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The idea of a progression in suicide phenomena, from death wishes to suicide attempts and completed suicides, is quite old and widely present in literature. This model of interpreting suicidality has great relevance in preventative approaches, since it gives the opportunity of intercepting suicidal trajectories at several different stages. However, this may not be the case for many situations, and the hypothesis of a continuum can be true only in a limited number of cases, probably embedded with a specific psychopathological scenario (e.g. depression) and with a frequency that should not permit generalisations. This paper reviews the available evidence about the existence and validity of this construct, and discusses its practical implications.

This qualitative research explores the relationship between religiosity, suicide thoughts and drug abuse among 55 homeless people, interviewed with interpretative phenomenological analysis. Analyzing the thematic structure of the participants' narrations, important main themes appeared in order to avoid suicide, among which family, the certainty of finding a solution and the will to live. However, the suicide ideation inheres in about 30% of participants, almost all believers, addicted and/or alcoholics. Results suggest that religiosity and meaning of death neither prevent from substances abuse and alcoholism, nor is a protective factor against suicide ideation. Meanings of life are the most important reasons for living, and when they are definitively considered unworkable, alcohol and drug help to endure life in the street. A specific model is discussed.

Recent years have seen the development of new approaches to the study of gender and sexuality in childhood, with attention given to socio-historical, cultural and political contexts. This chapter aims to contribute towards a limited field of research on queer childhood and youth in Central Asia by considering how narratives of queer childhood in Kazakhstan are culturally produced. This chapter draws on the material from in-depth interviews of 11 queer people living in Kazakhstan, focussing on their narratives of childhood. The study exposes the effect of silence about non-heteronormative identities in Kazakhstan on queer children. Narratives of bullying and managing school violence are explored along with narratives of queer childhood within the families of origin. Lastly, the chapter foregrounds instances of agency and resilience, considering how queer children manage to steer themselves away from being an ‘impossible subject’ and contest dominant societal attitudes and discourses.

Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC), Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide) are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.

Sleep disturbances, present in more than 90% of major depressive disorder (MDD) patients, are moderated by sex in adult MDD. In particular, slow-wave electroencephalographic activity (SWA; 0.5-4 Hz) accumulation is low and dissipation impaired. This SWA abnormality in depressed adult males does not change with age, suggesting that SWA abnormality appears at early ages. The present study evaluated sex differences in SWA in adolescents with MDD compared to healthy controls. We evaluated regularized sleep-wake schedules at home for 5-7 days, followed by two consecutive nights of sleep EEG recording. The study included 104 participants, 52 symptomatic and depressed subjects (MDD: 20 males and 32 females) and 52 healthy controls (HC: 20 males and 32 females), aged 13-18 years. SWA power and dissipation, and duration and latencies to each Non-Rapid Eye Movement (NREM) sleep period were calculated for each group. Results showed that SWA accumulation in the first NREM period was lower and its dissipation across the night more irregular in MDD males compared to HC males (P<0.009). By contrast, SWA was equivalent in MDD and HC females. In conclusion, as reported in adult MDD, the accumulation and dissipation of SWA was abnormal in depressed adolescents, but only in males. SWA abnormalities in adolescent MDD may relate to different depressive symptoms in females and males. These results underscore the need to develop sex-specific therapies to enhance and restore SWA in depressed adolescents.

Service members of the US Department of Defense (DoD) have alarmingly high rates of depression, anxiety, probable stress disorders and suicidality, all of which are negative health conditions exacerbated by various external stressors. High-stress work conditions – to include shift work, hazardous territories, high-stakes mission sets and generally disconnected sites – require a work environment that facilitates, rather than inhibits, stress reduction and mental well-being. This paper aims to present “salutogenic design” as an innovative approach: Salutogenic design offers demonstrated architectural solutions that improve health and well-being.

This paper describes salutogenic design strategies beginning with the need for such an approach, the call to action to implement strategic and tactical solutions and the challenges and financial impacts of such a broad and innovative strategy to improve workplace health, well-being and performance in the DoD and beyond. Examples of these strategies, via biophilic design solutions, are presented in the central Table 1 as an easy-to-reference tool and supported by the voluminous literature as referenced, in part, through this research paper.

Salutogenic design strategies offer innovative, financially viable solutions to help mitigate stress and improve workforce well-being while maintaining the highest level of building security requirements in access-controlled spaces and disconnected sites, such as military installations and government compounds.

