony Davis
the World Health Organization
2nd Vice President: Professor Paul Yip
National Rep: Dr Murad Khan
3rd Vice President: Dr Ella Arensman
Organisational Rep: Dr Jerry Reed
TASK FORCE:
Seminar on Suicide Prevention in Pakistan Aga Khan University and the Suicide Prevention Research Interest Group (SPRInG at AKU) in collaboration with John Hopkins Bloomberg School of Public Health, hosted Pakistan's first national seminar titled Suicide: Hidden Realities in Pakistan on September 30, 2009. The seminar was organized by Dr Muhammad Shahid, a Fellow in Injury Prevention, Johns Hopkins Bloomberg School of Public Health and Assistant Professor, Department of Emergency Medicine, AKU.
The seminar included lectures by Dr Murad Moosa Khan, Chairman and Professor, Psychiatry, Dr Ehsanullah Syed, Associate Professor, Psychiatry, Dr Nargis Asad, Assistant Professor, Psychiatry, Dr Haider Ali Naqvi, Assistant Professor, Psychiatry, Dr Muhammad Zahid Bashir, Assistant Professor, Pathology & Microbiology and Dr Muhammad Shahid, Assistant Professor, Department of Emergency Medicine. The second part of the seminar included a workshop on Suicide Risk: Identification and management. The programme was hosted by Dr Muhammad Junaid Patel, Assistant Professor, Department of Medicine. Muhammad Shahid, MBBS MPH MSc MCPS FCPS, Assistant Professor, Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan, e-mail: muhammad.shahid@aku.edu
The IASP Task Force on Genetics and Neurobiology of Suicide We all know that suicidal behavior is a major health problem worldwide. Each year more than 1 million people die by suicide and between 100 and 200 million people engage in suicide attempts. The risk of suicide-related behavior is supposed to be determined by a complex interplay of sociocultural factors, psychiatric history, personality traits, and genetic as well as neurobiological vulnerability. Major goals of this Task Force are to promote studies of genetic aspects of suicide ideation and behaviour among suicidologists on one side, and to promote genetic studies of suicide ideation and behaviour among behavioural geneticists on the other. This genetic view is supported by adoption and family studies indicating that suicidal acts have a genetic contribution that is independent of the heritability of Axis I and II psychopathology. The heritability for serious suicide attempts is estimated to be 55%. Furthermore, there are long known findings in neurobiology, such as a decrease of serotonin metabolite (5-HIAA) levels in patients with suicidal behaviour.
This Task Force will provide
Dan Rujescu
a place where scientists interested in the genetics of suicidal behavior can easily get in contact with each other and can cooperate and stimulate the whole field with innovative research and results. Further understanding of the genetics and patho-physiology of suicidal behavior is very important in suicide prevention. Therefore, we will organize workshops of the Task Force during the IASP meetings to meet each other, outline progress and discuss new developments in this exciting field. On behalf of the members (P. Baud, T Bronisch, P Courtet, V. Deluca, I Giegling, F Karege, A Malafosse, J Mann, N Perroud, T Postolache, A Roy, P Saiz, M Sarchiapone, G Turecki, K van Heeringen, M Voracek, D Yogesh, G Zalsman)
Please contact me if you would like to be a member of this Task Force. Professor Dan Rujescu, Chair of the IASP Task Force on Genetics and Neurobiology of Suicide, Department of Molecular and Clinical Neurobiology, Ludwig-Maximilians-Universität (LMU) Munich, e-mail: Dan.Rujescu@med.uni-muenchen.de
43RD ANNUAL AMERICAN ASSOCIATION OF SUICIDOLOGY CONFERENCE DRAWS RECORD ATTENDANCE A record 870 researchers, clinicians, public health specialists, crisis center staff members, survivors and others involved in the study and prevention of suicide assembled in the city of Orlando, Florida, 21st -24th April 2010 to attend the 43rd annual conference of the American Association of Suicidology. Competing for attendees’ attention to the sights and sounds of nearby Disney World and Mickey Mouse and friends were more than 175 paper presentations, workshops and panels in addition to 18 half and full-day pre-conference workshops.
Dr. Jerry Reed, IASP Chair of the Council of Organizational Representatives staffed the IASP display table making material available on the ESSSB13 meeting in Rome, Italy to be held September 1-4, 2010; the 4th Asia Pacific Regional IASP conference to be held November 17-20, 2010 in Brisbane, Australia; and the XXVI IASP World Congress to be held September 13-17, 2011 in Beijing, China to all who visited the display. All who stopped by during breaks were encouraged to become members of IASP to strengthen our collective voice worldwide. IASP members are welcome to attend next year’s 44th annual AAS conference meeting in April in Portland, Oregon.
