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Forensic Psychology

From the perspective of the forensic psychiatrist, suicide as a cause of death is particularly important in terms of its preventability. In many forensic settings, prior risk assessment for potential suicide victims can assist the psychiatrist in not only saving the lives of potential victims, but also in resolving crimes, preventing future crimes, or at the very least save uncountable grief and heartache to the families involved. The article by Borges et al. (2010) concerns a 12-month investigation of suicide risk on a cross-national basis. The global scale and long-term nature of this research might be expected to provide valuable information to forensic psychiatrists working in a clinical setting.

The purpose of the research was driven by a lack of data-driven methods for assessing suicide risks among clinical, criminal, and general populations. The 12-month epidemiological survey provided for the creation of a database to estimate the prevalence of suicidal behavior across the period of the survey. The database combines the various identified factors to create a risk index that can be applied separately to developed and developing countries.

Data for the study were collected from the WHO World Mental Health (WMH) Surveys, which were conducted from 2001 to 2007. There were 108,705 participants from 21 countries. The WHO Composite International Diagnostic Interview (CIDI) was used in conducting the interviews. Domains for the assessment of suicidal behaviors and risk factors included socio-demographics, parent psychopathology, childhood adversities, DSM-IV disorders, and the history of suicidal behavior.

Findings indicated a prevalence of 2.0%, 0.6%, and 0.3% for suicide ideation, plans and attempts over 12 months in developed countries, and 2.1%, 0.7%, and 0.4% for the same factors in developing countries. Risks were estimated to be higher for populations who were: female, younger, of lower education and income levels, unmarried, unemployed, of parentage where psychopathology was present, subject to adversity during childhood, and subject to a diversity of 12-month DSM-IV mental disorders. The combination of various risk factors resulted in an accurate prediction of 12-month suicide attempts for the domains and territories involved.

The study concluded that suicidal behaviors occurred at similar rates in both developed and developing countries. Risk indices created via the survey database are able to predict suicide events with relatively good accuracy.

Forensic psychiatrists working with various populations in clinical settings such as prison hospitals or psychiatric institutions can use the created database to identify the risk and prevent suicide among inmates and patients.

The study can also serve as a basis for further research in the clinical setting, where the existing database can be used as inspiration for investigations of smaller, more concentrated populations during shorter spans of time. In other words, more specific risk factors might be identified for populations with a specific uniform risk factor, such as parent psychopathology, for example.