Mortalidade por suicídio no Brasil: análise temporal (2010-2021) e comparação com os primeiros dois anos da pandemia de COVID-19 / Suicide mortality in Brazil: temporal analysis (2010-2021) and comparison with the first two years of the COVID-19 pandemic

Objetivo: Analisar casos de suicídio no Brasil de 2010 a 2021 e as características sociodemográficas deste fenômeno, incluindo os primeiros dois anos da pandemia de COVID-19, para avaliar a existência de relação dos aumentos de casos de suicídio no Brasil com esta doença. Métodos: Estudo ecológico de linhas temporais, com 140.339 casos analisados a partir das bases de dados do Sistema de Informações sobre Mortalidade (SIM). Taxas e regressões estatísticas foram aplicadas no software STATA®. Resultados: Observou-se maiores taxas de suicídio em homens, solteiros, e residentes nas regiões Sul e Centro-Oeste. A faixa etária de 10 a 19 anos teve crescimento de 1,7 casos x 100 mil habitantes/ano. A análise por região revelou variações significativas nas taxas, sugerindo influência de fatores contextuais. Embora a pandemia tenha gerado impactos na saúde mental, não foi possível estabelecer relação direta entre a COVID-19 e o aumento das taxas de suicídio. Conclusão: Esses resultados reforçam a necessidade de políticas públicas e intervenções preventivas, especialmente para grupos vulneráveis, como os jovens. Abordagem multifatorial é sugerida, considerando fatores socioeconômicos, acesso a serviços de saúde mental e redução do estigma associado com doenças mentais. Em suma, este estudo contribui para a compreensão das tendências temporais e características demográficas dos suicídios no Brasil, ressaltando a importância de investigações longitudinais adicionais para melhor compreensão desse fenômeno complexo. Espera-se que essas evidências fortaleçam as políticas de saúde mental e promovam estratégias mais eficazes de prevenção do suicídio.

Objective: To analyze suicide cases in Brazil from 2010 to 2021 and the sociodemographic characteristics of this phenomenon, including the first two years of the COVID-19 pandemic, to assess whether there was a relationship between the increase in suicide cases in Brazil and this illness. Methods: Ecological timeline study, with 140,339 cases analyzed from the Mortality Information System (SIM) databases. Rates and statistical regressions were performed using STATA® software. Results: Higher suicide rates in men, singles, and residents of the South and Midwest regions were observed. The age group of 10­19 years had an increase of 1.7 cases x 100 thousand inhabitants/year. Analysis by region revealed significant variations in rates, suggesting the influence of contextual factors. Although the pandemic affected mental health, it was not possible to establish a direct relationship between COVID-19 and increased suicide rates. Conclusion: These results reinforce the need for public policies and preventive interventions, especially for vulnerable groups such as young people. A multifactorial approach is suggested that considers socioeconomic factors, access to mental health services, and reduced stigma associated with mental illness. In short, this study contributes to understanding the temporal trends and demographic characteristics of suicides in Brazil, highlighting the importance of further longitudinal investigations to better understand this complex phenomenon. Hopefully, this evidence will strengthen mental health policies and promote more effective suicide prevention strategies.

UTILIZING AI TECHNOLOGY TO PREVENT SUICIDAL BEHAVIOR BY ANALYSING SENTIMENTS EXPRESSED ON SOCIAL MEDIA PLATFORMS.

This study introduces a technique for leveraging sentiment analysis to detect potential suicide risk among social media users. Our approach utilizes machine learning to scrutinize the textual content of social media posts and identify signicant markers of suicidal behavior. Our methodology comprises data collection, data preprocessing, data labeling, machine learning model training, and model testing. The effectiveness of our approach is assessed using precision, recall, and F1 score metrics. The outcome of our evaluation demonstrates that our method is adept at detecting individuals who may be at risk of suicide on social media, yielding an impressive F1 score of 0.85.

Assessment of Suicide Risk and Potential Protective Factors among Patients Admitted at a Tertiary Mental Health Care Institute in Assam

Suicide is a major public health concern having a number of risk factors. Psychopathology is found to be one of the many protective factors of suicide. The current study intended to appraise the risks of attempting suicide and the presence of preventive factors among the patients admitted to tertiary mental health care setting. A total of 53 patients with mental illness care hospital in- cluded in the study. The risk of suicide was assessed with modified SAD PERSONS and Nurses'#39; Global Assessment of Suicide Risk tools and protective factors were assessed with the Reasons for Living inventory. The result showed that 13.3 percent of the admitted patients with mental illness had high risk of suicide and 3.8 percent very high risk of suicide requiring hospitalisation for the same. The participants had scored considerably higher in protective factors as described by the reasons for living inventory.