Renowned family therapist Monica McGoldrick keynoted the opening day’s plenary session with an exploration and celebrity examples of family risk of suicide. Other plenaries dealt with topics as diverse as suicide among veterans, an empirical test of the often-phrased “six survivors for every suicide,” and recommendations for improving continuity of care. In addition major panel presentations were made on homicide-suicide; helping children heal after a suicide of a parent; distinguishing non-suicidal self-injury and suicide; and the impact of suicide on cultural systems and clinicians. Past AAS president Frank Campbell received the association’s prestigious Dublin Award (for career contributions), and Harvard University psychologist Matt Nock was awarded the Shneidman Award (for outstanding research contributions). His presentation on A New Direction in Measuring the Suicidal Mind sparked a great deal of interest among researchers in attendance.
Dr. Mort Silverman, IASP Member and former US National Rep; Dr. Dan Reidenberg, IASP Member and current US National Rep; Dr. Lanny Berman, President IASP; and Dr. Jerry Reed, Chair, Council of Organizational Representatives.
International Association for Suicide Prevention
Dr Lanny Berman, IASP President
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Obituary
Preview of ESSSB13
Michel Hanus, pioneer in understanding and helping suicide survivors
Dear Colleagues,
Michel Hanus, who died on the 2nd of April 2010, was a pioneer in the development of programmes for bereaved persons and specifically suicide survivors in France and the European Community. Michel was a psychiatrist, a psychoanalyst and Doctor of psychopathology whose medical thesis was on “Pathological Grief.” He was President of the Society of Thanatology and the National Committee on Funeral Ethics in France. However, he is most known for being the founder of the French association “Vivre son deuil” - “Living with Bereavement”. This association, with many thousands of members, expanded to include 14 branches in France, Belgium and Switzerland where he continued to volunteer helping persons bereaved by suicide and developing support programmes in collaboration with other French organizations, including the Union National pour la Prevention du Suicide, the Fédération Française de Psychiatrie and the Government Health General Directorate. He spent much time training trainers and expanding the network of people helping support the bereaved in Europe. He published nine popular books in France including general books on death and bereavement and the classic “Le deuil après suicide” (Mourning after suicide). Michel is survived by his wife and his five sons. Persons who would like to contact his family can send an e-mail to: famille.michel@hanus.fr Professor Brian Mishara, Professor of Psychology and Director of the Centre for Research and Intervention on Suicide and Euthanasia (CRISE), University of Quebec, Montreal, e-mail: mishara.brian@uqam.ca
Time is running! The 13th European Symposium of Suicide and Suicidal Behaviour will be held on September, 1st to 4th in Rome, the city where past ages revive, overlap and melt into Modern Living and Transcultural Exchange. That's why it represents the ideal ground for the theme of the Symposium which is
Preview of the 4th Asia Pacific Regional Conference of the International Association for Suicide Prevention BRISBANE AWAITS YOU ALL! Between 17 and 20 November 2010, the beautiful Brisbane, Land of the Queens, Australia, will host 4th Asia Pacific Regional Conference of the International Association for Suicide Prevention. The theme of the conference is: “Suicide Prevention: A Dialogue Across Disciplines and Cultures”
“Integration of Knowledge for an Interdisciplinary Approach to Suicidology and Suicide Prevention”.
