Suicide Categories by Patterns of Known Risk Factors

CONTEXT: Multiple risk factors contribute to suicides; however, patterns of co-occurrence among these factors have not been fully identified. OBJECTIVES: To assess patterns of known suicide-related risk factors, classify suicide decedents by these patterns, track class proportions during a 6-year period, and characterize decedents across the classes to help focus prevention strategies. DESIGN, SETTING, AND PARTICIPANTS: Latent class analysis was conducted using 2003-2008 data from the National Violent Death Reporting System. The population included 28 703 suicide decedents from 12 US states. MAIN OUTCOME MEASURES: The known risk factors included having the following: mental health conditions; a sad or depressed mood; substance abuse problems; medical problems; recent crises; financial, job, and legal problems; intimate partner and other relationship problems; and perpetrated interpersonal violence. RESULTS: Nine distinct patterns of risk factors emerged. Of these classes, 1 only endorsed mental health-related factors and 1 only endorsed alcohol- and substance abuse-related factors; however, 7 classes of decedents had distinct patterns of factors that spanned multiple domains. For example, 5 of these classes had mental health factors with other risks (eg, substance abuse, financial problems, relationship problems, a recent crisis, and medical problems). Two classes had recent crises with relationship problems; one of these classes also had high probabilities for criminal problems and interpersonal violence. Class proportions differed during the 6 years. Differences across classes by demographic and event characteristics were also found. CONCLUSIONS: Most suicide decedents could be classified by patterns of risk factors. Furthermore, most classes revealed a need for more connected services across medical, mental health/substance abuse, and court/social service systems. Reducing fragmentation across these agencies and recruiting family, friend, and community support for individuals experiencing mental health problems and/or other stress might significantly reduce suicides.