A recent study of suicide deaths in Northern California conducted by researchers at Palo Alto University, the County of Santa Clara Behavioral Health Services Department, and the County of Santa Clara Office of the Medical Examiner / Coroner, could have important implications for culturally informed suicide prevention strategies, assessment, and risk management.
The study published in the journal of Death Studies analyzed 1,145 suicide deaths by method and location in Santa Clara County, CA from 2009 to 2016. It found that hanging was the most common method of suicide death among Latino/a/x and Asian and Pacific Islander (API) compared to White and African American decedents who were more likely to suicide-by-firearms. The study also found that API and African American decedents were less likely than White decedents to die-by-suicide at home. The ethnicity-location-method analysis revealed a notable variation in suicide patterns: compared to White firearm suicide deaths, API firearm suicide deaths were more likely to occur outside the home.
In the field of suicide prevention, the study is among the first to attempt to understand the relationship between cultural variations in suicide method and suicide location.
“This study fuses these two approaches in order to facilitate the further development of effective, culturally-informed suicide prevention,” says Dr. Brandon Hoeflein, the lead author who is a graduate of Palo Alto University and postdoctoral fellow at the Tampa Veterans Administration.
“In fact, the study is part of a larger collaborative effort to transform the way we study and prevent suicide for diverse and underserved populations,” says Dr. Joyce Chu, a professor and clinical psychologist at Palo Alto University and senior author of the study.
Hoeflein and Chu, along with PAU students Gabriel Corpus and Lorna Chiu. teamed with Mego Lien, a public health professional and manager of the County of Santa Clara Behavioral Health Services Department’s Suicide Prevention Program, and Dr. Michelle Jorden, Chief Medical Examiner-Coroner and Neuropathologist at the County of Santa Clara, to conduct the study. Three years ago, the PAU and the County of Santa Clara’s Suicide Prevention Program partnered to develop a culturally competent suicide prevention training program that prepares the citizens of Santa Clara County to be the eyes and ears of their community in detecting suicide distress. The training program launched this month, as part of Suicide Prevention Month.
“Compared to the oft-studied variable of suicide method, there is a dearth of data on suicide location,” says Dr. Jorden. “This research is notable because it suggests that both suicide method and location are factors that are susceptible to the influence of culture, such as the social implications of how a decedent's body is found. It may be time for the suicide prevention field to examine whether suicide method and location have cultural meanings,” added Lien.
The study yields implications and future directions for culturally-informed suicide risk assessment, management, and prevention at the clinical, community, and systems levels.