We are proud to inform you that we received more than 600 submissions of scientific contributions that will be presented in 6 plenary sessions, more than 60 parallel sessions and 4 poster sessions! A very rich scientific programme will engage us during these 4 days, in a continuous and mutual exchange of ideas that will undoubtedly enrich and integrate our knowledge. Both IASP and IASR are involved in organizing different activities such as the ‘Breakfast with Experts’, Symposia and the Andrej Marusic Award. For more details please, see the Symposium website: www.esssb13.org
Welcome to Rome! The Presidents of Symposium,
Marco Sarchiapone Roberto Tatarelli
Massimo di Giannantonio
a theme that strongly emphasises the two main targets of the conference: facilitating people of different scientific backgrounds speaking to each other, and facilitating people from different cultural backgrounds to identify commonalities and differences in relation to suicide and suicidal behaviour. Addressing transcultural differences is fundamental for us to progress in suicide prevention. Multidisciplinary approaches to suicide prevention have been my refrain for many years now, and – far from being an empty slogan - I am pretty proud to say that today the staff of my Institute includes psychiatrists, psychologists, sociologists, epidemiologists and health economists. Organised by the Australian Institute for Suicide Research and Prevention - AISRAP and Suicide Prevention Australia (SPA), with a fantastic scientific calendar, a seducing social program, and the complicity of a wonderful location for which weather is never an issue (“no worries, mate…”), the conference will constitute a truly exciting experience for all of those involved in the challenging mission of suicide prevention. Book now! See ya, guys. Diego De Leo
Professor Diego De Leo, Conference President and Director of the Australian Institute for Suicide Research and Prevention – AISRAP, Doctor of Science and Professor of Psychiatry, Director, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia, e-mail: d.deleo@griffith.edu.au
AUS
TRALIA BRISBANE
4th Asia Pacific Regional Conference of the International Association for Suicide Prevention 17th-20th November, 2010 The 4th Asia Pacific Regional Conference of the International Association for Suicide Prevention (IASP) is to be jointly hosted by Suicide Prevention Australia (SPA) and The Australian Institute for Suicide Research and Prevention (AISRAP).
For further information, see www.esssb13.org
Contributions for the news bulletin are welcomed from other organizations. Please send any contributions to Dr Jerry Reed or contact him for advice about preparing your report. jreed330@comcast.net
For further information, see www.suicideprevention2010brisbane.org
XXVI IASP World Congress 13-17 September 2011, Beijing, China
International Association for Suicide Prevention
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International Association for Suicide Prevention REPORT FROM A NATIONAL REPRESENTATIVE
FROM THE PRESIDENT One of the requirements that attends being president of an international organization, such as IASP, is that I am mandated to attend conferences either co-sponsored or officially administered by IASP; this, of course, is not quite the same for the everyday Suicidologist who has freedom of choice of where and when to travel. In this case, the loss of this freedom is both a blessing and a joy. Rome in September for ESSSB13 and Brisbane in November for IASP's 4th Asia-Pacific Regional Conference (and yet ahead, Beijing in September, 2012) – it's a tough life! Memories of Rome: Sophia Loren, Vittorio DeSica, Marcello Mastroianni, La Dolce Vita, Spartacus, Roman Holiday (ah, Audrey Hepburn)… Oops, please forgive my tangent.
Terrific hospitality – thank you Marco; fabulous pasta, great opportunities to network and more informally spend time with colleagues and friends (these are not mutually exclusive); as well, good science. It is rewarding for me, at my advanced age, to still be able to come away from a Suicidology conference convinced that I have much yet to learn and a great deal still to understand. My notes from Rome reflect knowledge gained, as well as musings and challenges. Here is a sampling:
• A reminder to factor in cultural considerations in cross-applications of international research. • A reinforced awareness that we still know far too little about preventing suicide among those who have co-occurring substance abuse. • A question: Do we understand well enough why the (diagnosis-based) medical model seems to apply in the Western world but may not be the model of choice in developing countries? • Another question: Have we yet developed any viable prevention models that apply to impulsiveaggressive suicides? • Any yet another: Why do we not focus more on developing interventions with the significant proportion of depressed patients who do not adhere to treatment protocols and recommendations? • Musing: Will we ever have samples of sufficient size and studies of significant duration to use completed suicides (versus repeat attempts) as the end-point measure of an intervention's success or lack thereof? • Pie in the sky musing: Will we be able to muster evidence that national suicide prevention strategies, when implemented, actually are effective, i.e. in proximately causing reduced rates of suicide?
• More specifically, with all the emphasis on public education initiatives in these strategies, how can we demonstrate that these approaches are effective and necessary components of a strategy? • Challenge: If the great majority of adolescent suicide attempters did not reveal having had suicide ideation to anyone before the attempt (this is from David Shaffer's plenary), then why is asking about suicidal ideation the only question most every clinician will ask when doing a risk assessment?
So now we transition some 10,000 miles to Brisbane. Co-chairs Diego De Leo and Michael Dudley, and members of their organizing committee, have put together what promises to be a thoughtprovoking and exciting program with a number of scheduled presentations of both regional and international focus. Interestingly (to me, at the least), they also have scheduled a debate on one of the questions I brought back from Rome, noted above: Is widespread public awareness and understanding of suicide indispensable to any effective program of suicide prevention? We should have more of these debatable issues at IASP conferences, no?