Issues of mental and physical health are complex and multi-faceted, and they require complex and multi-faceted solutions. Salutogenic design is presented as one facet of that solution: a tangible solution to an often-intangible issue. Further, as a novel approach to address a critical DoD issue, Table 1 bridges the common gap between high-concept design theory and practical construction-application solutions, with positive value to the health, performance, quality-of-life and well-being of service members.

To the best of the author’s knowledge, this paper is the first to approach the DoD’s imperative to reduce service members’ mental stress with “salutogenic design.”

This cross-sectional study focuses on the social psychological correlates of self-harm and suicidal ideation during the COVID-19 (coronavirus disease 2019) outbreak in Lebanon, which is a country characterized by political and economic instability.

A convenience sample of 191 Lebanese individuals completed measures of length of being in lockdown, fear of COVID-19, job insecurity, political trust, self-harm and suicidal ideation. Data were analyzed using independent samples t-tests and multiple regression.

Fear of COVID-19 was associated with neither self-harm nor suicidal ideation. Males and people with lower income reported higher suicidal ideation than females and those with higher income, respectively, and religiosity was inversely associated with suicidal ideation. People who reported self-harm generally exhibited lower political trust than those who did not report self-harm.

Beyond the fear of COVID-19, the socioeconomic sequelae of COVID-19 (especially the economic fallout and declining political trust), which are accentuated in already economically and politically unstable societies, may precipitate poor mental health and maladaptive coping strategies in Lebanon. There is a need to ensure adequate access to mental health services to the general population amid the COVID-19 outbreak in Lebanon.

This study provides novel insight into the risk factors for self-harm and suicidal ideation in Lebanon during the COVID-19 pandemic.

Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm.

Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017–2019 was used. Annual rates per 1,000 were calculated by age and gender.

The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18–29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner’s environment and relationships.

There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts.

To the best of the authors’ knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.

This paper aims to identify the risk factors that affect depression in students who sought psychological consultation during lockdown period in the health department at a university in Colombia.

The sample consisted of 33 students (12 men and 21 women) with a mean age of 21 ± 2.5 years during the COVID-19 lockdown in 2020. Convenience sampling was used. The beck depression inventory-II instrument and a sociodemographic questionnaire were used to determine levels of depression and associated risk factors. A Google Form was designed with the respective instruments and sent along with the informed consent by email.

The results indicated that the population is characterized by presenting a level of mild (24.2%), moderate (15.2%) and severe (21.2%) depression. Concerning the levels of depression and risk factors, a significant difference was found with a history of violence (p-value = 0.000), mainly during childhood and adolescence, as well as objection to psychological therapy, belonging to a medium–high socioeconomic stratum, lack of family support and recent significant losses coupled with the lockdown because of the pandemic, which increased symptoms of depression and suicidal ideation.

This research was conducted using Google Forms, which meant that some questionnaires were incomplete. In addition, this study did not count with the full participation of patients who attended psychological consultation.

Universities should generate programs for early detection of risk factors and prevention of depression in students, which could affect academic performance, school dropout, interpersonal relationships and trigger suicidal ideation. These results can also be applied to reducing family violence, which has increased since the pandemic, by improving students' family dynamics.

Because of the scarce research on this topic in Latin America, this study contributes to mental health in this population. The university becomes a fundamental scenario in which the ability to help students develop an adequate expression of emotions, positive coping strategies and sense of life as protective factors against depression can be enhanced.

Early identification of persons at risk is essential in suicide prevention. Undocumented migrants (UM) live under limited conditions and are to a high degree invisible, both in research and in suicide prevention programmes. The aim of this study was to investigate prevalence rates of suicidal thoughts among UM in Sweden.

This cross-sectional study was part of the Swedish Health Research on Undocumented Migrants project (SHERUM). The study population consisted of 104 UM over 18 years of age recruited through informal networks. Data on 112 multiple choice questions was collected via trained interviewers in Gothenburg, Stockholm and Malmö during 2014–2016. To assess suicidal thoughts (the last two weeks) one item asking about suicidal thought in the Beck Depression Inventory scale (BDI-II) was used. Logistic regression and chi-square analyses were made to identify risk and protective factors.

Suicidal thoughts were found in 43.2% of the 88 UM that answered the question on suicidal thoughts. Being a parent had some protective influence on the prevalence of suicidal thoughts while the housing situation, having been exposed to crime and having mental illness were all statistically significant risk factors for suicidal thoughts. However, due to low sample size, few variables presented statistically significant differences.

This study presents an alarmingly high prevalence of suicidal thoughts among undocumented migrants in Sweden, a difficult-to reach, vulnerable and rarely studied group. Targeted strategies are imperative to include undocumented migrants in suicidal prevention programmes.