Search Results (82)

Background: The prevalence of mental health problems among young adults has increased exponentially worldwide, with significant implications for public health. This study explores the structural and intermediate social determinants of health associated with emotional well-being and distress in Colombian young adults. Methods: A cross-sectional study was conducted with 1232 university students aged 18–28 years residing in Cali, Colombia. The Social Determinants of Mental Health Questionnaire for Young Adults (SDMH) was administered to assess structural and intermediate determinants. Participants were categorized into two groups: those with mental health diagnoses (n = 252) and those without (n = 980). Descriptive, comparative association and predictive analyses were conducted. Results: Significant differences were found between groups, with diagnosed participants showing higher exposure to violence and suicidal ideation. Women with diagnoses predominantly presented anxiety and depression, while men showed more externalizing symptoms. Violence experiences emerged as the strongest predictors of emotional distress in both groups. Psychosocial life skills and perceived social support were the most robust protective factors for emotional well-being, regardless of diagnostic status. Conclusions: This study reveals that multiple risk factors accumulate rather than single extreme factors characterizing mental health vulnerability. Violence prevention, life skills development, and social support enhancement should be prioritized in public health interventions for young adults. The findings emphasize the need for multisectoral approaches addressing social determinants to promote youth mental health. Full article

Purpose: Suicide is a leading cause of death among children and adolescents worldwide. This study examined the prevalence and characteristics of suicides among children and adolescents (aged ≤ 19 years) over a 13-year period in the broader area of Athens, Greece. Key aspects analyzed included victim demographics, circumstances surrounding the incidents, and methods employed. Methods: A retrospective analysis was conducted on autopsy cases performed at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, from 1 January 2011, to 31 December 2023. Results: Out of 5819 autopsies conducted between 2011 and 2023, 371 were classified as suicides. Among these, 12 cases (representing 3.2% of suicides) involved children and adolescents aged ≤ 19 years and met the study’s inclusion criteria for detailed forensic analysis. The average age of the victims was 17.7 ± 2.1 years (range: 14–19), with males representing 58.3% of cases. Hanging was the most common method of suicide (9 cases, 75.0%), followed by firearm use, falls from height, and hydrogen sulfide inhalation (one case each). Death occurred in the home in 10 cases (83.3%), with 6 specifically taking place in the bedroom. Scars indicative of prior self-harming behavior were present in two cases (16.7%), while suicide notes were found in three cases (25.0%). Toxicological analysis revealed alcohol and cannabis use in one case, cannabis alone in one case, and alcohol alone in two cases. Four victims (33.3%) had a documented psychiatric diagnosis, with two of them under antidepressant treatment at the time of death. Conclusions: This study highlights the forensic value of autopsy-based investigations in unveiling hidden patterns of adolescent suicidality and informs targeted prevention strategies. Integrating medico-legal findings into public health responses may enhance early identification and intervention in vulnerable youth populations. Full article

Background: Mental health issues among youth are a growing public health concern. Schools play a vital role in the early detection and prevention of mental health issues, with principals being central to the implementation of mental health initiatives. This study assessed the attitudes, preparedness, and practices of school principals regarding mental health promotion and prevention among school-aged children. Methods: A cross-sectional survey using computer-assisted web interviewing (CAWI) was conducted between March and April 2025. A 19-item questionnaire was sent to all 1564 primary and secondary school principals in the Lodz region. Data from 605 respondents (response rate: 38.7%) were analyzed. Results: A total of 94.9% of the principals reported an increase in student mental health problems over the past five years. Over one-quarter of school principals (26.3%) declared a very good or rather good level of preparation for teachers to work with students diagnosed with a mental disorder. Moreover, 42.3% declared a very good or rather good level of preparation of teachers for conversations with parents about mental health problems observed in their children. Mental health education was conducted in 94.7% of schools, and teacher training in 73.2% of schools. Secondary schools more often offered such training (81.9% vs. 70.7%; p = 0.01) and reported stronger support from specialist teachers (79.7% vs. 67.7%; p = 0.01) than primary schools did. Rural schools rated teacher-parent communication more positively (47.0% vs. 37.7%; p = 0.02) despite fewer training initiatives (68.7% vs. 77.7%; p = 0.01). Suicide response procedures were implemented in 78.5% of schools. Conclusions: The findings confirm a marked rise in student mental health needs and reveal structural disparities in providing school-based support. Enhancing school leadership, expanding teacher training, and ensuring systemic support may facilitate mental health promotion interventions in schools. Full article

