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Suicidal ideation and associated behaviors are up to four times more common among jail inmates than the general community (Jenkins et al., 2005; Hayes, 1986). Research finds a variety of social, biological, and psychological factors interact to influence suicidal thoughts of incarcerated individuals (Bonner, 1992; Borrill et al., 2005). Particularly, psychological distress such as, depression and feelings of hopelessness, along with loss of social support and decreased feelings of connectedness have been linked to suicidal ideation and behaviors (Moscicki, 1997; Hawton & van Heeringen, 2009). Recently, the Centers for Disease Control and Prevention (2017) has emphasized the importance of connectedness for suicide prevention. Feelings of loneliness and isolation are of particular concern among jail inmates. These factors have been linked to disproportionate rates of suicidal ideation or participation in suicidal behavior among inmates relative to community populations (Biggam & Power, 1997, Chapman et al., 2005, Ivanoff & Jang, 1991, Jenkins et al., 2005, Palmer & Connelly, 2005; Larney et al., 2012; Liebling, 1992, Marzano et al., 2011; Suto & Arnaut, 2010). Using longitudinal data collected from newly incarcerated jail inmates, the current study examines the impact family, social support, and connectedness have on suicide risk and ideation amongst jail inmates. Study findings have potential implications for policy and practice to better identify and manage suicide risk within jail settings.

Suicide is a major public health issue in the United States. Some studies show decreased suicide rates in religious populations, but it is unclear how religiosity might be linked to suicidal behavior of adolescents emerging into adulthood. To this point few studies have examined the relationship between adolescent suicidal ideation and several risk factors at once and the role of religiosity in these relationships. Drawing from Waves I-III of the National Longitudinal Survey of Adolescent Health data from 1994 to 2002, I sought to explore the relationship between religiosity (i.e. religious affiliation, service attendance, prayer, perceived importance of religion) and suicidal ideation of adolescents over time. Additionally, associations between risk factors (i.e. poor parental relationship, low self-esteem, depressive symptoms, suicidal behavior of friends and family, drug use, alcohol use, aggressive behavior) and risk of suicidal ideation were assessed by simple logistic regression analyses. Multivariate analyses were then used to examine the relationships among the risk factors and suicidal ideation. In a second step of the multivariate analyses, religiosity was added to the model to test if there would be a change in the odds ratios. Results of the simple logistic regression indicated adolescents’ religiosity was negatively correlated with suicidal ideation, while the selected risk factors were positively correlated with suicidal ideation among adolescent participants. However, as participants became young adults, one religiosity measure (i.e. prayer) and one aggressive behavior measure (i.e. access to weapons) were no longer significantly related to their suicidal ideation. Also, females and Whites were more likely to report suicidal ideation than males or African Americans, respectively. In the multivariate models all the selected suicide risk factors were positively correlated with suicidal ideation. When religiosity was added to the model, it had a positive impact on aggressive behavior among older adolescents in Wave II (35% reduced risk) and drug use among younger adolescents in Wave I (14% reduced risk). Religiosity had marginal impact on the rest of the risk factors: 0.1% – 2.4% reduced risk in some and 0.2% – 1.6% increased risk in others in all 3 waves.

Suicidal behavior, including suicide attempt, may result from maladaptive explanatory patterns for past negative life events, in which a person attributes the causes of stressors to internal, stable and global factors. Conversely, an optimistic explanatory style involves perceiving negative life events as external, transient and specific, and may be related to reduced suicide risk. We examined the association between attributional style and lifetime suicide attempts in 135 college students, covarying age, race and ethnicity. Participants provided informed consent and completed an online survey. An optimistic explanatory style was associated with reduced risk of suicide attempt; this effect persisted in a model controlling for hopelessness and depressive symptoms. The manner in which an individual interprets negative life events may buffer against suicidal behavior. Therapeutic strategies to promote an optimistic explanatory style may be successful in the prevention of suicide.

