In low- and middle-income countries (LMICs), suicide is a major problem. Research on the effectiveness of large-scale suicide prevention interventions is limited.

To test the effectiveness of an integrated intervention (school-based prevention; reducing access to means of suicide; increased identification and management of suicide risk) in reducing deaths by suicide and suicide attempts; and to evaluate the implementation and effectiveness of sub-interventions.

In this pragmatic cluster randomised controlled trial, 124 villages from Mehsana, India, were randomly assigned to either intervention or control arm. The intervention comprised school-based awareness intervention, community pesticide storage and training of community health workers (CHWs) to recognise, support, refer and follow up people at risk. Intention-to-treat analysis using mixed-effects Poisson regression tested the primary outcome (suicide attempts plus deaths by suicide), and multilevel linear models assessed sub-interventions. The primary outcome was captured through a novel suicide surveillance system.

There was no statistically significant difference in the primary outcome between the intervention (54 of 62 consenting villages) and control (62 villages) arms. Separately, the intervention arm showed a 43% reduction in risk of death by suicide at 12 months (suicide rate 30.7 versus 43.6 per 100 000 person-years in intervention versus control arm; incidence rate ratio 0.57, 95% CI: 0.32–1.02, adjusting for baseline and clustering). Most students (≥90%, n = 2330/2560) from 47 schools received the intervention and had lower depression and suicidal ideation than controls at month 3. Nearly all villages (52/54, 96.2%) provided pesticide lockers (n = 8370 households, 88.83% uptake). Compared with controls, CHWs in the intervention arm had significantly higher knowledge, confidence and skills, and identified 108 at-risk individuals.

The intervention increased identification without significantly reducing suicide attempts, but reduced suicide deaths. This trial, involving 116 villages and a multicomponent intervention implemented at scale, advances suicide prevention and complex intervention research, especially in LMICs.

Safety planning is a commonly used, evidence-based intervention for suicide prevention. There is a need for continuous engagement with safety plans post-discharge, and the improvement of safety plan portability has been discussed within our mental health organisation. This has led to the development of an app, called the Hope App. This study aims to implement this app into routine practice in a Canadian psychiatric emergency department.

We aimed to describe a collaborative, theoretically driven approach to co-design implementation strategies to elicit behaviour change among emergency department clinicians; co-develop a set of tailored, theory-informed, multifaceted implementation strategies for embedding an app into a psychiatric emergency department; and describe engagement evaluation received by the co-design team.

Co-design approaches and the Behaviour Change Wheel were used to develop implementation strategies with clinicians, patients and care partners. The co-design team consisted of 12 members, and we held four design sessions. Design sessions were iterative in nature and organised such that the findings of each session fed into the next session.

We identified 11 implementation strategies encompassing different combinations of intervention functions and behaviour change techniques, targeting barriers and leveraging facilitators identified in our previous work.

The tailored implementation strategies developed in this study have the potential to fill existing gaps in integrating digital technology. A key strength of this study is its use of behaviour change theories and a collaborative approach. The strategies are designed to align with the needs and preferences of clinicians, patients and care partners.

Interventions at frequently used suicide locations that restrict access to means, encourage help-seeking, and increase the likelihood of intervention by a third party are effective in preventing suicide at such sites. However, there have been concerns that such efforts may displace suicides to other sites. It is important to synthesize the evidence on suicide displacement effects.

We conducted a systematic search of Medline, PsycINFO, Scopus, and Google for eligible studies from their inception to February 20, 2025. Meta-analyses were conducted to assess the pooled effects of interventions on suicides at frequently used locations and other sites, and on overall suicides involving the same method.

Our search identified 17 studies. Meta-analyses showed a reduction in suicides at the intervention sites (pooled incidence rate ratio [IRR] 0.09, 95% confidence interval [95% CI] 0.04–0.21) and no evidence of changes in suicides at other sites after restricting access to means was deployed alone. The pooled IRR for nearby sites (same type) was 0.99 (95% CI 0.72–1.38); for other sites (same type), it was 0.99 (95% CI 0.76–1.29); and for other sites (different/unspecified type), it was 1.19 (95% CI 0.90–1.58). There was an overall reduction in suicides involving the same method during the post-intervention period (IRR 0.77, 95% CI 0.65–0.92). Similar patterns were observed when restricting access to means was assessed alone or with other interventions.

Suicide numbers at other sites did not change after interventions such as restricting access to means were deployed at frequently used locations.

Individuals who die by suicide tend to share more characteristics with those who attempt suicide using violent methods than with those who employ nonviolent means. To date, limited research has been published on the demographic characteristics of individuals who engage in violent suicide attempts.

This study aimed to examine trends in the characteristics of violent suicidal behavior in comparison to nonviolent suicidal behavior.

Patients included in the study were consecutively admitted between 2016 and 2021 to the Dr. Manninger Jenő National Trauma Center and the Psychiatric and Toxicology Wards of Péterfy Sándor Hospital in Budapest, Hungary, for medical treatment following violent or nonviolent suicide attempts. Differences in demographic characteristics, risk factors associated with violent suicidal behavior, and methods of attempt were analyzed using Chi-square tests and logistic regression models.