In the meantime, we continue to receive reports of the success of this year's World Suicide Prevention Day activities across the globe – check out IASP's website for the latest update. We immediately need to begin planning for yet more energy and events to be organized for 2012's WSPD. Stay tuned.
Since returning from Rome, one item of concern to Suicidologists across the globe has come to my attention and is prominently in my agenda for followup over the next few weeks. This pertains to a proposed and recommended restructuring of the code structure used for external causes of injury in ICD11. The proposal is to move the coding for Intent (e.g. suicide, homicide, unintentional…) from its current leading order position to that following after the coding for Mechanism (e.g. drowning) and Object (e.g. in bathtub). It is unclear at this date whether there has been much involvement of the Suicidology community in framing or commenting on this proposal, but many of our colleagues have communicated to me that , by moving the positional coding of Intent from where it now resides to last position, there is the very real danger that this would result in a significant reduction in the number of deaths classified as suicide, simply because coders don't code all the items in the chain of codes – the further down that chain, the less likely it will get coded. This could have significant implications for our field and those impacted by it. If ever we see a reduction in the number of documented cases of suicide, I would hope it is because of our prevention programs and interventions, not because of a failure in their being coded as suicides. I hope to be able to tell you more about this in the near future. Lanny Berman, Ph.D., ABPP
COUNTRY REPORT FROM GHANA Ghana, one of the low and middle income countries, is in the Western part of Africa. It is bordered on the East by Togo, on the West by Cote D'Ivoire, on the North by Burkina Faso and on the South by the Gulf of Guinea. It has a population estimate of about Charity S. Akotia 22 million, with 51% being female and 49% male. Life expectancy at birth is 56 years (males: 55.04 years; females: 56.99 years). With regard to religion, Ghana has about 69% Christian, 15.6% Muslim, 8.5% Traditionalists and 6.9% others. The labour force in Ghana is predominantly agricultural. On economic indicators, Ghana has a per capita income of US $450. Although there are some private health care facilities, most health care is provided by the government. In 2005, Ghana spent 6.2% of GDP on health care, or $30 per capita.
Although there are no national statistics on the rate of suicide in Ghana, media reports, personal communications and daily encounters at the hospitals indicate an increase in suicidal behavior. However, suicide is a taboo and hardly talked about. Various reasons account for this including cultural and religious factors. Generally, the Ghanaian culture and the religion of the people proscribe suicide. Anyone who therefore engages in suicidal act is frowned upon and stigmatized by society. Suicide also carries legal sanctions in Ghana and to date, many Ghanaians hold the view that a suicide should remain criminalized in the country. Researchers from Norway, Ghana and Uganda are currently conducting a research project: “Suicidal behavior in a cultural context”. One of the components of this project is to address attitudes towards suicide and suicide prevention in the three countries.
On April 13th, 2010 some of the researchers (Charity S. Akotia and Joseph Osafo from Ghana and Heidi Hjelmeland and Birthe Loa Knizek from Norway) organized a dissemination workshop for the psychology students of the University of Ghana where some of the results from this study were presented.
About 90 students participated in the workshop. Papers on attitudes towards suicide among students and emergency room nurses, which were generally negative, were presented at the workshop. There were group discussions on, for example, the role of religion in suicide prevention in Ghana. Generally, participants gave very positive evaluations of the workshop and were eager to spread what they had learned to others. It is believed that this workshop will help reduce the stigma and myths associated with suicide among university students in Ghana. We believe that this will facilitate efforts towards the initiation of suicide prevention programs in Ghana. Dr. Charity S. Akotia is a Senior Lecturer and IASP National Representative for Ghana. She is with the Department of Psychology, University of Ghana. E-mail: sakotia@libr.ug.edu.gh
President: Dr Lanny Berman
Treasurer: Professor Michael Philips
In official relations with
1st Vice President: Professor Heidi Hjelmeland
General Secretary: Dr Tony Davis
the World Health Organization
2nd Vice President: Professor Paul Yip
National Rep: Dr Murad Khan
3rd Vice President: Dr Ella Arensman
Organisational Rep: Dr Jerry Reed
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REPORT FROM A NATIONAL REPRESENTATIVE
REPORT FROM AN ORGANIZATIONAL REPRESENTATIVE
SUICIDE PREVENTION IN IRELAND
SAMARITANS USA - WORKING TOGETHER
Reach Out is the 10 year national strategy for action on suicide prevention in the Republic of Ireland. Agreed by government in 2005, the strategy builds on an earlier report in 1998 which reflected the rapid increase in suicides in Ireland in the 1990s. Suicide was only decriminalised in Ireland in 1993.