Background: Unhealthy lifestyles constitute significant risk factors for adolescent suicide, and their detrimental effects may persist from adolescence into adulthood. This research study sought to examine how Body Mass Index (BMI), alongside various lifestyle behaviors among teenagers in Korea, correlates with suicidal thoughts, the formulation of suicide plans, and actual suicide attempts. Methods: The research examined unprocessed information collected during the 2022 Korean Youth Risk Behavior Web-based Survey (KYRBS), which was administered by the Korea Disease Control and Prevention Agency (KDCA). Lifestyle factors associated with suicidal behavior were selected as independent variables. The sample was stratified according to BMI for further analysis. Logistic regression models were applied to assess the association between lifestyle factors and the risk of adolescent suicide. Results: The analysis identified significant correlations between unhealthy dietary patterns, hazardous drinking behavior, smoking, and a sleep duration of less than 5 h, all of which were associated with a heightened suicide risk among adolescents. Notably, underweight adolescents who had a sleep duration of less than 5 h demonstrated a markedly elevated risk of suicidal ideation (OR = 2.391, 95% CI [1.035–5.525]). Among overweight adolescents, frequent coffee consumption was significantly associated with both suicidal planning (OR = 1.850, 95% CI [1.133–3.020]) and suicide attempts (OR = 1.958, 95% CI [1.024–3.742]). Importantly, hazardous drinking behavior was strongly associated with suicide attempts (OR = 2.277, 95% CI [1.132–4.580]). Non-smoking behavior exhibited a significant relationship with a decreased likelihood of suicidal ideation (OR = 0.706, 95% CI [0.507–0.983]) and suicidal planning (OR = 0.528, 95% CI [0.299–0.930]). Furthermore, among obese adolescents, non-smoking behavior significantly decreased the risk of suicidal ideation compared to smoking (OR = 0.514, 95% CI [0.297–0.887]). Conclusions: The study revealed that the combined impact of unhealthy behaviors—smoking, eating an unhealthy breakfast, sleeping for less than 5 h, and hazardous drinking behavior—significantly affect suicide-related behaviors in adolescents. The interaction between BMI and lifestyle factors is a critical determinant of these behaviors. Specifically, sleep health exerts a substantial influence on suicide-related behaviors in underweight adolescents, while smoking strongly correlates with suicidal behaviors in overweight and obese adolescents. Targeted attention to the interplay of smoking, diet, sleep, and alcohol consumption with BMI is crucial for the early detection and prevention of adolescent suicide. Full article

Background The COVID-19 epidemic had a deleterious impact on mental health and substance abuse and led to an increase in several forms of violence, including self-harm and interpersonal violence among youth from low- and middle-income countries. Nevertheless, the relationship between the variables and their directionality has not been recognized. This study describes the relationship directionality between these variables among 18- to 20-year-old Mexican youths during the COVID-19 pandemic. Methods The longitudinal cohort study comprises an evolving group of young Mexican adults: 1390 participants aged 18 in 2021, 654 aged 19 in 2022, and 442 aged 20 in 2023. Proportions by sex—50% were matched in every cohort, and the evolution–age sample accomplishment accounted for 47% in 2022 and 32% in 2023. Results According to a structural equation model, which fit the data from 195 iterations with 246 parameters (X²[2722] = 8327.33, p < 0.001), yielding a CFI of 0.946, a TLI of 0.943, and an RMSEA of 0.029 [0.028–0.029]), perpetrating intimate violence, preceded by suffering intimate violence, combined with suffering anxiety symptoms, was associated with self-harm–suicide thoughts and behaviors (ShSTB), marked distress, dysfunction, and somatization symptoms. The relationship was stronger in women and 20-year-old Mexicans. In men, this pathway was exclusively associated with ShSTB. Suffering from intimate violence has been associated with depression, anxiety, and PTSD symptoms, as well as harmful alcohol use. Conclusions During an epidemic, prevention programs should be designed to warn about self-harm–suicide thoughts and behaviors, not only to ensure the safety of the victims of intimate personal-violence but also to prevent the suicidal behavior of perpetrators. Full article