The objective of this study was to examine the combined moderating effects of life stress and loneliness on the association between social problem solving ability (SPS) and suicidal behaviors. We assessed SPS, suicidal behavior, loneliness, and stressful life events in a sample of 385 ethnically diverse college students. Overall, only loneliness moderated the association between SPS and suicidal behaviors. Across ethnic groups, loneliness moderated the association between SPS and suicidal behavior for Blacks, Whites, and Asians; life stress was a moderator for Hispanics. For most individuals, loneliness increases the strength of the association between poor problem-solving and suicidal behaviors. For Hispanics, life stress exacerbates this relationship. Ethnically-specific prevention strategies targeting loneliness and life stress may promote effective problem-solving, reducing suicide risk.

Bakgrund: Runtom i världen är det cirka 800 000 personer som begår självmord varje år. Årligen i Sverige, är det cirka 1800 personer under 19 år som någon gång har försökt ta sitt liv och en tredjedel av alla unga vuxna har haft självmordstankar. Av dessa unga vuxna lyckas 40-50 stycken ta sitt liv. Suicid har under de senaste 15 åren minskat men dock inte bland unga vuxna. Självmordsförsök och självmordstankar går att förebygga. Syfte: Syftet var att undersöka unga vuxnas upplevelser av omvårdnad vid suicidtankar och efter suicidförsök samt deras känslor runt detta. Metod: Deskriptiv design med litteraturstudie som metod användes. Litteraturstudien baserades på 11 vetenskapliga, kvalitativa originalartiklar. Artiklarna granskades enligt SBU:s (2014), granskningsmall för patientupplevelser. Vid analys av inkluderade artiklar tillämpades innehållsanalys enligt Forsberg och Wengström (2016). Resultat: Bemötandet från vårdpersonalen hade stor betydelse för unga vuxna. Unga vuxna hade en längtan av att bli sedda och respekterade, det skapade trygghet för dem, speciellt när de fick en god relation med personalen. Resultatet visade att majoriteten av unga vuxna upplevde god omvårdnad vid sin suicidalitet. Resterande unga vuxna upplevde en känsla av att bli nedvärderade, speciellt inom den somatiska vården. De flesta unga vuxna är nöjda med sin vård och är beredda på att blicka framåt i livet samt att börja leva. Slutsats: Vårdpersonalen bör utbilda sig mer inom psykisk ohälsa. Det är viktigt att unga vuxna blir sedda och förstådda i sin suicidalitet och att deras känslor blir uppmärksammade. Om individerna får denna bekräftelse kommer unga vuxna troligtvis kunna se en större mening med livet. Det krävs mer forskning på hur unga vuxna upplever omvårdnaden vid suicidalitet. / Background: All around the world, around 800 000 individuales succeed with suicide every year. Every year in Sweden, it is 1800 persons under 19 years old try to take their life and a third of all young adults have had suicidal thoughts. Of these young adults there are 40-50 persons who succeed to take their life. Suicide has under the past 15 years reduced but not with young adults. Suicide attempt and suicide ideation can be prevented. Aim: The aim was to describe young adults experiences of nursing care in suicide ideation and after suicide attempt and their feelings around it. Method: Descriptive design with litterature study was chosen. The litterature study was based on 11 scientific, qualitative original articles. The quality of the articles were examined by SBU:s (2014), reviewed tampled for patients´ experiences. The analysis of the included articles, where content analysis by Forsberg and Wengström (2016), was elected. Result: The reception from nursing staff meant a lot to young adults. Young adults had the desire to be seen and respected, that created safety for them, especially when they had a good relationship with the staff. The result showed that the majority of young adults experienced good nursing in their suicidality. Remaining young adults experienced a feeling of being undervalued, especially in somatic care. Most young adults are satisfied with their care and are prepared to look forward to life as well as to start living. Conclusion: Healthcare professionals should be more trained in mental health. It is important that young adults are seen and understood in their suicidality and that their feelings are brought to attention. If individuals get this attention, young adults will probably be able to see a bigger meaning in life. More research is required on how young adults experiences nursing in suicidality.