Samaritans USA (SAMS USA) is the coalition of the nine community-based
Ireland's rate of suicide peaked at 13.9 per 100,000 in 1998 and since then has gradually reduced to a rate of 10.6 in 2007. Geoff Day However provisional rates for 2008 and 2009 indicate that the rate will rise again almost certainly due to the impact of the economic downturn. Youth suicide (15 to 24 years) is the 4th highest in the EU at 14.4 per 100,000.
The National Office for Suicide Prevention (NOSP) was established in 2005 as part of the Population Health Directorate of the Health Service Executive (HSE), to ensure implementation of the 96 actions in Reach Out. The HSE has a statutory obligation to report every year to the Houses of the Oireachtas (Irish parliament) on suicide prevention activities. This report is available on www.nosp.ie
Projects to meet many of the actions in Reach Out. have been established and funded through the NOSP. These range from pilot projects in early intervention through primary care, mental health awareness programmes, support in emergency departments for those who have self harmed, postvention, support/counselling and research. Some examples of recent activities include: - The office has used web based initiatives to reach young people including its own www.yourmentalhealth.ie and www.letsomeoneknow.ie as well as supporting other NGO web based initiatives. - The office funds the National Registry of Deliberate Self Harm operated by the National Suicide Research Foundation (NSRF) and that organisation has also been funded to undertake a pilot project with Coroners to look at ways of improving recording of suicides and supporting people bereaved through suicide. - Reach Out recommends a targeted approach and the office has funded research into suicidal behaviour in the LGBT community. Supporting LGBT lives is the first comprehensive research in this area in Ireland and is available on www.glen.ie. Actions arising from this research will further support the LGBT community. - A cross border suicide prevention action plan with Northern Ireland has been agreed. This plan sets out actions which are common to both jurisdictions. Partnerships between the statutory and non statutory sectors are critical in continuing to implement the actions in Reach Out. Geoff Day is Director of the HSE National Office for Suicide Prevention and IASP National Representative for Ireland. E-mail: geoff.day1@hse.ie
TASK FORCE ARTICLE:
Samaritans suicide prevention centers in the United States whose mission is: 1) to provide immediate and ongoing emotional support to those who are depressed, in crisis or suicidal; 2) to educate lay and professional care-givers and service providers, academics, those in government, industry and the general public about the keys to effective suicide prevention;
Alan Ross
3) to provide support to those who have lost a loved one to suicide.
As with the majority of the hundreds of Samaritans centers throughout the world, the primary means of implementing our mission is through Samaritans volunteer-staffed suicide prevention hotlines which practice a non-judgmental, active listening approach in providing support we call “befriending� which seeks to alleviate a person's despair, isolation and suicidal feelings.
SAMS USA is a collective association that for 25 years has allowed the various branches to share information and materials, program and staff development, advertising and marketing techniques, hotline policies and procedures, etc. The SAMS USA Centers' hotline volunteers will respond to approximately 250,000 calls this year from those in crisis; our paid and volunteer staff will train thousands of caregivers in our communities' school systems, social service agencies and government departments; and our Safe Place survivor support programs will provide solace to hundreds of people who have lost a loved one to suicide. In addition to our core programs, Samaritans centers provide services that are adapted to the needs of our respective communities. Examples include projects in Samaritans Fall River and Cape Cod, Massachusetts branches that focus on outreach to senior citizens living alone who receive weekly calls from Samaritans volunteers and on elder suicide prevention. The Keene, New Hampshire branch's work with veterans groups as well as ensuring hotline volunteers learn how depression and suicide impact veterans and their families. Providence Rhode Island's key role in their community health network is enhancing access through the internet to community resources and referral information. Samaritans in Boston, Massachusetts operates a Samariteens hotline for adolescents, hosts major awareness events for businesses and corporations, is a founding member of the Massachusetts Coalition for Suicide Prevention and works nationally and internationally to prevent railway suicides.
