Understanding for Prevention: Qualitative and Quantitative Analyses of Suicide Notes and Forensic Reports

Suicide Notes: A Scoping Review of Qualitative Studies to Highlight Methodological Opportunities for Prevention

Suicide is a public health concern, and prevention programs are fundamental to decreasing its rates. Suicide notes might be crucial to understanding motives associated with suicidal behaviours. In this way, it is necessary to understand the qualitative methods that are most frequently used to analyze this data. Investigating these factors is crucial for developing targeted and preventive interventions. This scoping review aimed to answer the question "What is the state of art about qualitative methods adopted to analyze suicide notes?" by systematically mapping the literature on this topic. This review adopted the JBI guidelines for Scoping Reviews and followed the PRISMA-ScR guidelines. A comprehensive search strategy has been implemented across PubMed, Web of Science, and Scopus databases. Grey literature was not included in this review. Eligible studies encompassed qualitative studies on suicide notes published in English. Two independent researchers screened titles and abstracts and subsequently conducted full-text assessments based on predefined inclusion criteria. Relevant data have been systematically extracted and tabulated. The findings were thematically organized and qualitatively summarized, with potential visual aids such as graphs and tables. The studies highlighted the most used qualitative methods to analyze suicide notes, such as LIWC, Leenar's, Grounded Theory, Thematic Analysis and others. This study summarizes the current knowledge about qualitative methods to analyze suicide notes. Further research is necessary for the development of prevention programs destined for this population.

Suicide in Italy: Epidemiological Trends, Contributing Factors, and the Forensic Pathologist's Role in Prevention and Investigation

Suicide in Italy represents a serious public health problem, with significant data highlighting the urgency for prevention interventions. According to the epidemiological data, in the two-year period 2020-2021, 7422 suicides were recorded, representing an increase compared to previous years. Suicide is the most extreme self-harm. The contributing factors that surround this event are multiple, typically in conditions of serious distress or psychological distress, in particular in people suffering from serious psychiatric and/or mental disorders, such as depression. The role of the forensic pathologist in the context of suicide is crucial for ascertaining the contributing factors of death and for understanding the circumstances that lead to the suicidal act. Forensic medicine plays a crucial role in the analysis and understanding of suicides, addressing both the legal and medical implications. The aim of this study was to accurately describe the phenomenon of suicide in Italy. The accuracy of the review was very important in paying attention to the large difference in how the phenomenon manifests itself in the male population compared to the female population. The different ages at which suicide is committed were highlighted. The geographical difference between the North and the South and between the more urbanized areas compared to the rural areas where suicide is committed was analyzed. This scientific work also aimed to explore how forensic pathologists contribute to the resolution of complex forensic investigations. Psychological autopsy is an investigative method used primarily in cases of violent or questionable death, with the aim of understanding the psychological and social circumstances that led to an individual's death. This practice is distinct from forensic autopsy, which focuses on the physical analysis of the body to determine the cause of death. The role of forensic pathologists in investigating suicide cases is crucial, as they not only determine the cause of death but also analyze the psychological implications that may have led to the extreme act. The main objective of a forensic pathologist in these cases is to gather and interpret evidence that can help understand the psychological and social context that influenced the decision to commit suicide, identifying any warning signs and underlying motivations and factors that may have contributed to the suicide. This approach provides valuable information for prevention, enhancing the understanding of the psychological mechanisms behind suicide and supporting targeted interventions in the future. The manuscripts also have an explanatory purpose and may have a therapeutic role in helping surviving relatives understand suicide. Knowledge of the messages contained in suicide notes could be useful for suicide prevention programs.

An Exploratory Study in the Portuguese Population on Writing a Suicide Note: Correlates in the Suicide Spectrum and Qualitative Analysis

Suicide notes are an important warning sign for suicidal behaviors. The aim of this exploratory research is (a) to contribute to understanding the place of suicide notes in the spectrum of suicidal behaviors in Portugal, and (b) to analyze the content remembered by individuals regarding a suicide note. Two complementary studies were carried out. In the first, a quantitative investigation, the statistical relationship of writing a suicide note: To the occurrence of lifetime suicide attempts, to lifetime self-harming behaviors, and to suicidal ideation in the two weeks prior to the assessment was evaluated. In the second study, a qualitative investigation, the content recalled by individuals regarding a suicide note was analyzed. In the quantitative study, 841 adults aged between 18 and 65 years, and 1,012 young adults participated. In the qualitative study, 18 young adults participated. Findings of the quantitative study reveal that writing a suicide note significantly related to the lifetime presence of a suicide attempt and to self-harming behaviors and to suicidal ideation in the two weeks prior to the assessment. Findings of the qualitative study suggest that individuals who have written suicide notes exhibit a significant self-oriented focus, yet they also demonstrate a strong sense of concern for the survivors.

Suicide news on Peruvian television channels: evaluation of compliance with WHO's reporting recommendations

OBJECTIVE.

To determine if suicide news reports broadcasted by Peruvian television channels comply with the World Health Organization (WHO) recommendations for reporting suicide news.

MATERIALS AND METHODS.

Quantitative and descriptive study. The unit of analysis was the suicide news broadcasted by eight Peruvian television channels during the years 2020 and 2021. News were classified into three categories: news about suicide, attempted suicide and suicide prevention. We used an evaluation instrument composed of WHO recommendations.

RESULTS.

A total of 126 news reports were analyzed; but none of these complied fully with the WHO recommendations. The news reports on suicide or attempted suicide complied with 4 of 13 recommendations. Most reports complied with avoiding to publish suicide notes (97.4%); on the other hand, educating about suicide and its prevention, and not disseminating myths was the recommendation least complied with (0.9%). Suicide prevention news reports complied with 5 of 7 recommendations.

CONCLUSIONS.

Suicide news reports on Peruvian television in 2020 and 2021 showed low compliance with WHO recommendations. Communication professionals have a fundamental role in suicide prevention, limiting sensitive information and disseminating helpful information. It is essential for communicators to be aware of these recommendations and for the journalism team and mental health professionals to work together in the communication of news related to suicide.