El suicidio asistido como estrategia de prevención del suicidio traumático / Assisted suicide as prevention against traumatic suicide

En este artículo, el autor reflexiona sobre la importancia de reconocer el suicidio como un problema de salud pública,sus causas y las recomendaciones generales para prevenirlo. Finalmente, propone considerar la muerte médicamente asistida o el suicidio asistido como una estrategia de prevención del suicidio traumático. (AU)

In this article, the author reflects on the importance of recognizing suicide as a public health problem, its causes, and general recommendations to prevent it. Finally, he proposes considering medical assistance in dying or assisted suicide as a prevention strategy against traumatic suicide. (AU)

Profesores delante del comportamiento suicida de alumnos adolescentes: percepciones e intervenciones / Professores diante do comportamento suicida de alunos adolescentes: percepções e intervenções / Teachers facing the suicidal behavior among adolescent students: perceptions and interventions

Esta pesquisa buscou analisar intervenções de professores do Ensino Médio integrado ao perceberem o comportamento suicida em alunos. Para tanto, desenvolveu-se uma pesquisa de campo, de abordagem qualitativa e natureza aplicada com 12 professores efetivos de uma instituição federal de ensino. Os dados foram coletados por formulário eletrônico (Google Forms) e analisados por meio da análise de conteúdo. Os achados revelaram que os docentes têm uma visão superficial acerca do suicídio e dificuldades em manejar o comportamento suicida de seus alunos e, quando o fazem, tomam como base valores e experiências pessoais; hesitação e insegurança marcam as condutas dos docentes. O estudo realça a necessidade de a escola se tornar um espaço de diálogo e formação docente acerca do comportamento suicida.

En esta investigación se buscó analizar intervenciones de profesores de la enseñanza secundaria integrada al percibir el comportamiento suicida en alumnus. Para tanto, se desarrolló una investigación de cmapo, de abordaje cualitativa y naturaleza aplicada con 12 profesores efectivos de una institución federal de enseñanza. Los datos se recompilaron por formulario electrónico (Google Forms) y analizados através del análisis de contenido. Los hallazgos apuntaron que los docents tienen una visión superficial acerca del suicidio y dificultades en manejar el comportamiento suicida de sus almnos; cuando lo hacen, toman como base valores y experiencias personales; hesitación e inseguridad marcan las condutas de los docents. El studio pone de relieve la necesidad de la escuela volverse espacio de diálogo y formación docente acerca del comportamiento suicida.

This research sought to analyze the interventions of integrated high school teachers when they perceived suicidal behavior in students. Therefore, a field research was developed, with a qualitative approach and applied nature, with 12 permanent professors from a federal educational institution. Data were collected using an electronic form (Google Forms) and analyzed through content analysis. The findings revealed that teachers have a superficial view of suicide and difficulties in managing their students' suicidal behavior; when they do so, they are based on personal values and experiences; hesitation and insecurity mark the conduct of professors. The study highlights the need for the school to become a space for dialogue and teacher training on suicidal behavior.

Moral distress experienced by online suicide prevention volunteers: qualitative research / La angustia moral experimentada por los voluntarios de la prevención del suicidio en línea: investigación cualitativa / Stress moral experimentado por voluntários de prevenção de suicídio online

Abstract: Background: With the increasing number of internet users, it becomes feasible to identify individuals at high risk of suicide and then carry out online suicide prevention. At the same time, online suicide prevention volunteers may encounter moral distress, which requires more attention. Purpose: This study aimed to explore the experience of moral distress in online suicide prevention. Method: The study was carried out as a qualitative study following the method of phenomenology. 11 interviewers were recruited through the purposive sampling method. Data were collected through semi-structured, in-depth face-to-face interviews. Colaizzi's phenomenological framework was used for data analysis. Results: All participants reported they encountered moral distress during online suicide prevention. Four themes were condensed, including: "constraints from the surrounding," "be cruel to be kind," "baby spoiled by free milk," and "when face death and depression" Participants also described their emotional experiences and response when they encountered moral distress. Conclusion: Moral distress in the process of online suicide prevention exists. More attention should be paid to the moral distress and ethical issues in online suicide prevention as the internet gradually becomes a brand-new way to prevent suicide.

Resumen: Antecedentes: Con el creciente número de usuarios de Internet, es posible identificar a las personas con alto riesgo de suicidio y llevar a cabo la prevención del suicidio en línea. Al mismo tiempo, los voluntarios de esta prevención pueden encontrarse con angustia moral, lo que requiere más atención. Objetivo: Este estudio tiene como objetivo explorar la experiencia de la angustia moral en la prevención del suicidio en línea. Método: El estudio se llevó a cabo como un estudio cualitativo siguiendo el método de la fenomenología. Se reclutó a 11 entrevistadores mediante el método de muestreo intencional. Los datos se recogieron mediante entrevistas semiestructuradas y en profundidad, cara a cara. Se utilizó el marco fenomenológico de Colaizzi para el análisis de los datos. Resultados: Todos los participantes informaron que habían encontrado angustia moral durante la prevención del suicidio en línea. Se condensaron cuatro temas, a saber: "limitaciones del entorno", "ser cruel para ser amable", "bebé mimado por la leche gratis" y "cuando se enfrenta a la muerte y la depresión". Los participantes también describieron sus experiencias emocionales y su respuesta cuando se encontraron con la angustia moral. Conclusión: La angustia moral en este proceso existe. Hay que prestar más atención a la angustia moral y a las cuestiones éticas en la prevención del suicidio en línea, ya que Internet se convierte gradualmente en una nueva forma de prevenir el suicidio.