Background/Objectives: The homeless population (HP) is a heterogeneous group characterized by the absence of stable and conventional housing, often relying on public spaces and deteriorated environments for shelter and survival, either temporarily or permanently. This group is exposed to multiple health vulnerabilities, with substance use disorder (SUD) identified as a significant risk factor for suicidal behavior. The aim of this study was to conduct a scoping review of the relationship between PAS use and suicide among homeless individuals. Methods: A comprehensive literature search was performed using five databases: PubMed, Scopus, SciELO, LILACS, and Google Scholar. Studies were selected based on their relevance to the topic, and data were extracted regarding substance use, suicide-related outcomes, and associated sociodemographic and clinical factors. Results: The findings indicated a strong association between PAS use and increased suicidal ideation and behavior among homeless individuals, particularly among youth, men, and women. Opioids and alcohol were the most frequently reported substances in this context. Additional factors such as unemployment, exposure to violence, social inequalities, and mental health disorders further exacerbated the risk of suicide in this population Conclusions: The reviewed literature underscores the urgent need for integrated, context-sensitive interventions addressing both substance use and mental health among the homeless. Tailored public health strategies focused on prevention, harm reduction, and psychosocial support are essential to reducing suicide risk and promoting overall well-being in this highly vulnerable group. Full article

The phenomenon of suicide has become a significant global concern, claiming over 800,000 lives annually and resulting in millions of suicide attempts worldwide. In the aftermath of the COVID-19 pandemic, these troubling statistics have worsened, with notable increases in suicidal behavior, especially among vulnerable populations such as the youth, the elderly, and those in socioeconomically disadvantaged groups. This paper aims to explore the impact of the COVID-19 pandemic on suicide rates in Spain, using a theoretical ex post facto analysis. Spain has witnessed an alarming rise in suicide rates, particularly among young people, and a disturbing trend of increased suicidal ideation and self-harm behaviors. While some studies report no significant change in suicide rates during the pandemic, others point to the exacerbating effects of social isolation, economic instability, and public health measures. This study provides an in-depth examination of the psychosocial consequences of the pandemic on mental health in Spain, emphasizing the urgency of the need to address pre-existing inequalities and implement effective suicide prevention measures. Furthermore, it highlights the importance of gender-sensitive strategies and the need for systemic reforms to ensure better mental healthcare access for all segments of society. To achieve this goal, this paper uses a narrative literature review combined with a theoretical ex post facto analysis to assess the influence of the COVID-19 pandemic on suicide patterns in Spain. Full article

Suicide is a major public health concern, and Uruguay has one of the highest suicide mortality rates in the Americas. In 2022, the Ministry of Public Health implemented a real-time digital surveillance system for suicide attempts as part of the National Suicide Prevention Strategy. This study presents findings from its first year, analysing 4723 emergency department presentations nationwide. The age-standardised suicide attempt rate was 140.44 per 100,000 inhabitants, with women accounting for 71.6% of cases. Self-poisoning was the most common method, followed by hanging and suffocation for men and self-cutting for women. Nearly half of all attempts involved individuals aged 15–29, highlighting the need for youth-focused and gender-sensitive interventions. This study demonstrates the value of real-time surveillance systems in identifying at-risk groups, informing prevention efforts, and supporting timely interventions. While some challenges in system implementation remain, future efforts should focus on strengthening data integration, leveraging artificial intelligence for risk assessment, and improving follow-up care to reduce repeated attempts and overall suicide mortality. Full article

Background/Objectives: Adequate sleep is critical for adolescents’ physical and mental health. However, academic demands and lifestyle habits lead to insufficient sleep among many adolescents. This study examined the relationship between sleep patterns and general characteristics, health behaviors, and mental health among South Korean adolescents. Methods: Data were obtained from the Korea Youth Risk Behavior Survey conducted by the Korea Disease Control and Prevention Agency, involving 21,283 students aged between 13 and 18 years. Self-reported sleep duration was categorized as adequate (8–10 h) or insufficient (less than 8 h on both weekdays and weekends), and 20 independent variables across demographic, socioeconomic, lifestyle, health-related behavioral, and psychological factors were analyzed. Multiple logistic regression analyses were conducted to evaluate the effects of insufficient sleep. Results: Insufficient sleep was more prevalent among female students (odds ratio [OR]: 2.064) and older students (OR: 16.588 for Grade 12 vs. Grade 7) and was associated with higher stress levels (OR: 4.338 for almost always vs. never), suicidal ideation (OR: 1.826), and unhealthy behaviors such as alcohol consumption (OR: 2.009), smoking (OR: 1.998), and smartphone overdependence (OR: 2.313 for severe vs. normal). In contrast, adolescents with adequate sleep reported greater happiness (OR: 4.167 for very much vs. not at all) and better academic performance (OR: 1.377 for very high vs. very low). Conclusions: The findings show that insufficient sleep significantly affects adolescent well-being, highlighting the need for tailored interventions and increased societal awareness. Future research should explore the mechanisms underlying gender differences and weekday–weekend sleep disparities to enhance sleep quality in this population. Full article

