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Wang X, Beltran S, Burns R, Hamel M, Gray S, Gryglewicz K. Suicide Risk Help-Seeking Among Middle- to Old-Age Adults: A Systematic Review. Innov Aging 2023; 7:igac079. [PMID: 36815014 PMCID: PMC9940623 DOI: 10.1093/geroni/igac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Indexed: 01/28/2023] Open
Abstract
Background and Objectives Suicide has become a major public health concern worldwide and in the United States. Rates of suicide increase during the life course and are highest among middle- to old-age adults. Help-seeking represents a crucial coping mechanism that can mitigate suicide risk. Yet, less is known about suicide risk help-seeking, especially among these age groups. To address this knowledge gap, a systematic review of existing literature was performed to obtain a refined understanding of help-seeking for suicide risk among middle- to old-age adults. Research Design and Methods Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, electronic databases and key journals with suicide and/or gerontology focuses were searched to identify peer-reviewed publications in English between 2010 and 2020. A total of 4 732 unduplicated publications were screened for relevance based on titles and abstracts, of which 52 were reviewed in full text. Results Twenty-four articles met inclusion criteria and were included in the qualitative synthesis. These articles discussed a range of topics, including the prevalence of service utilization, service use prior to a suicide death, and correlates of help-seeking. In general, the prevalence of service utilization was low and varied by suicidal history (eg, higher prevalence among individuals with a history of suicide attempts than those with suicide ideation only). Key facilitators (eg, current or history of suicidal thoughts, plans, or attempts) and barriers (eg, stigma) for service use and help-seeking were also identified. Discussion and Implications Findings highlight the need for future studies and tailored services to improve age-appropriate and culturally responsive suicide prevention and intervention strategies for middle- to old-age adults.
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Affiliation(s)
- Xiaochuan Wang
- Address correspondence to: Xiaochuan Wang, PhD, School of Social Work, University of Central Florida, Orlando, FL 32816, USA. E-mail:
| | - Susanny Beltran
- School of Social Work, University of Central Florida, Orlando, Florida, USA
| | - Rachael Burns
- School of Social Work, University of Central Florida, Orlando, Florida, USA
| | - Marie Hamel
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, USA
| | - Sydney Gray
- School of Social Work, University of Central Florida, Orlando, Florida, USA
| | - Kim Gryglewicz
- School of Social Work, University of Central Florida, Orlando, Florida, USA
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Areán PA, Pratap A, Hsin H, Huppert TK, Hendricks KE, Heagerty PJ, Cohen T, Bagge C, Comtois KA. Perceived Utility and Characterization of Personal Google Search Histories to Detect Data Patterns Proximal to a Suicide Attempt in Individuals Who Previously Attempted Suicide: Pilot Cohort Study. J Med Internet Res 2021; 23:e27918. [PMID: 33955838 PMCID: PMC8138707 DOI: 10.2196/27918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite decades of research to better understand suicide risk and to develop detection and prevention methods, suicide is still one of the leading causes of death globally. While large-scale studies using real-world evidence from electronic health records can identify who is at risk, they have not been successful at pinpointing when someone is at risk. Personalized social media and online search history data, by contrast, could provide an ongoing real-world datastream revealing internal thoughts and personal states of mind. OBJECTIVE We conducted this study to determine the feasibility and acceptability of using personalized online information-seeking behavior in the identification of risk for suicide attempts. METHODS This was a cohort survey study to assess attitudes of participants with a prior suicide attempt about using web search data for suicide prevention purposes, dates of lifetime suicide attempts, and an optional one-time download of their past web searches on Google. The study was conducted at the University of Washington School of Medicine Psychiatry Research Offices. The main outcomes were participants' opinions on internet search data for suicide prediction and intervention and any potential change in online information-seeking behavior proximal to a suicide attempt. Individualized nonparametric association analysis was used to assess the magnitude of difference in web search data features derived from time periods proximal (7, 15, 30, and 60 days) to the suicide attempts versus the typical (baseline) search behavior of participants. RESULTS A total of 62 participants who had attempted suicide in the past agreed to participate in the study. Internet search activity varied from person to person (median 2-24 searches per day). Changes in online search behavior proximal to suicide attempts were evident up to 60 days before attempt. For a subset of attempts (7/30, 23%) search features showed associations from 2 months to a week before the attempt. The top 3 search constructs associated with attempts were online searching patterns (9/30 attempts, 30%), semantic relatedness of search queries to suicide methods (7/30 attempts, 23%), and anger (7/30 attempts, 23%). Participants (40/59, 68%) indicated that use of this personalized web search data for prevention purposes was acceptable with noninvasive potential interventions such as connection to a real person (eg, friend, family member, or counselor); however, concerns were raised about detection accuracy, privacy, and the potential for overly invasive intervention. CONCLUSIONS Changes in online search behavior may be a useful and acceptable means of detecting suicide risk. Personalized analysis of online information-seeking behavior showed notable changes in search behavior and search terms that are tied to early warning signs of suicide and are evident 2 months to 7 days before a suicide attempt.
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Affiliation(s)
- Patricia A Areán
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,ALACRITY Center, University of Washington, Seattle, WA, United States
| | - Abhishek Pratap
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States.,Sage Bionetworks, Seattle, WA, United States
| | - Honor Hsin
- Kaiser Permanente, Northern California, CA, United States
| | - Tierney K Huppert
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Suicide Prevention and Research, University of Washington, Seattle, WA, United States
| | - Karin E Hendricks
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Suicide Prevention and Research, University of Washington, Seattle, WA, United States.,University of South Alabama, Mobile, AL, United States
| | - Patrick J Heagerty
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Trevor Cohen
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, United States.,VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Katherine Anne Comtois
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Suicide Prevention and Research, University of Washington, Seattle, WA, United States
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