Resumo: Antecedentes: Com o crescente número de usuário de internet, torna-se viável identificar indivíduos com alto risco de suicídio e então conduzir prevenção de suicídio online. Ao mesmo tempo, voluntários de prevenção de suicídio online podem enfrentar stress moral, o qual requer mais atenção. Proposta: Esse estudo objetiva explorar a experiência de stress moral em prevenção de suicídio online. Método: O estudo foi conduzido como um estudo qualitativo seguindo o método da fenomenologia. Foram recrutados 11 entrevistados do método de amostragem intencional. Foram coletados dados através de entrevistas face a face, semiestruturadas e em profundidade. O referencial fenomenológico de Colaizzi foi utilizado para análise dos dados. Resultados: Todos os participantes relataram terem experimentado stress moral durante a prevenção de suicídio online. Quatro temas foram condensados: "limitações do ambiente", "ser cruel para ser gentil", "bebê mimado com leite gratuito" e "quando encarando a morte e a depressão". Os participantes também descreveram suas experiências emocionais e respostas quando enfrentaram stress moral. Conclusão: Stress moral no processo de prevenção de suicídio online existe. Mais atenção deve ser dada ao stress moral e aspectos éticos em prevenção de suicídio online na medida em que a internet se torna gradualmente uma maneira totalmente nova de prevenção de suicídio.

Mental health interventions for suicide prevention among indigenous adolescents: a systematic review

ABSTRACT BACKGROUND: The legacies of colonization and of policies of forced assimilation continue to be a cause of intergenerational trauma, manifested through feelings of marginality, depression, anxiety and confusion, which place indigenous peoples at increased risk of suicide. OBJECTIVES: To assess the quality, content, delivery and effectiveness of interventions for preventing suicides among indigenous adolescents. DESIGN AND SETTING: Systematic review conducted with Cochrane methodology, Campo Grande, Mato Grosso do Sul, Brazil. METHODS: The Cochrane library, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO databases were searched for studies published up to February 2021. The following inclusion criteria were used: published in any language; interventions that aimed to prevent suicides among indigenous adolescents; randomized or non-randomized study with a control or comparative group; and validated measurements of mental health problems. RESULTS: Two studies were identified: one on adolescents in the remote Yup'ik community in south-western Alaska, and the other on Zuni adolescents in New Mexico. Both studies showed evidence of effectiveness in interventions for reducing some of the risk factors and increasing some of the protective factors associated with suicide. High levels of community engagement and culture-centeredness were key anchors of both studies, which ensured that the intervention content, delivery and outcome measurements aligned with the beliefs and practices of the communities. Both studies were judged to have a moderate risk of bias, with biases in sample selection, attrition and inadequate reporting of results. CONCLUSIONS: The current evidence base is small but signaled the value of culturally appropriate interventions for prevention of suicide among indigenous adolescents. REGISTRATION DETAILS: The study protocol is registered in the international prospective register of systematic reviews (PROSPERO); no. CRD42019141754.

Assessment and associations between quality of life and risk of suicide / Avaliações e associações entre qualidade de vida e risco de suicídio / Evaluaciones y asociaciones entre calidad de vida y riesgo de suicidio

This study aimed to verify the extent to which the levels of quality of life are related to and influence suicide risk indices. A descriptive, correlational, quantitative research was performed. A non-probabilistic sample was used which was composed of 11,863 Brazilian participants all over 18 years old, who responded to the Risk Assessment Suicide Scale (RASS) and the World Health Organization Quality of Life BREF Instrument (WHOQOL-BREF), and whose data were analyzed by using descriptive statistics, the Spearman correlation and multiple linear regression using the Statistical Package for Social Sciences (SPSS). The results identify negative, moderate and significant correlations between the constructs, and that the domains of quality of life influence 47.8% of the variations in the suicide risk indices, confirming that the psychological domain is the most relevant within the explanatory model created. The conclusion is that there is a the need for public policies to improve the quality of life and prevent suicide (AU).

Este estudo objetivou verificar em que medida os níveis de qualidade de vida se relacionam e influenciam os índices de risco de suicídio. Realizou-se uma pesquisa descritiva, correlacional, de abordagem quantitativa. Contou-se com uma amostra não probabilística composta por 11.863 participantes - brasileiros e maiores de 18 anos, que responderam à Risk Assessment Suicide Scale (RASS) e ao Word Health Organization Quality of Life Instrument Bref(WHOQOL-bref), cujos dados foram analisados por meio de estatística descritiva, correlação de Spearman e regressão linear multivariada pormeio do Statistical Package for Social Science (SPSS). Os resultados identificam correlações negativas, moderadas e significativas entre os construtos; e que os domínios de qualidade de vida influenciam em 47,8% as variações nos índices de risco de suicídio, constatando que o domínio psicológico é o mais relevante dentro do modelo explicativo criado. Conclui-se a necessidade de políticas públicas para melhoria da qualidade de vida e prevenção de suicídio (AU).

