This study focuses on the national and subnational estimation of prevalence, incidence, disability-adjusted life years (DALYs) related to self-harm and suicide mortality in Iran. These indicators of disease burden were analyzed over the period from 1990 to 2021, with stratifications based on sex, age and geographic location. Additionally, the percentage change observed between 1990 and 2021 was documented. The age-standardized prevalence rate (per 100,000) of self-harm decreased from 173.92 (95% UI: 146.13–208.75) in 1990 to 131.2 (95% UI: 110.55–156.67) in 2021, reflecting a percentage change of −0.25% over the period. In terms of self-harm prevalence in 2021, males had a higher rate (137.62 per 100,000) compared to females (124.82 per 100,000). The findings of the current study revealed that, despite significant challenges such as demographic shifts, economic instability and the impacts of war, the trends in self-harm incidents and suicide mortality rates in Iran have generally been on the decline. Additionally, it was observed that suicide-related deaths were more prevalent among males when compared to females. However, when examining self-harm behaviors over previous decades, these acts appeared to be more frequent among females.

Suicide is a significant global public health concern, particularly among adolescents, with substantial implications for economies, societies and individuals’ mental well-being. Understanding its patterns and intention and psychosocial determinants in a given context can suggest potential intervention points. This population-based cross-sectional study aimed to document suicidal ideas, behaviors and intensity among youths aged 14 to 25 in the Nairobi metropolitan area and associated socio-economic position, demographic indicators and potential intervention points. A diverse sample of 1,972 participants was recruited from urban and peri-urban settings within the Nairobi metropolitan area. Data analysis included descriptive statistics, chi-square tests and logistic regression. Our findings confirm a high prevalence of suicidal ideas and behavior in the youth (19.9% and 3.6%, respectively), with very few significant differences between the urban and peri-urban areas. The severity of suicidal ideation and behavior reported methods and reasons, and the socio-demographic profile of participants, point to multiple potential intervention targets. These findings ought to be used to design, manage and evaluate suicide prevention programs.

Suicide is a serious global health problem with ~73% deaths by suicide occurring in low- or middle-income countries (LMICs), many of which are among people experiencing humanitarian emergencies. Few guidelines outline specific steps and strategies to tackle suicide risk and manage post-attempt consequences in these settings, leaving program implementers with limited information to translate guidance to practice. This article describes the implementation of the Common Elements Treatment Approach (CETA) suicide safety protocol as part of a randomized controlled trial in northern Thailand for displaced adults from Myanmar with chronic physical health conditions. The CETA safety protocol has been used in many trials and programs to screen for and manage suicide risk, including in a prior CETA effectiveness trial with Myanmar adults. In this article, we describe how this safety protocol was adapted for the study setting, and utilized to effectively screen, assess suicidal thoughts and behaviors, develop and manage action plans for study participants with active suicidal ideation. We present three illustrative case descriptions of individuals with whom we implemented the safety protocol to highlight how suicide risk intersects with physical illness, psychosocial stressors and structural vulnerability. Reflections on feasibility, acceptability and adaptations – such as language translation, culturally grounded referral pathways and training for nonspecialist providers – are shared to inform future implementation. Our findings support the implementation of suicide safety protocols within humanitarian programming and offer practical insights for global health practitioners and policymakers working in similarly complex settings.

Suicide is the third leading cause of death among children and youth aged 10–24, and nearly three-quarters of suicides occur in low- and middle-income countries (LMICs). Despite global efforts, children and youth mental health and suicide prevention remain underprioritized in national policy and are often deployed separately in LMICs. Governments should develop standalone, multisectoral mental health policies for children and youth that integrate suicide prevention strategies and that address social determinants of suicide risk. This commentary aims to inform national policymakers, global health and international development actors, and researchers engaged in the mental health and suicide prevention of children and youth in LMICs.

Suicide disproportionately burdens low- and middle-income countries. In Uganda, attempt survivors encounter intense stigma, minimal mental-health services and social exclusion, elevating their risk of future attempts. Rural African data on post-attempt experiences are scarce. From June to August 2023, we conducted semi-structured, in-depth interviews in Buyende District with 18 attempt survivors, 17 relatives, 10 healthcare workers and 9 community health workers. Transcripts were translated into English and thematically analyzed using the framework method within a phenomenologically informed qualitative design. Three interlinked themes emerged. (1) Stigma-shaped immediate responses: cultural, religious and legal norms fostered moral judgment, social distancing, bureaucratic delays and occasionally police involvement. (2) Informal, uneven support: survivors relied on family aid, religious counseling and ad-hoc community advocacy; effectiveness varied widely. (3) Conditional reintegration: sustained practical help, employment and communal acceptance promoted recovery, whereas their absence perpetuated economic hardship and marginalization. Post-attempt trajectories in rural Uganda are governed by multilevel stigma and fragile support systems. Priority actions include provider training, family-community psychoeducation, stigma-reduction initiatives, structured follow-up care and decriminalization of suicide to foster compassionate responses and reduce repeat attempts.