Background/Objectives: Suicide in the United States (US) adolescents is a major clinical and public health problem. In this original investigation, we explored trends in suicidal behaviors (ideation, planning, and attempts) among US adolescents from 2011 to 2021. Methods: The study sample included 90,306 adolescents from the 2011–2021 Youth Risk Behavior Surveillance System. Descriptive statistics and the chi-squared test were used to assess differences in suicidal behaviors across gender, race/ethnicity, and grade between 2011 and 2021. Results: The overall percentage of female adolescents reporting suicidal behaviors increased significantly between 2011 and 2021, and it was higher than males. In 2021, females exhibited significantly higher rates of considering suicide (30.0% vs. 14.3%), planning (23.6% vs. 11.6%), and attempts (13.3% vs. 6.6%) compared to their male counterparts. Whites were more likely to report suicidal ideation (22.7%) while Black non-Hispanic youth had a higher likelihood of making a suicide plan (17.7%), attempting suicide (14.5%), or making a suicide attempt requiring medical treatment (4.4%) relative to other racial/ethnic groups. Overall, ninth graders were more likely to report suicide attempts (11.6%) compared to 12th graders (8.6%). Conclusions: The results demonstrate significant increases in suicidal behavior among US adolescents, particularly in females. They suggest the need for gender-sensitive approaches in mental health support and prevention strategies. Overall, given the significant increase in suicidal behaviors, healthcare providers as well as public health professionals should prioritize mental health initiatives, promote awareness, and ensure access to mental health resources for adolescents. Full article

Suicide rates have increased in the US over the last decades. Schools often deliver suicide prevention trainings and there is growing evidence that these trainings in schools are effective. The current study examined a new upstream approach, CODE RED in which trainees complete their own safety plan prior to a mental health emergency. Participants were adult school personnel (n = 201) who completed CODE RED trainings and were surveyed using three validated 4-item measures: acceptability of intervention measure (AIM), intervention appropriateness measure (IAM), and feasibility of intervention measure (FIM). Open-ended questions were analyzed using a thematic approach. Of 201 participants who completed the survey, acceptability (18.0), appropriateness (17.9) and feasibility (18.0) were high as assessed by standardized implementation measures (each out of 20). Open-ended responses further indicated a great deal of satisfaction with the training. As a first step in determining acceptability and feasibility, CODE RED was found to be highly acceptable to adult school employees who found it applicable, appealing as an intervention, and easy to use. Most staff are hopeful that it will be useful with youth as well. It will be important to determine how this activity is used by youth and if it can be used in mental health crises to decrease symptoms. Full article

Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust suicide prevention program which includes a community-led database and case management follow-ups. Due to the success of the program in preventing suicides, the White Mountain Apache team has worked with other tribal communities to adapt the program. We wanted to understand the factors that are most important to implementing and sustaining this model and how these factors compare with existing implementation science frameworks. We employed an adapted nominal group technique to compile facilitators and barriers to implementation of the suicide prevention model across settings with five partner teams. Two researchers independently coded the resulting list of facilitators and barriers using the Consolidated Framework for Implementation Research (version 1.0) codebook. The final list of cross-site prioritized facilitators and barriers included 41 factors. Some factors did not match easily with the framework’s constructs. The White Mountain Apache suicide prevention team noted that seven of the top prioritized factors are considerations they most try to emphasize to new communities working in suicide prevention. The factors fall into two key themes: staffing and tribal engagement. This finding affirms their focus when they conduct suicide prevention trainings with new communities and provides an opportunity for more structure and in-depth training in those two areas. Several factors could not be easily coded to the framework, especially around the sociocultural characteristics of suicide prevention work in Native communities. This contributes to the larger discussion in implementation science concerning the ways in which Indigenous approaches to public health differ from Western models. Full article