Este estudio objetivó comprobar hasta qué medida los niveles de calidad de vida se relacionan e influyen en las tasas de riesgo de suicidio. Se realizó una investigación descriptiva, correlacional y cuantitativa. Hubo una muestra no probabilística compuesta por 11.863 participantes brasileños mayores de 18 años, que respondieron a la Risk Assessment Suicide Scale (RASS) y al Word Health Organization Quality of Life Instrument Bref(WHOQOL-bref), cuyos datos fueron analizados mediante estadística descriptiva, correlación de Spearman y regresión lineal multivariante en Statistical Package for Social Science (SPSS). Los resultados identifican correlaciones negativas, moderadas y significativas entre los constructos; y que los dominios de calidad de vida influyen en un 47,8% en las variaciones de los índices de riesgo de suicidio, encontrando que el dominio psicológico es el más relevante dentro del modelo explicativo creado. Estos hallazgos revelan la necesidad de políticas públicas para mejorar la calidad de vida y prevenir el suicidio (AU).

Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness

A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and costeffectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation. (AU)

Comportamento suicida: o paradoxo vida e morte em meio à pandemia de COVID-19 / Suicide behavior: life and death paradox in the midst of the COVID-19 pandemic / La conducta suicida: la paradoja de la vida y la muerte en el contexto de la pandemia de COVID-19

A pandemia da COVID-19 provoca inúmeros impactos na saúde mental, que variam desde reações esperadas de estresse agudo até agravos que podem descompensar condições psicopatológicas preexistentes ou deflagrar novas. O objetivo deste estudo é identificar e analisar fatores de risco para o suicídio que podem ser exacerbados pela situação de emergência sanitária global. A revisão narrativa permitiu mapear os seguintes fatores de risco: luto complicado, insegurança econômica, isolamento social, violência doméstica, abuso de álcool e drogas, barreiras no acesso ao sistema de saúde e às redes de suporte comunitário, psicossocial e espiritual, riscos inerentes às situações de hospitalização e vulnerabilidade dos profissionais da linha de frente. Também foram abordados aspectos que podem funcionar como proteção e métodos de prevenção/posvenção ao suicídio. A situação pandêmica eleva a vulnerabilidade ao comportamento suicida, porém os efeitos deletérios podem ser mitigados com estratégias de proteção à saúde mental, que devem ter prioridade na agenda de saúde pública (AU).

The COVID-19 pandemic causes numerous impacts on the mental health, ranging from expected reactions of acute stress to more pronounced complications, which can decompensate pre-existing psychopathological conditions or trigger new ones. The purpose of this study is to identify and analyze risk factors for suicide that may be exacerbated by the global health emergency situation. The narrative review allowed mapping the following risk factors: complicated grief, economic insecurity, social isolation, domestic violence, alcohol and drug abuse, barriers in accessing the health system and community, psychosocial and spiritual support networks, risks inherent to hospitalization situations, and vulnerability of frontline professionals. Aspects that can act as protection and methods of suicide prevention and postvention were also addressed. The pandemic situation raises the vulnerability of people to suicidal behavior, but the deleterious effects can be mitigated with mental health protection strategies, which should have priority on the public health agenda (AU).

La pandemia de COVID-19 causa numerosos efectos en la salud mental de las personas, desde las esperadas reacciones de estrés agudo hasta complicaciones que pueden descompensar condiciones psiquiátricas preexistentes o desencadenar otras nuevas. El objetivo de este estudio es identificar y analizar los factores de riesgo de suicidio que pueden verse exacerbados por la situación de emergencia sanitaria mundial. La revisión narrativa permitió mapear los siguientes factores de riesgo: duelo complicado, inseguridad económica, aislamiento social, violencia doméstica, abuso de alcohol y drogas, barreras de acceso al sistema de salud y a las redes de apoyo comunitario, psicosocial y espiritual, riesgos inherentes a las situaciones de hospitalización y vulnerabilidad de los profesionales de primera línea. También se abordaron los factores que pueden funcionar como protección y los métodos de prevención y postvención del suicidio. La situación de pandemia aumenta la vulnerabilidad al comportamiento suicida, pero los efectos nocivos pueden mitigarse con estrategias de protección de la salud mental, a las que debería darse prioridad en la agenda de salud pública(AU).

Estratégias de prevenção do suicídio em médicos: revisão sistemática de literatura / Suicide prevention strategies in physicians: systematic literature review

O objetivo deste estudo foi realizar uma revisão sistemática da literatura para identificar e analisar as estratégias de prevenção do suicídio utilizadas em médicos. A classe médica é uma das que mais cometem suicídio, é um problema mundial e de saúde pública. A Organização Mundial da Saúde -OMS e outras organizações internacionais têm trabalhado juntas para reduzir o suicídio, no entanto, esse fenômeno não foi reduzido entre os médicos. A revisão sistemática foi realizada em cinco base de dados (PubMed, LILACS, SciELO, PsycINFO, Cochrane) com estudos publicados referentes à prevenção do suicídio em médicos nos últimos 11 anos (2008-2018). Foram encontrados apenas 05 artigos que atenderam os critérios de inclusão. Observou-se que não há homogeneidade ou sistematização clara nas intervenções, houve pouca participação dos médicos nos programas de prevenção do suicídio devido ao estigma do transtorno mental e ao suicídio, mas que foram eficazes para aqueles que procuraram por ajuda.

