Suicide prevention by limiting access to methods: a review of theory and practice.

This review discusses the limitation of access to suicide methods as a way to prevent suicide, an approach which forms a major component of many national suicide prevention strategies. An important distinction is made between efforts that attempt to limit physical access to suicide methods and those that attempt to reduce the cognitive availability of suicide. Physical imitations will be reviewed with reference to restricting access to domestic gas, catalytic converters, firearms, pesticides, jumping, paracetamol and methods used in prisons. Impacts of cognitive availability will be discussed mainly with regard to the media in terms of providing access to technical information and sensational or inaccurate portrayals of suicide. Drawing on psychological models of suicidal ideation and behaviour, this review explores how processes leading to suicidal behaviour and issues around method choice may relate to the effectiveness of limiting access to methods. Potential problems surrounding method limitations are explored, in particular the factors contributing to substitution, the risk that alternative methods of suicide may be used if one is restricted. It is concluded that in appropriate contexts, where substitution is less likely to occur, and in conjunction with psychosocial prevention efforts, limitation of both physical and cognitive access to suicide can be an effective suicide prevention strategy.

[1]  R. Kendell Catalytic converters and prevention of suicides , 1998, The Lancet.

[2]  C. Crane,et al.  Suicide and the media: pitfalls and prevention. Report on a meeting organized by the Reuters Foundation Program at Green College and University of Oxford Centre for Suicide Research at Green College, Oxford, UK, November 18, 2003. , 2005, Crisis.

[3]  Yu Lee,et al.  The influence of media reporting of a celebrity suicide on suicidal behavior in patients with a history of depressive disorder. , 2007, Journal of affective disorders.

[4]  N. Kreitman,et al.  The coal gas story. United Kingdom suicide rates, 1960-71. , 1976, British journal of preventive & social medicine.

[5]  B. Prusoff,et al.  Suicide attempts and recent life events. A controlled comparison. , 1975, Archives of general psychiatry.

[6]  T R Miller,et al.  Suicide acts in 8 states: incidence and case fatality rates by demographics and method. , 2000, American journal of public health.

[7]  C. Crane,et al.  Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links , 2006, Psychological Medicine.

[8]  D. Leo Why are we not getting any closer to preventing suicide , 2002 .

[9]  K. Hawton,et al.  MEDIA INFLUENCES ON SUICIDAL BEHAVIOUR: AN INTERVIEW STUDY OF YOUNG PEOPLE , 2004, Behavioural and Cognitive Psychotherapy.

[10]  D. Gunnell,et al.  The epidemiology and prevention of suicide by hanging: a systematic review. , 2005, International journal of epidemiology.

[11]  M A Hill,et al.  Suicide from River Bridges , 1990, The Australian and New Zealand journal of psychiatry.

[12]  Gernot Sonneck,et al.  Preventing suicide by influencing mass-media reporting. The Viennese experience 1980–1996 , 1998 .

[13]  J. Caron Gun Control and Suicide: Possible Impact of Canadian Legislation to Ensure Safe Storage of Firearms , 2004, Archives of suicide research : official journal of the International Academy for Suicide Research.

[14]  J. Williams,et al.  Effective problem solving in suicide attempters depends on specific autobiographical recall. , 2001, Suicide & life-threatening behavior.

[15]  J. Lonnqvist,et al.  Trends and Availability of Suicide Methods in Finland , 1995, British Journal of Psychiatry.

[16]  D. Lester,et al.  The effect of restricting access to lethal methods for suicide: a study of suicide by domestic gas in Japan , 1989, Acta psychiatrica Scandinavica.

[17]  Marc S Daigle,et al.  Suicide prevention through means restriction: assessing the risk of substitution. A critical review and synthesis. , 2005, Accident; analysis and prevention.

[18]  D. Gunnell,et al.  Suicide by Gunshot in the United Kingdom: A review of the literature , 2004, Medicine, science, and the law.

[19]  J. Piotrowski,et al.  Child and adolescent suicide attempts: an opportunity for emergency departments to provide injury prevention education. , 1997, The American journal of emergency medicine.

[20]  D. H. Rosen,et al.  Suicide survivors: psychotherapeutic implications of egocide. , 1976, Suicide & life-threatening behavior.

[21]  A. Leon,et al.  Increase in fatal suicidal poisonings and suffocations in the year Final Exit was published: a national study. , 1994, The American journal of psychiatry.

[22]  K. Hawton Prevention and treatment of suicidal behaviour: from science to practice , 2005 .

[23]  Gonghuan Yang,et al.  Risk factors for suicide in China: a national case-control psychological autopsy study , 2002, The Lancet.

[24]  L. Appleby The National Service Framework for Mental Health - Five Years On , 2005 .

[25]  E. Holmes,et al.  Imagery about suicide in depression—“Flash-forwards”? , 2007, Journal of behavior therapy and experimental psychiatry.

[26]  G J Wintemute,et al.  Mortality among recent purchasers of handguns. , 1999, The New England journal of medicine.