This study aimed to describe changes over time in the prevalence and associated factors of suicidal behaviours among 13– to 15–year–olds in Southeast Asian countries. It is a secondary analysis of cross-sectional data from the Global School-based Student Health Surveys conducted in Indonesia, Myanmar, the Philippines and Thailand in 2007/2008 and 2015/2016. Each survey included a nationally representative sample of students aged 13–15 years. Data on suicidal thoughts, plans, attempts, and associated factors—including health risk behaviours, experiences of physical violence and bullying, social difficulties, and parental supervision—were collected using self-report questionnaires. The population attributable fraction for each risk factor was calculated using multiple logistic regression. The prevalence of suicidal behaviours ranged from 0.7% (Myanmar) to 17.3% (Philippines) in 2007/2008, and from 8.6% (Indonesia) to 20.9% (Thailand) in 2015/2016. Being physically attacked or bullied and experiencing social difficulties were the most consistent and significant risk factors across countries and time points. Female gender, poverty, alcohol consumption, and drug use also contributed to risk at varying levels. Suicidal behaviours have risen alarmingly in several Southeast Asian countries. These findings suggest the urgent need for coordinated action by policymakers, health professionals, educators, and families to prevent adolescent suicidal behaviours.

The role of Law enforcement agencies (LEA) is significant in suicide prevention efforts as first responders. Nevertheless, no published study to date has systematically compiled the body of knowledge about suicide prevention efforts involving LEA. The current scoping review aims to methodically map and examine the peer-reviewed literature and grey literature on the role of LEA in suicide prevention. Electronic searches of the databases like Medline, PsycINFO, Google Scholar, Web of Science, Scopus, CINAHL and Google were conducted using a comprehensive search strategy to identify relevant resources. Grey literature was searched searches were undertaken on relevant databases and, as well as government and organisational websites. The reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The inclusion criteria comprised research articles, reports, and guidelines/policy documents on the role of law enforcement agencies (LEAs) in suicide prevention. Studies on prevalence, custodial settings, non-English publications, and reviews were excluded. Inclusion criteria comprised research articles, reports and guidelines/policy documents focusing on law enforcement’s role in suicide prevention. Studies focusing solely on prevalence or epidemiology, studies confined strictly to custodial settings, publications not in English and systematic reviews or meta-analyses were excluded. Out of 3,327 records screened, the full texts of 82 resources were included in the review. All the resources identified were categorised between peer-reviewed literature and grey literature. Resources were thematically categorised based on functional roles into- I. Strategic and System-Embedded Roles of LEA, II. Capacity Building and Training Oriented Engagements, III. Surveillance Reporting and Data Systems Role, IV. Community Facing and Preventive Engagement, and V. Means Restriction and Environmental Prevention Roles. The chronological development of the resources was inconsistent. Most resources were from high-income countries, focusing on the evaluation of training, capacity building programmes, surveillance initiatives and the exploration of varied roles of LEA across custodial, community and crisis settings and other interdisciplinary collaborations. Notably, the resources show increased disparity in quantity and research methodological approaches across geographies. The review highlights substantial heterogeneity and a limited resource base from low- and middle-income countries on the role of LEA in suicide prevention, with a dearth of structured, evidence-based, scalable models in these settings. These gaps point to an urgent need for locally relevant and cross-sectoral models that position law enforcement as integral partners in suicide prevention efforts, especially where these agencies play a major role as first responders.

We examine whether decriminalization of suicide in India following the 2017 Mental Health Act corresponds with changes in suicide mortality overall and by level of state development. Our study utilizes counts of suicides from the National Crime Records Bureau (NCRB) across 35 Indian states from 2001 to 2020. The exposure variable is a binary indicator for the decriminalization of suicide following 2018. We use fixed-effect Poisson regression models that include population offsets and adjust for time trends, literacy, gross state domestic product and infant mortality. We find no relation between decriminalization of suicides and overall suicide mortality (Incidence Rate Ratio (IRR): 1.037; 95% CI (0.510–2.107)). Stratification by level of state development shows that less developed states saw an increase in suicide mortality by 1.9 times following decriminalization, compared to prior years (IRR: 1.859; 95% CI (1.028–3.364)). Our findings thus indicate that decriminalization did not coincide with a decline in suicide mortality in the country, thereby highlighting the need for improved mental health infrastructure and support in India, especially in less developed states.