The objective this study was to conduct a systematic literature review to identify and analyze suicide prevention strategies used by physicians. The medical profession is one of the most committing suicide; it is a worldwide and public health problem. WHO (World Health Organization) and other international organizations have worked together to reduce suicide worldwide, but this phenomenon has not been reduced among doctors. The review was performed in five electronic databases (PubMed, LILACS, SciELO, PsycINFO, Cochrane) to systematically find and present published studies on suicide prevention in physicians in the last 11 years (2008-2018). Despite the relevance of the question, only 05 articles that met the inclusion criteria were found. It was observed that there is no clear homogeneity or systematization of interventions, there was little participation of doctors in suicide prevention programs due to the stigma of mental disorder and suicide, but they were effective for those seeking help.

Atención colaborativa para depresión y prevención de suicidio: una intervención viable en el sistema de salud mexicano / Collaborative care for depression and suicide prevention: a feasible intervention within the Mexican health system

Resumen: México enfrenta un enorme desafío para atender los trastornos mentales, con la depresión como uno de los principales contribuyentes a los años de vida ajustados por discapacidad (AVAD) y el aumento de las tasas de suicidio. Estos desafíos se combinan con la escasez de recursos y asignación ineficiente de fondos. Si bien no hay una solución mágica a corto plazo, discutimos experiencias actuales que podrían usarse para brindar una mejor atención primaria en salud mental. Nos centramos en depresión y conducta suicida argumentando que la atención colaborativa es un modelo factible y replicable, enfatizando la capacitación del personal no especializado para que se convierta en administrador de casos y brinde atención primaria en salud mental. México está experimentando un proceso de cambios, incluido el surgimiento de la atención médica universal, por lo que es el momento para que la atención en salud mental sea más transversal, disponible y científicamente probada.

Abstract: Mexico faces an enormous challenge in attending mental health disorders with depression rising as one of the five main contributors to disability adjusted life years (DALYs) and increasing suicide rates. These challenges are coupled with a dearth of resources and an inefficient allocation of the meager funds. While no magical bullet is available to ameliorate this situation in the short term, here we discuss current concepts and experiences that could be used in Mexico to deliver better primary mental health care. We focus on depression and suicidal behavior and argue that collaborative care is a feasible and replicable model, emphasizing the importance of training non-specialized primary care personnel to become case managers and provide primary mental health care. Mexico is currently undergoing a process of changes, including the emergence of universal health care. The time seems right to make mental health care more transversal, widely available and scientifically proven.

Suicide and social media: Dialogue with clinical psychologists / Suicídio e mídias sociais: Diálogos com psicólogos clínicos / Suicidio y medios sociales: Diálogos con psicólogos clínicos

New tools originating from the internet, such as Social Media (SM), offer psychologists complementary methods for psychological treatment and counseling. This study aimed: (a) to comprehend the views of clinical psychologists regarding online professional counseling, especially when the patient is diagnosed with Suicidal Behavior (SB); and (b) to find out what these professionals think about the ways SM and the internet can contribute to the treatment of patients with SB. This was a descriptive, cross-sectional, qualitative study. The participants were ten psychologists that work in a town in the state of Minas Gerais (Brazil). Semi-structured interviews were used to collect data. The sample was defined using the snowball technique, which was terminated when theoretical saturation was detected. The results were analyzed using the thematic analysis of Braun and Clarke, and debated in the light of the contemporary literature focusing on SM and SB. Three thematic axes were formed: Positive and negative aspects of the use of SM in general clinical situations; Positive and negatives perspectives regarding the use of SM when SB is present; and the use of SM in academic and professional environments. The limits and scope of the study are highlighted.

Novas ferramentas advindas da internet, como as mídias sociais (MS), oferecem ao profissional psicólogo métodos complementares de tratamento e acompanhamento psicológico. Este estudo objetivou: (a) compreender a visão de psicólogos clínicos a respeito da atuação profissional on-line, em especial na atenção psicológica a pessoas que apresentam Comportamento Suicida (CS); e (b) averiguar como esses profissionais têm pensado sobre como MS e a internet podem contribuir no tratamento dessas pessoas. O estudo é descritivo, de corte transversal e amparado em enfoque qualitativo. Dez psicólogos clínicos, atuantes numa cidade no interior mineiro, participaram. Entrevistas semiestruturadas foram instrumentos utilizados para coletar dados. A amostra foi definida por meio da técnica de bola de neve e a coleta de dados foi encerrada por saturação teórica. Os resultados foram analisados por meio da análise temática de Braun e Clarke e debatidos à luz de literatura contemporânea que dialoga sobre MS e CS. Três eixos temáticos foram ordenados: Aspectos positivos e negativos no uso de MS em situações clínicas gerais; Perspectivas positivas e negativas frente ao uso de MS quando o CS se presencia; e Uso de MS no meio acadêmico e profissional. Limites e alcance da pesquisa são apontados.