[27]  D. Gunnell,et al.  Method availability and the prevention of suicide – a re-analysis of secular trends in England and Wales 1950–1975 , 2000, Social Psychiatry and Psychiatric Epidemiology.

[28]  I. Sakinofsky Repetition of Suicidal Behaviour , 2008 .

[29]  T. Joiner Why People Die by Suicide , 2005 .

[30]  R. Farmer,et al.  Effect of availability and acceptability of lethal instruments on suicide mortality AN ANALYSIS OF SOME INTERNATIONAL DATA , 1980, Acta psychiatrica Scandinavica.

[31]  D. N. Bateman Limiting paracetamol pack size: has it worked in the UK? , 2009, Clinical toxicology.

[32]  K. Rodham,et al.  Distinguishing between subgroups of adolescents who self-harm. , 2009, Suicide & life-threatening behavior.

[33]  D. Brent,et al.  Firearms and Suicide , 2001, Annals of the New York Academy of Sciences.

[34]  L. Appleby,et al.  Changes in rates of suicide by car exhaust asphyxiation in England and Wales , 2001, Psychological Medicine.

[35]  H. Hinterhuber,et al.  The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt? , 2009, The Journal of clinical psychiatry.

[36]  D. Gunnell,et al.  Suicide by Jumping: is prevention possible? , 2005 .

[37]  A. Beck,et al.  Cognitive Therapy in Clinical Practice: An Illustrative Casebook , 1989 .

[38]  S. Newstead,et al.  Firearm related deaths: the impact of regulatory reform , 2004, Injury Prevention.

[39]  T. Lu,et al.  Association between the accessibility to lethal methods and method-specific suicide rates: An ecological study in Taiwan. , 2006, The Journal of clinical psychiatry.

[40]  D. H. Rosen,et al.  Suicide survivors. A follow-up study of persons who survived jumping from the Golden Gate and San Francisco-Oakland Bay Bridges. , 1975, The Western journal of medicine.

[41]  K. Hawton,et al.  Restricting access to methods of suicide rationale and evaluation of this approach to suicide prevention , 2007 .

[42]  D. Duffy,et al.  The National Suicide Prevention Strategy for England , 2003 .

[43]  Matthias Bopp,et al.  Changing times: a longitudinal analysis of international firearm suicide data. , 2006, American journal of public health.

[44]  A. Burroughs,et al.  Change in occurrence of paracetamol overdose in UK after introduction of blister packs , 2000, The Lancet.

[45]  P W O'Carroll,et al.  Community suicide prevention: the effectiveness of bridge barriers. , 1994, Suicide & life-threatening behavior.

[46]  S Simkin,et al.  Trends in deliberate self-harm in Oxford, 1985–1995 , 1997, British Journal of Psychiatry.

[47]  D. Lester The effects of detoxification of domestic gas on suicide in the United States. , 1990, American journal of public health.

[48]  D. Gunnell,et al.  Pattern of pesticide storage before pesticide self-poisoning in rural Sri Lanka , 2009, BMC public health.

[49]  C. Bagley,et al.  The evaluation of a suicide prevention scheme by an ecological method. , 1968, Social science & medicine.

[50]  P. Cook,et al.  Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act. , 2000, JAMA.

[51]  M. Nordentoft Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. , 2007, Danish medical bulletin.

[52]  L. Templeton,et al.  Admissions to hospital for deliberate self-harm in England 1995-2000: an analysis of hospital episode statistics. , 2002, Journal of public health medicine.

[53]  F. S. Bridges,et al.  Gun Control Law (BILL C-17), Suicide, and Homicide in Canada , 2004, Psychological reports.

[54]  C. Cantor,et al.  Changing methods of suicide by young Australians 1974-1994 , 1998 .

[55]  Sing Lee,et al.  Burning charcoal: a novel and contagious method of suicide in Asia. , 2002, Archives of general psychiatry.

[56]  Ronald V. Clarke,et al.  Suicide: Closing the Exits , 1989 .

[57]  R. Fowler,et al.  Guns and suicide: possible effects of some specific legislation. , 1990, The American journal of psychiatry.

[58]  D. Gunnell,et al.  Suicide and the internet , 2009 .

[59]  S. Littmann The Role of the Press in the Control of Suicide Epidemics , 1983 .

[60]  J. Williams,et al.  Psychology and suicidal behaviour: elaborating the entrapment model , 2005 .

[61]  J. Motto Newspaper influence on suicide. A controlled study. , 1970, Archives of general psychiatry.

[62]  D. Schotte,et al.  Problem-solving deficits in suicidal patients: trait vulnerability or state phenomenon? , 1990, Journal of consulting and clinical psychology.

[63]  K. Hawton United Kingdom legislation on pack sizes of analgesics: background, rationale, and effects on suicide and deliberate self-harm. , 2002, Suicide & life-threatening behavior.

[64]  D. Gunnell,et al.  Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. , 2003, International journal of epidemiology.

[65]  K. Hawton,et al.  The International Handbook of Suicide and Attempted Suicide , 2002 .