A total of 298 inpatients (46.1% male, 53.9% female), aged between 18 and 65 – representing the economically active population – were included in the study. The sample comprised 145 individuals who attempted suicide using nonviolent methods (73% female, 27% male) and 153 who used violent methods (64.7% male, 35.3% female). Of the total sample, 22 individuals (12.1%) died during treatment due to severe medical complications. Among male attempters, the highest proportion fell within the economically active age range of 18–55 years, whereas among female attempters, the 18–35 age group represented the highest proportion. The most common violent methods, in descending order of frequency, were stabbing (49.7%), jumping from a height (29.8%), and jumping in front of a train (7.7%). The most frequently diagnosed psychiatric disorders among the sample were major depressive disorder (42.2%), anxiety disorders (44.9%), and bipolar disorder (12%). The leading reported motives for violent suicide attempts, in decreasing order of frequency, were marital conflict (32.4%), divorce/separation/break-up (30.2%), and severe or chronic somatic illnesses (12%). When comparing the two subgroups, the strongest risk factors associated with violent suicide methods included male gender, older age, and residence in the capital city.

Previous studies suggest that risk factors are largely indistinguishable between individuals who engage in violent versus nonviolent suicide attempts. However, individuals who attempted suicide using violent methods exhibited characteristics more closely aligned with those who died by suicide than with the remainder of the sample. The majority of data in this study were collected during the COVID-19 pandemic – a period marked by multiple overlapping crises – which may have played a disproportionately large role in the emergence of suicide risk.

Improving media adherence to World Health Organization (WHO) guidelines is crucial for preventing suicidal behaviors in the general population. However, there is currently no valid, rapid, and effective method to evaluate the adherence to these guidelines.

This comparative effectiveness study (January–August 2024) evaluated the ability of two artificial intelligence (AI) models (Claude Opus 3 and GPT-4O) to assess the adherence of media reports to WHO suicide-reporting guidelines. A total of 120 suicide-related articles (40 in English, 40 in Hebrew, and 40 in French) published within the past 5 years were sourced from prominent newspapers. Six trained human raters (two per language) independently evaluated articles based on a WHO guideline-based questionnaire addressing aspects, such as prominence, sensationalism, and prevention. The same articles were also processed using AI models. Intraclass correlation coefficients (ICCs) and Spearman correlations were calculated to assess agreement between human raters and AI models.

Overall adherence to WHO guidelines was ~50% across all languages. Both AI models demonstrated strong agreement with human raters, with GPT-4O showing the highest agreement (ICC = 0.793 [0.702; 0.855]). The combined evaluations of GPT-4O and Claude Opus 3 yielded the highest reliability (ICC = 0.812 [0.731; 0.869]).

AI models can replicate human judgment in evaluating media adherence to WHO guidelines. However, they have limitations and should be used alongside human oversight. These findings may suggest that AI tools have the potential to enhance and promote responsible reporting practices among journalists and, thus, may support suicide prevention efforts globally.

Suicidal ideation and behaviours are common among adolescents, posing significant challenges. Parents have a protective role in mitigating this risk, yet they often feel ill-equipped to support their adolescents, and their specific support needs are not well understood.

To explore the lived experiences of parents with suicidal adolescents and identify their support needs in the context of a therapist-assisted online parenting programme.

Semi-structured interviews were conducted with three stakeholder groups based in Australia: nine parents with lived experience caring for a suicidal adolescent, five young people who experienced suicidality during adolescence and five clinical/research experts in youth mental health/suicide prevention. Inductive thematic analysis was used to analyse and interpret findings.

Three key themes highlight the experience of parenting a suicidal adolescent: the traumatising emotional experience, uncertainty and parent empowerment. Six themes described parents’ support needs: validation and support, practical and tailored strategies, rebuilding the parent–adolescent relationship, parental self-care, flexible and accessible modes of delivery, and understanding non-suicidal self-injury.

Findings highlight key themes of parenting a suicidal adolescent and parental support needs. An online parenting programme could offer parents flexible access to evidence-based parenting strategies. Yet, a purely digital approach may not address the complexities of the parent-adolescent dynamic and provide adequate tailoring. As such, a hybrid approach incorporating therapist support can provide parents with both the compassionate support and practical guidance they seek.

This article describes an innovative program to provide safe, evidence-based psychiatric care at the Baltimore Convention Center Field Hospital (BCCFH), set up for COVID-19 patients, to alleviate overextended hospitals.

This article describes the staffing and workflows utilized at the BCCFH including universal suicide risk assessment and co-management of high acuity patients by an NP-led psychiatry service.

The Columbia-Suicide Screening Rating Scale (C-SSRS) proved feasible as a suicide screening tool. Using the SAFE-T protocol, interdisciplinary teams cared for moderate and low risk patients. The NP psychiatry service evaluated over 70 patients, effecting medication changes in more than half and identified and transferred several decompensating patients for higher-level psychiatric care. Group therapy attendees demonstrated high participation. There were no assaults, self-harm incidents, or suicides.

The BCCFH psychiatry/mental health program, a potential model for other field hospitals, promotes evidence-based, integrated care. Emphasizing safety, including suicide risk, is crucial within alternate care sites during disasters. The engagement of dually-certified (psychiatric and medical) nurse practitioners boosts safety and provides expertise with advanced medication management and psychotherapeutic interventions. Similar future sites should be ready to handle chronically ill psychiatric patients, detect high-risk or deteriorating ones, and develop therapeutic programs for patient stabilization and support.