In New York City, Samaritans is the key provider of suicide prevention education for the entire 1,200 site public school system, coordinates the citywide suicide prevention coalition and provides technical support to hundreds of community and government agencies. Samaritans USA is a member of the National Council for Suicide Prevention (NCSP), which was intrinsic in the development of the US National Strategy for SuicidePrevention, and the IASP. Alan Ross, SAMS USA Representative, National Council for Suicide Prevention, e-mail: samscouncil@aol.com
IASP TASK FORCE ON SUICIDE AND THE WORKPLACE
Dear IASP Members, Most people who die by suicide around the globe are of working age, but very few suicide prevention programs target the workplace as a venue for suicide prevention. The workplace provides opportunities for suicide prevention that have not been realized. For instance, workplaces offer people in potential distress social connection and a purpose that may help sustain them during difficult times. In many instances workplaces are also already situated to disseminate public health messages, and in some cases even refer people to mental health services such as Employee Assistance Services. Depending on the number of hours worked, co-workers often spend more time with the person involved and may be able to recognize changes in mood and behavior because of this contact. Finally, suicide affects the social and financial functioning of the workplace. Whether it is ideation, attempts or completion, morale and productivity are impacted significantly. Thus, while often challenging to engage, the workplace offers a unique contribution to a public health approach to suicide, and increased efforts to develop
policy, protocols, and programs for this critical sector of society are needed. For these reasons, IASP has recently developed a Workplace Task Force with the following goals: Objective #1: Expand the study of suicide and workplace issues. Objective #2: Develop model policies and protocols for workplaces to adapt. Objective #3: To share promising suicide prevention programs and training for the workplace.
Sally Spencer-Thomas
If you would like to be a part of this Task Force, please contact Sally Spencer-Thomas for more information, e-mail: Sally@CarsonJSpencer.org Thank you, Sally Spencer-Thomas, Executive Director, Carson J Spencer Foundation USA www.WorkingMinds.org
International Association for Suicide Prevention
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Andrej Marusic Awards 2010 At the 13th European Symposium on Suicide and Suicidal Behaviour in Rome, 1st–4th September 2010, the International Association for Suicide Prevention, the International Academy for Suicide Research and the ESSSB13 organising committee assigned the Andrej Marusic Award to three young researchers in the field of suicidology: Dr Carmel McAuliffe, Dr Marcus Sokolowski, and Dr Holly Wilcox. Family members of Andrej Marusic were present at the award ceremony, which was co-chaired by Professor Marco Sarchiapone (ESSSB13) and Dr Tony Davis (IASP). Summaries of the research proposals of the successful candidates: Dr Carmel McAuliffe, National Suicide Research Foundation, Cork, Ireland, e-mail: carmel.nsrf@iol.ie
Identification of suicide risk profiles and emerging suicide clusters: A psychological autopsy study The classification of suicides, based on demographic and/or clinical characteristics facilitates the identification of individuals at elevated risk of self-harm or suicide (Ovenstone & Kreitman, 1974; Chen et al, 2007). Most classification studies concentrate on non-fatal self harm. The robustness of subgroups derived from classification studies may be compromised by reliance on a single data source (O' Connor et al, 1999). A key outcome of classification studies is the development of suicide risk profiles but these are subject to geographical effects and may also change (WHO, 2000). A related problem is that of suicide clusters (Gould, 1989; 1990).
The aim of the proposed study is to optimise the early identification of individuals at risk of suicide and the development of emerging suicide clusters, using multiple data sources. The proposed study will have a link with a Suicide Support and Information System (SSIS), a psychological autopsy study already piloted in a defined catchment area in Ireland. Over an 18-month period the estimated number of suicide cases for inclusion in the proposed study is 120. Data will be collected after conclusion of the coroners' inquest from multiple sources including coroners' records, police records, interviews with bereaved next-ofkin, and questionnaires completed by healthcare professionals. Cluster analysis (complete and average linkage) will be used to identify the optimal number of subgroups, and to verify homogeneity. Complete linkage will be applied to data followed by average linkage to ascertain whether the clusters remain stable across different algorithms. Stability will be measured in terms of transfer of cluster membership. To identify the quality of the group separation and variables that best describe group membership, discriminant function analysis will be performed. The Knox test will be used to assess the extent of time space clustering.