A high prevalence of anxiety, depression and suicide risk in patients with chronic kidney disease (CKD) on dialysis is reported in the literature, compromising quality of life, increasing hospitalization rates and mortality. These studies focus on the screening of symptoms rather than on diagnostic confirmation. Considering the number of patients affected, there is a need for therapeutic interventions with good clinical evidence to reduce the symptoms of these psychopathologies. OBJECTIVES: To ascertain the frequency of mood, anxiety disorders and suicide risk; identify associations between diagnostic results and clinical-demographic factors; and measure the effects of non-pharmacological interventions in hemodialysis patients with depressive symptoms. MATERIAL AND METHOD: A cross-sectional study conducted between April and July 2017 in Aracaju, Brazil, with 192 adults on dialysis (142 on hemodialysis [HD]; 50 on peritoneal dialysis [PD]), selected by use of a random number table, and without cognitive impairment or a previous diagnosis of anxiety or depression. The Mini International Neuropsychiatric Interview Plus, Brazilian version 5.0, was used for the psychological diagnosis of mood disorders, anxiety and suicide risk assessment. A systematic review and meta-analysis were performed following the protocol of the Preferred Reporting Items of Systematic Reviews and Meta- Analyses (PRISMA), using the Cochrane tool for the detection of bias in the studies. Randomized clinical trials with non-pharmacological interventions in renal patients with depressive symptoms on HD were used. RESULTS: On average, the patients were 49 years old and had been on dialysis for 62 months. At least one mental disorder was diagnosed in 78 individuals (41%) and half had two or more disorders. Among those who had presented current or previous mood disorders, depressive disorders (major depressive episodes and dysthymia) were the most frequent, with 17 individuals (9%) with current symptoms and 38 (20 %) with previous symptoms. In anxiety disorders, the diagnosed subtypes totalled 31 patients (16%). The risk of suicide was present in 37 patients (19%). Previous depression (OR=2.82 [1.27; 6.26]), current depression (OR= 20.45 [6.16; 67.93]) and anxiety (OR=4.12 [1.79; 9.5]) were significantly associated with increased suicide risk. In the meta-analysis, 11 studies with 321 participants from the intervention groups and 347 from the control groups were included. Psychosocial interventions and telephone monitoring of patients by nurses (telenursing) presented moderate and high effects respectively in the reduction of depressive symptoms. CONCLUSION: Depressive disorders (current and previous) and anxiety were common in dialysis patients and there was a high risk of suicide, especially when the subjects were affected by these disorders. Psychosocial interventions and telenursing demonstrated a significant quality of clinical evidence. / É referido na literatura alta prevalência de sintomas de ansiedade, depressão e risco de suicídio em pacientes com doença renal crônica (DRC) em diálise comprometendo a qualidade de vida, aumentando as taxas de hospitalizações e de mortalidade. Tais estudos se concentram no rastreamento de sintomas necessitando confirmação diagnóstica. O alto número de pacientes adoecidos demanda intervenções terapêuticas com evidências clínicas para a redução de sintomas dessas psicopatologias. OBJETIVOS: Determinar a frequência de transtornos de humor, de ansiedade e risco de suicídio; identificar associações entre resultados diagnósticos com fatores clínico-demográficos; definir os efeitos de intervenções não farmacológicas em pacientes com sintomas depressivos em hemodiálise. CASUÍSTICA E MÉTODO: Estudo transversal, realizado entre abril e julho de 2017, em Aracaju-SE, com 192 adultos em diálise (142 em hemodiálise [HD]; 50 em diálise peritoneal [DP]), selecionados por meio de tabela de números aleatórios, sem comprometimentos cognitivos e sem diagnóstico prévio de ansiedade ou depressão. Utilizou-se o instrumento Mini International Neuropsychiatric Interview Plus versão brasileira 5.0 para diagnóstico psicológico dos transtornos do humor, ansiedade e avaliar risco de suicídio. Foi realizada revisão sistemática e metanálise seguindo o protocolo de Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e ferramenta Cochrane para detecção de vieses nos estudos. Utilizou-se