Suicide methods and severe mental illness: A systematic review and meta-analysis

Area of Science:

• Psychiatry
• Public Health
• Epidemiology

Background:

• Individuals with severe mental illness (SMI) face elevated suicide risks compared to the general population.
• Previous research has not extensively examined how suicide methods differ across various SMI diagnoses.
• Understanding these variations is crucial for targeted suicide prevention strategies.

Purpose of the Study:

• To systematically review and pool data on suicide methods among individuals with SMI.
• To compare the odds of specific suicide methods in people with SMI versus those without SMI.
• To identify differences in suicide methods across distinct SMI diagnoses.

Main Methods:

• A systematic review and random-effects meta-analysis of 12 eligible studies (n=380,523).
• Searches conducted across PubMed, PsycInfo, CINAHL, and Embase databases.
• Risk of bias assessed using the Joanna Briggs Institute checklist; no high risk of bias identified.

Main Results:

• People with schizophrenia showed higher odds of death by jumping (3.38x) and drowning (1.93x).
• Individuals with bipolar disorder had higher odds of death by jumping (3.2x).
• Those with major depression had higher odds of death by drug overdose (3.11x) and jumping (2.11x), but lower odds of death by firearms (0.43x).

Conclusions:

• Findings highlight distinct suicide method profiles associated with schizophrenia, bipolar disorder, and major depression.
• Results can inform lethal means counseling and public health interventions for SMI populations.
• Prioritizing means restriction, such as access to heights or drugs, is recommended for suicide prevention in individuals with SMI.