Background/Objectives: A favorable attitude towards suicidal behavior is associated with an increased risk of suicidal behavior in youth populations. Hence, the aim of the present study was to analyze attitudinal beliefs about suicidal behavior among Mexican medical and nursing students. We also compared attitudinal beliefs about suicidal behavior according to the religious affiliation of the participants. Methods: This is a cross-sectional observational study. Attitudinal beliefs about suicidal behavior were assessed using the Attitudinal Beliefs Questionnaire about Suicide Behavior (CCCS-18). We evaluated personal and family histories of suicide using the Spanish version of the MINI International Neuropsychiatric Interview. Comparative analysis between nursing and medical students was performed, using Chi-square tests for categorical variables and Student t-tests for continuous variables. Results: A total of 195 (52.2%) medical students and 178 (47.8%) nursing students participated. Medicine students reported a higher prevalence of a family history of suicide attempts and knowing someone who had tried to die by suicide compared to nursing students (p = 0.001). Regarding attitudinal beliefs—specifically, suicide in terminal patients—medical students reported higher scores than nursing students (9.50 ± 5.91 vs. 11.23 ± 6.38, p < 0.001), while the latter exhibited higher scores in attitudinal beliefs related to suicide itself (9.55 ± 4.45 vs. 7.28 ± 4.09, p < 0.001). Both groups display similar scores when compared by religious affiliation. Conclusions: Our findings show differences in attitudinal beliefs about suicidal behavior between medical and nursing students. Medical students exhibited more positive responses toward suicide in terminal patients, while nursing students had higher values for attitudinal beliefs related to suicide itself. These results could be considered in the planning of health sciences curricula in order to positively impact future suicide prevention efforts. This study was retrospectively registered at the Universidad Juarez Autónoma de Tabasco, with the registration number 20240063 on 8 June 2024. Full article

Background: Suicide is the second leading cause of death among American Indian (AI) adolescents and young adults in the 15- to 24-year-old age group and is the third leading cause of death in the 10- to 14-year-old age group. Methods: Key informant interviews were conducted with AI youth (n = 10) ages 12–18, and young AI adults (n = 10) ages 19–24 to gather input on activities and programs to decrease AI suicidal-related behaviors in Nebraska. These interviews were 45 min in length at maximum. Themes were created once the interviews were completed. Results: The overarching theme was creating and implementing more suicide prevention programs and cultural activities for these age groups. Respondents identified three important characteristics that they believe all programs should have: (1) positive reinforcement, (2) culturally-centered activities, and (3) strength-based approaches that are not from a negative or punitive viewpoint. Conclusion: The results from these interviews can be used to build strengths-based approaches to promoting positive mental health in Indigenous communities and can lead to other successful programs and activities. Full article

Objectives: This systematic review evaluates the anti-suicidal properties of Lithium in children and adolescents with Bipolar Disorder (BD), addressing gaps in evidence regarding its efficacy and safety in reducing suicidality and self-harming behaviors. Methods: A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus up to February 2024. Eligible studies were those focusing on patients aged 25 years or younger, examining Lithium therapy and its impact on suicidal ideation and behaviors. The review included randomized controlled trials, longitudinal prospective and retrospective studies, and cross-sectional studies, while excluding expert opinions and case reports. Results: Evidence generally supports the efficacy of Lithium in reducing suicidal ideation and self-harming behaviors in youth with BD, though results are mixed. Randomized controlled trials demonstrated its effectiveness in mitigating suicidal thoughts during acute manic episodes, with effects persisting post-treatment. Longitudinal studies suggested that Lithium might offer superior outcomes compared to other mood stabilizers, although its specific impact on suicidality remains inconclusive. Cross-sectional studies and retrospective analyses reveal associations between Lithium use and reduced self-harming behaviors, but causality remains uncertain. While mood-stabilizing effects of Lithium offer potential benefits for reducing suicidality in youth, evidence on its direct impact on emotional dysregulation (ED) and long-term efficacy is limited. Variability in individual responses and adherence issues underscore the need for further research. Future studies should include larger, diverse samples, focus on ED symptoms, and explore Lithium mechanisms in suicidality prevention. Conclusions: Lithium remains a promising treatment for mood stabilization and reduction in suicidality in youth with BD. Full article