Nuevas herramientas provenientes de internet, como los medios sociales (MS), ofrecen al profesional psicólogo métodos complementarios de tratamiento y acompañamiento psicológico. Este estudio tuvo como objetivos: (a) comprender la visión de psicólogos clínicos acerca de la actuación profesional en línea, en especial en la atención psicológica a personas que presentan Comportamiento Suicida (CS); y (b) averiguar cómo estos profesionales han pensado sobre cómo MS e internet pueden contribuir en el tratamiento de personas que presentan CS. El estudio es descriptivo, de corte transversal y amparado en enfoque cualitativo. Diez psicólogos clínicos, actuando en una ciudad en el interior de Minas Gerais (un estado de Brasil), participaron. Entrevistas semiestructuradas fueron instrumentos utilizados para recoger datos. La muestra fue definida por medio de la técnica de bola de nieve y la recolección de datos fue cerrada por saturación teórica. Los resultados se analizaron por medio del análisis temático de Braun y Clarke y debatidos a la luz de la literatura contemporánea que dialoga sobre MS y CS. Se ordenaron tres ejes temáticos: Aspectos positivos y negativos en el uso de MS en situaciones clínicas generales; Perspectivas positivas y negativas frente al uso de MS cuando el CS se presenta; y el uso de MS en el medio académico y profesional. Los límites y el alcance de la investigación son señalados.

Intervención educativa para la prevención de la conducta suicida en adolescentes y jóvenes / Educational intervention for the prevention of suicidal behavior in adolescents and young people

Introducción: La Organización Mundial de la Salud define el suicidio como "el acto deliberado de quitarse la vida". Los comportamientos suicidas abarcan un amplio espectro, desde la ideación suicida, hasta el intento y la consumación del acto. Objetivo: Determinar los efectos de una intervención educativa en el nivel de conocimientos sobre el comportamiento suicida en adolescentes y jóvenes. Métodos: Se realizó un estudio de intervención educativa encaminado a adolescentes y jóvenes, pertenecientes al área de salud del policlínico docente Bayamo Oeste, en el período comprendido entre abril del 2010 y marzo del 2011. A través de cuestionarios se identificó el riesgo suicida dentro de los participantes, así como el nivel de conocimientos sobre el tema; a partir de ello se desarrollaron actividades docentes educativas con temáticas referentes al suicidio. Los datos fueron procesados mediante el sistema SPSS y se emplearon como medidas de resumen de variables cuantitativas las frecuencias absolutas y porcentajes. Resultados: Se identificaron 11 participantes con riesgo suicida. Más del 80 por ciento del grupo de estudio muestra nuevos conocimientos luego de aplicada la intervención educativa. Conclusiones: Se diseñó y aplicó con efectividad la intervención educativa lo cual permitió elevar el nivel de conocimientos sobre el comportamiento suicida en adolescentes y jóvenes(AU)

Introduction: Suicide is defined by the World Health Organization as "the deliberate act of taking one's own life". Suicidal behavior covers a wide spectrum, from suicidal ideation to the attempt and completion of the act. Objective: To determine the effects of an educational intervention on the level of knowledge of suicidal behavior in adolescents and young people. Methods: We conducted an educational intervention study aimed at adolescents and young people, belonging to the health area of the Bayamo Oeste teaching polyclinic, in the period between April 2010 and March 2011. Through questionnaires, we identified the suicidal risk within the participants, as well as the level of knowledge about the subject; from this, educational teaching activities were developed with topics related to suicide. The data obtained were processed through the SPSS and absolute frequencies and percentages were used as summary measures of quantitative variables. Results: 11 participants with suicidal risk were identified. More than 80 percent of the study group showed new knowledge after the educational intervention was applied. Conclusions: The educational intervention was designed and effectively applied which allowed to increase the level of knowledge about suicidal behavior in adolescents and young people(AU)

Prevención del suicidio: concepción de estudiantes universitarios / Suicide prevention: university students' conception / Prevenção do suicídio: concepção de estudantes universitários