estudos clínicos randomizados com intervenções não farmacológicas em pacientes renais em HD com sintomas depressivos. RESULTADOS: Em média, os pacientes tinham 49 anos e estavam em diálise há 62 meses. Diagnosticou-se ao menos um transtorno mental em 78 indivíduos (41%) e metade deles apresentaram dois ou mais distúrbios. Entre os que apresentaram transtorno de humor atual e no passado foram mais frequentes os transtornos depressivos (episódio depressivo maior e distimia), com 17 indivíduos (9%) com sintomas atuais e 38 (20%) no passado. Em transtornos de ansiedade foram reunidos os subtipos diagnosticados, totalizando 31 pacientes (16%). O risco de suicídio estava presente em 37 pacientes (19%). Depressão no passado (OR=2.82 [1.27; 6.26]), depressão atual (OR=20.45 [6.16; 67.93]) e ansiedade (OR=4.12 [1.79; 9.5]) se associou significativamente a maior risco de suicídio. Na metanálise foram incluídos 11 estudos com 321 participantes do grupo de intervenção e 347 do grupo controle. As intervenções psicossociais e o acompanhamento dos pacientes por enfermeiros por meio de telefone (telenursing) apresentaram moderado e alto efeito, respectivamente, na redução dos sintomas depressivos. CONCLUSÃO: Transtornos depressivos (atual e no passado) e ansiosos foram frequentes em pacientes em diálise e houve elevado risco de suicídio, especialmente quando os indivíduos foram acometidos desses transtornos. As intervenções psicossociais e telenursing demonstraram significativa qualidade de evidência clínica. / Aracaju

Suicide ideation, suicide attempts, and suicide (SISAS) are increased in poststroke patients, yet not everyone who has suffered a stroke is at risk for SISAS. Two risk factors for SISAS, marital status and burdensomeness, may be of particular relevance to poststroke patients. The majority of poststroke patients have a disability that may require help from a family member with basic functions such as dressing and bathing. It was not known if being married decreases risk of SISAS for stoke victims as shown in studies with nonpoststroke subjects or increases risk for SISAS due to its influence on feelings of burdensomeness. Guided by the interpersonal psychological theory of suicidal behavior, the purpose of this study was to examine if marital status moderates the association between burdensomeness (measured by disability level) and suicide ideation. A secondary analysis was performed of the Outcome and Assessment Information Set data, which was collected by the National Centers for Medicare and Medicaid Services. A data sample of 1,596,962 records was obtained. This data sample included 5% of the Home Health Outcome Information and Assessment Set for the year 2008. Of those, 8,6381 (5.4%) individuals had suffered a stroke. The results suggested partial support for the hypotheses presented in this study. However, a significant moderation was found. As burdensomeness increased, suicide ideation increased in patients who were married. High levels of burdensomeness increase suicide risk to those who are married. Identifying a vulnerable population can provide potential positive social change by serving as basis for future research regarding program implementation in reducing suicide rates.

Suicide risk is rapidly increasing in children and adolescents. It is vital that research explores the causes in child and adolescent suicide risk. Research has failed to identify if the marital relationship may be correlated with this increase in suicide ideation in children. This study set out to determine if a child's perception of their parents' marital conflict impacts the child's suicidal risk. Using the Family Foundations of Youth Development project this study analyzed 1,692 parent and child participants to test if the child's perceptions of the marital conflict impacted their suicide risk and if the parent's own report of their relationship instability would impact child suicide risk. Results indicated that the child's perceptions were statistically significant in predicting suicide risk in adolescents. However, the parent's report was not statistically significant. These findings suggest that the child's perceptions of the parent's marital conflict impacts their suicide risk and should be considered when working with suicidal adolescents. Implications for working with suicidal youth is that clinicians focus on working with and treating the whole family system.