Dr Marcus Sokolowski,
Dr Holly Wilcox, Department of
The National Prevention of Suicide and Mental Ill-Health (NASP), Karolinska Institute, S-171 77, Stockholm, Sweden, e-mail: Marcus.Sokolowski@ki.se Co-authors: Yair Ben-Efraim, Danuta Wasserman, Jerzy Wasserman
Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD USA, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Holly Wilcox University, Baltimore, MD USA, e-mail: hwilcox1@jhmi.edu Co-authors: Janet Kuramoto, Bo Runeson
Marcus Sokolowski
Genetic studies of the corticotropinreleasing hormone receptor 1 (crhr1) in suicide attempts According to the stress diathesis model, genes and environment, as well as possible interactions in-between (GxE), may result in vulnerability towards suicidal behaviors. We wished to investigate this hypothesis for a key regulator of the stress-responsive hypothalamic-pituitary-adrenal (HPA) axis, the CRHR1 gene. Single nucleotide polymorphisms (SNPs), covering 80% of the common variation in CRHR1, were investigated in severe suicide attempters (SA) and their characteristics: method, medical damage, previous attempt, precautions, depression- and anger/ aggression-scores. We first investigated main genetic effects, and SNP rs12936511 showed main genetic effect on depression intensity in males proximal to the SA in time. However, result with SNP rs4792887 only appeared in a strata of SA males exposed to low levels of lifetime stressful life events (SLEs), indicating that GxEs might be involved. Thus, we next formally re-tested all SNPs for GxEs involving exposures to rape and/or physical assault (below or over age of 18; U18 and O18) and a lifetime scale with a broad range of SLEs. The index SNP, rs4792887, showed antagonistic GxE with lifetime SLEs (but not rape or physical assault), among male SA with high depression intensity or high medical damage (but not with anger/aggression [AA]). Other AA/impulsive or high medical damage male SA showed synergistic GxE between the 3'-exonic SNP rs16940665 and physical abuse O18 (and not physical abuse U18). AA/impulsive SA further also showed synergistic GxE between another group of 5'-region SNPs (rs7209436 and a “TCA”-haplotype) and physical abuse U18. Among these haplotype-SNPs, particularly rs110402 showed GxE with physical abuse U18 in both male and females in SA with high precautions against discovery. We conclude that inclusion of environment in analysis revealed novel genetic effects, and that the different combinations of CRHR1 SNPs, age/type of exposure(s) and depression or anger/aggression observed, may represent several possible patterns of SA-risk between individuals.
Carmel McAuliffe and Mrs Marusic
International Association for Suicide Prevention
Biological Parents' Suicidal Behaviors and Environmental Risk: A Populationbased Adoption Study in Sweden Adoption studies provide a method for studying environmental risk (conferred by adoptive, rearing parents) disentangled from genetic risk (conferred by biological parents not involved in rearing their children). The objective of this study was to 1) compare the risk of suicide attempt hospitalization among adoptees whose biological parents engaged in suicidal behavior (suicide or suicide attempt hospitalization) with adoptees whose biological parent had been psychiatrically hospitalized but did not engage in suicidal behavior; 2) examine if risk varied by having an adoptive parent psychiatrically hospitalized during adoptees childhood or adolescence (ages 0-18). This retrospective cohort study used Swedish registry data from 1973-2003 to identify 1,953 adoptees of biological parents with suicidal behaviors, and 5,892 adoptees with biological parents with psychiatric hospitalizations but not suicidal behaviors. Adopted offspring of biological parents with suicidal behaviors were not at increased risk of hospitalizations for suicide attempt, unipolar depression, drug, alcohol, personality disorders or violent criminal convictions, as compared to adopted offspring of biological parents with psychiatric hospitalizations but no suicidal behaviors. However, among adoptees whose adoptive parent was psychiatrically hospitalized during adoptees ages 0-18 years, adoptees whose biological parent had suicidal behavior had increased risk for suicide attempt hospitalization (HR = 6.6, 95% CI 1.922.4) and drug use disorders (HR = 3.7, 95% CI 1.2-11.5), as compared to adoptees of a biological parent without suicidal behavior but with a history of psychiatric hospitalization (interaction p<0.001 and p=0.05, respectively). The relationship between having a biological parent with suicidal behavior on adoptees hospitalization risk for unipolar depression, alcohol use disorders, personality disorder and violent criminal convictions did not vary by adoptive parent's psychiatric hospitalizations. Results suggest that aspects of the child rearing environment increase risk for hospitalizations for suicide attempt and drug dependence over and above genetic vulnerability for suicidal behaviors.
This study was funded by the American Foundation for Suicide Prevention (AFSP).