Resumen Introducción: El ingreso en las Universidades representa un cambio en el estilo de vida social, económico, personal y mental en los discentes (estudiantes). A veces el proceso de habituación representa un factor estresante que puede culminar en síntomas de ansiedad y depresión, y representa un factor de riesgo para la salud mental. Objetivo: Analizar la concepción de los discentes del Curso de Bachillerato en Enfermería, sobre la experiencia de vivenciar discusiones sobre la temática de suicidio. Métodos: Estudio descriptivo-exploratorio de abordaje cualitativo realizado en una Universidad Federal del Nordeste de Brasil, cuyo manejo de la información se realizó con un software de procesamiento de datos. En la investigación participaron quince estudiantes del curso Bachillerato en Enfermería que integraban el Proyecto de Intervención Ser, Saber, Escuchar, Vivir, en el cual se desarrollan acciones para los universitarios sobre prevención al suicidio y valorización de la vida. Resultados: Los resultados fueron analizados a partir de la nube de palabras y la representación gráfica del análisis de similitud, se observó que la concepción de los discentes se resumió a las palabras Proyecto y Salud. La palabra proyecto se relacionó con la motivación y las experiencias de los discentes, y la palabra salud con el suicidio como problema de salud pública. Conclusión: La discusión sobre el tema se muestra positiva en la Academia por favorecer un espacio de escucha y libertad de diálogo que proporciona alivio mental, contribuye a minimizar síntomas de ansiedad y depresión entre los discentes, y puede contribuir a reducir los índices de suicidio en la institución.

Abstract Introduction: Entering the university entails changes in the students' lifestyles regarding the social, economic, personal, and metal areas. Sometimes, the related habituation process can produce stress, which is externalized as anxiety and depression, and which can become a risk to the students' mental health. Objective: To analyze the conception which students from a course of nursing have on experiencing discussions around suicide. Methods: This is a descriptive-exploratory qualitative study carried out in a Federal University of Northeastern Brazil. Fifteen students from a course of nursing, who integrated a project to develop actions on suicide prevention and life valorization, participated in this study. The resulting information was produced using a data processing software. Results: The conceptions were analyzed through a word-cloud and graphical representation of similarities methodology. The resulting combined conception was summarized by the words Project and Health, representing the students' motivation and experiences, and suicide as a health problem, respectively. Conclusion: The corresponding free-dialog discussion on the issue provided mental relief among the students by minimizing their symptoms of anxiety and depression. This approach can contribute to reduce the suicide rates in the institution.

Resumo Introdução: O ingresso nas universidades representa uma mudança no modo de vida social, econômico, pessoal e mental dos estudantes. Às vezes, o processo de habituação representa um estressor que pode culminar em sintomas de ansiedade e depressão e, desse modo, representar um fator de risco para saúde mental. Objetivo: Analisar a percepção dos discentes sobre a experiência de vivenciar discussões sobre temática de suicídio. Métodos: Trata-se de um estudo descritivo-exploratório, com abordagem qualitativa, realizado em uma Universidade Federal do Nordeste do Brasil. Participaram da pesquisa 15 estudantes do curso Bacharelado em Enfermagem que integravam o Projeto de Intervenção Ser, Saber, Ouvir, Viver, no qual eram desenvolvidas ações de prevenção ao suicídio e valorização da vida direcionado aos estudantes universitários da instituição. Resultados: Os resultados foram analisados a partir a nuvemn da palavra e da representação gráfica de análise de similaridade, observou-se que a concepção dos alunos foi resumida às palavras Projeto e Saúde. A palavra projeto estava relacionada à motivação e as experiências dos alunos e a palavra saúde com suicídio como um problema de saúde público. Conclusão: Portanto, o projeto em questão além de favorecer um ambiente de liberdade de diálogo no âmbito acadêmico, proporciona também alívio mental que, com o passar das reuniões, pode minimizar os sintomas depressivos e ansiosos que os discentes podem apresentar, em consequência, reduzindo os índices de suicídio na instituição.

How to approach to suicide prevention

In early 2018, the National Action Plan for Preventing Suicide was announced by the Ministry of Health and Welfare and related ministries. The Action Plan presents a realistic goal of reducing suicide mortality to two-thirds of the present level, which would make it 1.4 times higher than the Organization for Economic Cooperation and Development average (in contrast to current circumstances, in which it is 2.4 times higher than the Organization for Economic Cooperation and Development average). Several public and private organizations are engaged in various suicide prevention activities. However, it is crucial for a seamless network to be formed, including government organizations, medical institutions, private organizations, and religious organizations. In medical settings, it is imperative that clinicians assess patients' risk of depression or suicide and arrange for a referral service. We need to connect modern social trends with classical mental health treatment modalities by using technologies such as smartphones and the internet. Strategies for research and development and for actual implementation must be established. Suicide prevention requires the active cooperation of not only mental health professionals, but also all physicians and health professionals. Experts in philosophy, sociology, economics, religion, and anthropology must also collaborate to find ways of affirming the importance of human life.

Medical policy for suicide prevention

Suicide is a serious problem worldwide, especially in Korea, but the factors affecting suicide are complex and diverse. Therefore, a medical policy should be developed to help establish an effective national suicide prevention policy in Korea. To reduce suicide rates effectively, some of the current suicide prevention policies need to be improved. This study proposes the following steps to do so: 1) standardizing the suicide attempt management system, 2) strengthening effective counseling programs in the psychiatric field, and 3) strengthening early psychiatric interventions in patients with a physical illness. These improvements should be considered high-priority measures for ensuring successful suicide prevention at the national level.