The study evaluated a training programme adapted from the WHO mhGAP to enhance suicide prevention knowledge, attitudes, and confidence among 436 Community Health Workers (CHWs) in India. A pre–post intervention design assessed outcomes at four time points using a structured questionnaire, analysed via repeated-measures ANOVA. Mean knowledge scores increased from 6.32 ± 0.14 at baseline to 11.12 ± 0.12 post-training, then levelled off at 10.10 ± 0.14 and 10.10 ± 0.13 at 6 and 12 months, respectively; similarly, mean confidence scores increased from 4.96 ± 0.11 to 7.84 ± 0.11, remaining at 7.28 ± 0.10 and 7.44 ± 0.10 at the same time points. Mean attitude scores changed slightly from 41.00 ± 0.38 to 42.72 ± 0.43 over 12 months, indicating increased negative attitudes. Knowledge and confidence scores across time points were statistically significant (p < 0.05); however, this was not observed for attitude scores. Improvements were associated with CHW cadre and educational status. Post-training, CHWs demonstrated sustained improvements in knowledge and confidence for identifying, referring, and managing suicidal behaviour over 12 months, with those having lower baseline scores improving uniformly following the programme.

Suicidal ideation and trauma exposure are significant health challenges worldwide, and their interaction increases their burden on individuals and communities. However, limited research has been devoted to these conditions in low- and middle-income countries, where the majority of the burden of these disorders exists. Additionally, unique cultural factors that may contribute to differential relationships in these symptoms and disorders make this an important area to explore. This study examines relationships between the number and types of adverse exposures, PTSD symptoms and severity, depression and suicidal ideation in a sample of Cambodian women with experiences of trauma using logistic and linear regressions. Overall, PTSD severity significantly contributes to suicidal ideation, with hyperarousal symptoms playing a particularly influential role in this association. Further, adverse experiences, including physical abuse and parental mental health problems, contributed significantly to increased suicidal ideation. Lastly, depression severity partially mediates the relationship between PTSD severity and suicidal ideation. These results illustrate the significant role of PTSD in the experience of suicidal ideation, particularly within regions like Cambodia with high trauma loads. These findings point to psychological constructs that may be especially important to include in suicidality screening tools and to target within prevention and intervention efforts.

This study investigates the epidemiology of adolescent suicide in India, addressing the limited research on the subject. Data on adolescent suicide (14–17 years) by sex and state were obtained from the National Crimes Records Bureau for 2014–2019, which included acquiring unpublished data from 2016 to 2019. Crude suicide rates for the period 2014–2019 were calculated by sex and state. Rate ratios (RRs) by sex and state were also calculated to assess changes over time, comparing suicide rates from 2017–2019 to 2014–2016. Female adolescent suicide rates, which ranged between 9.04 and 8.10 per 100,000 population, were consistently higher than male adolescent suicide rates, which ranged between 8.47 and 6.24 per 100,000 population. Compared to the first half of the study period (2014–2016), adolescent suicide rates significantly increased between 2017 and 2019 among less developed states (RRs = 1.06, 95% uncertainty interval [UI] = 1.03–1.09) and among females in these states (RRs = 1.09, 95% UI = 1.05–1.14). Male suicide rates aligned with global averages, while female rates were two to six times higher than in high-income and Southeast Asian countries. Findings highlight the urgent need for comprehensive surveillance and targeted suicide prevention strategies to address this critical public health issue.

Firearm suicide among adolescents in the United States has increased in recent years, with Black and Latino youth experiencing disproportionately rising rates. Although firearm violence and mental health disparities have received growing attention, the structural conditions that shape racial inequities in firearm suicide risk remain insufficiently examined. This overview applies an intersectional and structural lens to analyze how systemic inequities including residential segregation, concentrated disadvantage, punitive school discipline practices, underinvestment in mental health infrastructure and commercial determinants of firearm availability contribute to differential suicide risk. Drawing on interdisciplinary literature and recent epidemiologic data, the manuscript maps the causal pathways through which structural racism and institutional inequities shape exposure to community violence, access to culturally responsive care, crisis response practices and household firearm environments. It further examines how these mechanisms interact with gender and lethal means availability to amplify disparities in suicide mortality. The analysis underscores the importance of multilevel, upstream interventions that address structural inequities, strengthen community-based supports and reduce access to lethal means. By reframing firearm suicide as a structurally patterned outcome rather than an individual-level phenomenon, this work advances a socio-ecological understanding of adolescent suicide prevention with implications for structural reform and suicide prevention policy.