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WORLD SUICIDE PREVENTION DAY 2010 In connection with World Suicide Prevention Day (WSPD) on September 10th this year, 42 countries submitted and carried out a wide range of WSPD activities, such as conferences, general public awareness campaigns, candlelight vigils and theatre plays. Maurizio Pompili gives a summary of the WSPD activities in Italy:
This year World Suicide Prevention Day was particularly alive in Italy. It started with the historical meeting between me and Pope Benedict XVI. During those moments, I just told him that I was involved in suicide prevention, that I was supporting IASP, WSPD and I asked him to help us. The Pope very charmingly held tightly both my hands for a few seconds, listened to a few words and then blessed the prevention of suicide. I saw this meeting as a symbolic event that put in the Pope's hands the prevention of suicide after so many centuries of stigmatization towards this phenomenon.
Maurizio Pompili meets Pope Benedict XVI
The days preceding WSPD were characterized by huge media coverage with live coverage by main television networks and the most popular newspapers. Then was the time of our two day-conference. Based at Sant' Andrea Hospital, this event presented the breadth and depth of the state of the art in suicide prevention. Highlights included Prof. Diego De Leo's great presentation entitled “Many faces, many places: suicide prevention across the world” and Prof. Zoltan Rihmer's presentation entitled “Suicide prevention across Europe: pitfalls and future perspectives”. This year also marked the first edition of the Race for Life, a sport event that took place in the magnificent surroundings of the Terme di Caracalla in Rome. For the first time suicide prevention was illuminated by a lovely sunny day, cheerful atmosphere and many people from the community running for our cause (I also ran both the three and six kilometer races). WSPD was also popular in Rome's underground and buses. ATAC, that runs the entire transportation in Rome, allowed us to have ads, and radio and television messages (in the circuit of transports) related to WSPD and our suicide prevention activities. A new cartoon was also developed which depicted a crisis situation that could be solved by asking for help. WSPD was also a success in Genoa where Prof. Maltsberger and Prof. Goldblatt provided insight into the psychodynamics of suicide. What's next? We have begun planning next year's activities. Maurizio Pompili, M.D., Ph.D. - IASP National Representative for Italy, e-mail: maurizio.pompili@uniroma1.it
44th American Association of Suicidology Annual Conference Changing the Legacy of Suicide April 13th - 16th, 2011 Hilton Portland & Executive Towers, Portland, OR, USA
For further information, see www.suicidology.org American Association of Suicidology (AAS)
The Aeschi Working Group The therapeutic approach to the suicidal patient: New perspectives for health professionals
Obituary Vladimir Fedorovich Voitsekh, 1941– 2010 Professor Vladimir Fedorovich Voitsekh was born in 1941. At the age of 32 he completed his Doctor of Philosophy, and in 1990 he successfully obtained a Doctor of Science, based on the subject “Forecast during Depressions”. Since 1995 Mr. V.F. Voitsekh was head of the Centre of Suicidology at the Scientific Research Institute of Psychiatry, Moscow, and in 2006 he received the title of Professor.
Vladimir Fedorovich was the author of 120 scientific works and a range of monographs. “Clinical Suicidology”, one of his key works, has become one of the most important monographs in Russian suicidology. Vladimir Fedorovich was intensively involved in research: 5 Ph.D. theses were defended under his guidance. He continued the scientific and practical activities of the Suicidological Centre of Moscow Scientific and Research Institute of Psychiatry of the Russian Ministry of Public Health, and essentially strengthened its substantiation, expanded business contacts, and won the respect and favour of colleagues by his numerous works. Professor Voitsekh fearlessly overcame grave illness and continued his work. He was a man of his word and faithful to his friends. The Suicidological Service headed by Professor Vladimir Fedorovich Voitsekh has achieved significant success. “Suicide Prevention in the Army”, providing key guidelines for military psychologists, was released in 2008. Vladimir Fedorovich fully devoted himself to work. He was gentle, thoughtful, principled man, who always adhered to principles. He was a reliable and loyal friend. Vladimir Fedorovich Voitsekh died on 2nd May 2010. Ludmila Arkhangelskaya
4th Asia Pacific Regional Conference of the International Association for Suicide Prevention 17th-20th November, 2010 The 4th Asia Pacific Regional Conference of the International Association for Suicide Prevention (IASP) is to be jointly hosted by Suicide Prevention Australia (SPA) and The Australian Institute for Suicide Research and Prevention (AISRAP). For further information, see www.suicideprevention2010brisbane.org
XXVI IASP World Congress 13-17 September 2011, Beijing, China
6th AESCHI CONFERENCE 20.–23. MARCH 2011 Patient-Oriented Concepts of Suicide: Trauma and Suicide Hotel Aeschi Park, Aeschi, Switzerland
www.aeschiconference.unibe.ch
International Association for Suicide Prevention
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