Bakgrund Suicid är ett folkhälsoproblem. Varje år tar mer än 700 000 personer sitt liv i världen. Under 2020 vårdades 6 666 personer i Sverige på sjukhus till följd av ett suicidförsök. Stigmatisering av suicidala personer förekommer både i samhället och inom hälso- och sjukvården. Patienter med suicidalt beteende söker vård inom alla delar av hälso- och sjukvården och vårdpersonal uppger ofta att de har en bristande kunskap om suicidalitet och vad som krävs för ett gott omhändertagande av dessa patienter. Det finns därför ett behov av att sammanställa aktuell forskning för att öka vårdpersonalens kunskap och förståelse för suicidalt beteende och mötet med dessa patienter. Syfte Syftet var att belysa hur patienter med suicidalt beteende upplever mötet med hälso- och sjukvården. Metod En icke-systematisk litteraturöversikt som baserades på 15 vetenskapliga originalartiklar med kvalitativ ansats. Artiklarna inhämtades från databaserna PubMed och CINAHL med hjälp av sökord i olika kombinationer. Artiklarna har genomgått kvalitetsgranskning utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Resultatet sammanställdes och analyserades med en integrerad dataanalys. Resultat I sammanställningen av resultatet identifierades fyra huvudkategorier: Upplevelser av värdighet, Upplevelser av engagemang och partnerskap, Upplevelser av stigma samt Upplevelser av en trygg och säker vårdmiljö. Resultatet visade att upplevelsen av trygghet i mötet var den mest centrala aspekten för att forma ett partnerskap och för att uppnå en öppenhet kring det suicidala beteendet. Personcentrerad vård och ett ömsesidigt engagemang framkom vara av betydelse för att upprätthålla värdighet och lindra lidande. Slutsats Denna litteraturöversikt visade värdefulla möjligheter i ett partnerskap och ömsesidigt engagemang mellan patienter med suicidalt beteende och hälso- och sjukvården. Studien identifierade upplevelsen av trygghet och personcentrerad vård som centrala premisser i mötet för att suicidala patienter ska känna förtroende för vården. Med ökad kunskap och förståelse kan hälso- och sjukvården förbättra omhändertagandet av suicidala patienter och förhindra fler suicid. / Background  Suicide is a public health problem. Globally, every year more than 700 000 people commit suicide. In 2020, 6 666 people in Sweden were hospitalized as a result of a suicide attempt. Stigmatization of suicidal patients are prevalent both in society and in healthcare. Patients with suicidal behaviour seek care in all areas of healthcare. Healthcare personnel often state that they have a lack of knowledge about suicidality and what is required for good care of suicidal patients. For that reason, there is a need to compile latest research to increase healthcare personnels’ knowledge and understanding of suicidal behaviour and the encounter with these patients. Aim  The aim of this study was to illuminate how patients with suicidal behaviour experience the encounter with healthcare. Method  Non-systematic literature review based on 15 scientific articles with a qualitative approach. The articles were retrieved from the databases PubMed and CINAHL using keywords in various combinations. The articles have undergone a quality review based on Sophiahemmet University assessment basis for scientific classification and quality. The results were compiled and analyzed with an integrated data analysis. Results  In the compilation of the results, four main categories were identified: Experiences of dignity, Experiences of commitment and partnership, Experiences of stigma, and Experiences of a safe and secure care environment. The results showed that the experience of trust in the encounter was the most central aspect in order to form a partnership and for achieving openness about suicidal behaviour. Person-centered care and mutual commitment emerged to be significant for maintaining dignity. Conclusions  This literature review showed valuable opportunities in a partnership and mutual commitment between suicidal patients and healthcare. The study identified experiences of trust and person-centered care as central premises in the encounter, for suicidal patients to have confidence about the care. With increased knowledge and understanding, healthcare can improve the care of suicidal patients and prevent more suicide.