The Need of Integrated Approach for Suicide Prevention / 보건행정학회지

Suicide is a major problem in Korean health care and a serious social problem. In Korea, 12,463 people (24.3 per 100,000) lost their lives due to suicide in 2017. Although the government has established three National Comprehensive Plan of Suicide Prevention (2004, 2009, 2016), and National Action Plan of Suicide Prevention (2018), the suicide rate is still high. The suicide rate of the elderly is especially high. This is due to the economic vulnerability of the elderly in Korea. Therefore, in order to prevent suicide in Korea, mental health care approach and social welfare approach should be integrated. The intervention of preventing suicide of suicide attempters should include social welfare services as well as mental health program and should be based on community. There are many health problems, including prevention of suicide, which can not be solved only by the efforts of health care. Many health problems are social problems and the integrated approach is needed to solve them. In order to solve many health care problems and improve health, integrated approach of health, social science, and humanities is needed.

Blanca Susana Guevara Werlang (15/10/1955­15/11/2013): Um Pouco da História / Blanca Susana Guevara Werlang (15/10/1955­15/11/2013): A Little Bit of History / Blanca Susana Guevara Werlang (15/10/1955­15/11/2013): Un Poco de la Historia

Este artigo tem como objetivo revisitar os feitos e homenagear a professora doutora Blanca Susana Guevara Werlang, cinco anos após seu falecimento. Trata-se de uma importante figura na área da avaliação psicológica e em assuntos ligados à prevenção do suicídio, cujo legado se colhe ainda nos tempos atuais. Sua expressiva e relevante produção abarca principalmente temas ligados ao desenvolvimento e adaptação de instrumentos de avaliação psicológica, nas áreas de intervenção clínica e comportamentos violentos. Blanca foi Bolsista Produtividade do CNPq, Professora Titular da Faculdade de Psicologia da Pontifícia Universidade Católica do Rio Grande do Sul e integrou a Comissão Consultiva em Avaliação Psicológica do Conselho Federal de Psicologia de 2005 até seu falecimento, no ano de 2013....(AU)

This article aims to review the achievements and to honor Professor Blanca Susana Guevara Werlang, five years after her death. She was an important figure in the area of psychological evaluation and in matters related to suicide prevention, and her legacy is still current. Her expressive and relevant production covers topics related to the development of instruments of psychological evaluation and areas of clinical intervention and violent behavior. Blanca was Professor of Psychology at the Pontifícia Universidade Católica do Rio Grande do Sul and joined the Committee of Psychology of the Council of Psychology from 2005 until her death in 2013....(AU)

Este artículo tiene como objetivo revisar los hechos y homenajear a la profesora doctora Blanca Susana Guevara Werlang, cinco años después de su fallecimiento. Se trata de una importante figura en el área de la evaluación psicológica y en asuntos relacionados a la prevención del suicidio, cuyo legado sigue siendo un tema actual. Su expresiva y relevante producción abarca principalmente temas vinculados al desarrollo y adaptación de instrumentos de evaluación psicológica, en las áreas de intervención clínica y comportamiento violento. Blanca fue Becaria de Productividad del CNPq, Profesora Titular de la Facultad de Psicología de la Pontifícia Universidad Católica de Rio Grande do Sul e integró la Comisión Consultiva en Evaluación Psicológica del Consejo de Psicología de 2005 hasta su fallecimiento en el año 2013....(AU)

Self-poisoning as a Target Group for Prevention of Suicide

PURPOSE: The Korean government has tried to decrease the suicide death rate over the last decade. Suicide attempts, particularly non-fatal attempts, are the most powerful known risk factor for a completed suicide. An analysis of suicide attempt methods will help establish the effective preventive action of suicide. Fit prevention according to the method of suicide attempt may decrease the incidence of suicide death. Self-poisoning is suggested as a major method of both suicide attempts and suicide death. The aim of this study was to determine if a self-poisoning patient is a suitable target for the prevention of the suicide. METHODS: This was retrospective analysis of a prospective cohort, which included patients who presented to the emergency department (ED) after a self-harm or suicide attempt from Jan 2013 to Dec 2017. The proportion of methods in suicide attempts, psychological consultation, and fatality according to the suicide attempt method were analyzed. The types of poison were also analyzed. RESULTS: Poisoning was the most common method of suicide attempts (52.1%). The rate of psychological consultations were 18.8% for all patients and 29.1% for poison patients (p < 0.001). The rate of mortality in poisoning was 0.6%. Psychological consultation was performed more frequently in admission cases than discharged cases. The most common materials of poisons was psychological medicines and sedatives that had been prescribed at clinics or hospital. CONCLUSION: Self-poisoning is a major method of suicide attempt with a high rate of psychiatric consultation, low mortality rate, versus others methods. The prevention of suicide death for suicide attempts may focus on self-poisoning, which is the major method of suicide attempts. A suitable aftercare program for self-poisoning may be an effective method for preventing suicide if an early diagnosis and management of psychiatric disorders through psychiatric consultation can be made, and early connection to social prevention program for non-fatal patients are possible.