Suicide across older adulthood is not a homogenous phenomenon. Our findings showed significant differences in the prevalence of potential risk factors within the three different age groups considered. To prevent suicide in older adults would require targeting specific factors for each subgroup while using holistic and comprehensive approaches.

Acceptability, availability and lethality are important factors impacting choice of means and should be considered when designing suicide prevention activities in older adults.

Background: Gap Park in Sydney, Australia has historically been recognised as a suicide jumping site. In 2010À2011 the Gap Park Masterplan initiative implemented a series of suicide prevention measures. This study applied a mixed-methods design to evaluate the effectiveness of the Masterplan in reducing suicides. Methods: Data from the Australian National Coronial Information System (NCIS) was examined to compare suicides at Gap Park before and after the Masterplan was implemented. This was complemented with qualitative data from interviews with police officers who respond to suicidal behaviours at Gap Park. Findings: Joinpoint analysis of NCIS data showed a non-significant upward trend in jumping suicides during the study period. A significant upward trend in suicides was seen for females before the implementation of the Masterplan (2000À2010), followed by a significant downward trend from the implementation period onwards (2010À2016) for females: however, a non-significant upward trend for males was observed. Qualitative analysis of police interviews identified six key themes: romanticism and attraction at hotspots, profiles and behavioural patterns of suicidal individuals, responding to a person in a suicidal crisis, repeat attempts, means restriction, and personal impacts on police officers. Interpretation: The mixed-method study provided important insights, suggesting the Gap Park Masterplan has contributed to a reduction in female, but not in male jumping suicides. Further qualitative information from police officers suggested that the safety barriers were not difficult to climb, and may be more of a visual or psychological barrier. However, the effectiveness of CCTV and alarms in the detection and location of suicide attempters was highlighted.

Our findings show older adults who died by suicide were more likely to experience somatic illnesses, bereavement, and pay attention to suicide in the media compared to middle aged. Preventing suicide in older adults would therefore require holistic and comprehensive approaches.

Background and Objective: Wesley Mission LifeForce training is an Australian suicide prevention gatekeeper program which has not been formally evaluated. The aims of this evaluation were to (1) determine the short- and medium- term impacts of the training on worker capabilities (perceived and declarative knowledge), attitudes, and reluctance to intervene measures; and (2) compare the impact of the half and full day workshops on these measures.Method: 1,079 Australian community workers of diverse professional backgrounds completed a pre-workshop questionnaire as part of registration for the Wesley LifeForce suicide prevention training between 2017 and 2019. Of these, 299 participants also completed the post workshop questionnaires (matched sample). They attended either half day (n = 97) or full day workshops (n = 202) and completed also a 3- and 6- month follow-up questionnaire. We used linear mixed-effect modeling for repeated measures to analyze data.Results: LifeForce training participants experienced an increase in perceived capability, declarative knowledge, more positive attitudes and reduced reluctance to intervene, at least in the short term. The program is particularly well targeted for community gatekeepers with no prior training, albeit those with prior training in this study also experienced positive and significant gains on most measured constructs.Conclusions: We found evidence of effectiveness of the Wesley LifeForce training over time, without difference between the short (half day) and longer (full day) formats of delivery. Nevertheless, the latter format offers skills-based and skills rehearsal opportunities, the impacts of which we were unable to measure in this evaluation and should be estimated in the future.

Aims Previous studies analysing blood alcohol concentration (BAC) at the time of suicide have primarily focused on sociodemographic factors. Limited research has focused on psychosocial factors and co-ingestion of other substances to understand the mechanisms of how alcohol contributes to death by suicide. The aim was to examine time trends, psychosocial factors related to acute alcohol use and co-ingestion of alcohol and other substances before suicide. Methods The Queensland Suicide Register in 2004–2015 was utilised and analysed in 2019. The cut-off point for positive BAC was set at ⩾0.05 g/dl. Substances were categorised as medicines, illegal drugs and other. Medicines were coded by the Anatomical Therapeutic Chemical (ATC) classification system. Joinpoint regression, univariate odds ratios, age and sex-adjusted odds ratios and Forward Stepwise logistic regression were performed. Results BAC information was available for 6744 suicides, 92% of all cases in 2004–2015. The final model showed that independent factors distinguishing BAC+ from BAC− were: age group 25–44 years, Australian Indigenous background, being separated or divorced, hanging, diagnosis of substance use, lifetime suicidal ideation, relationship and interpersonal conflict, not having psychotic and other psychiatric disorder, and no nervous system drugs or any other substances in blood at the time of suicide. Conclusions Our findings suggest that people who die by suicide while under the influence of alcohol are more likely to be under acute stress (e.g. separation) and not have earlier psychiatric conditions, except substance use. This highlights the importance of more strict alcohol policies, but also the need to improve substance use treatment.

Background:The Pacific Islands have some of the highest rates of suicide in the Western Pacific region. The purpose of this study was to systematically review the literature on suicidal behaviour in the Pacific Islands. Methods: A comprehensive search of Web of Science, PubMed, PsycINFO, Cochrane, CINAHL and Embase databases was conducted for all articles published until 1 st February 2021. Inclusion criteria included papers that referred to a pre-specified list of Pacific Islands. Papers referring exclusively to other countries were excluded. Other exclusion criteria included not being about suicide or suicide attempts or not presenting original research. Narrative synthesis was applied without meta-analysis. The review followed PRISMA guidelines. Findings: A total of 36 papers were included for review. Of the Pacific Islands, Kiribati has the highest age-standardised rate of suicide mortality. Key risk groups across the Islands included youth, people of Indian ethnicity in Fiji (a prominent ethnic group in Fiji), and Indigenous peoples across other Islands. Prominent methods were self-poisoning and hanging. A distinct lack of intervention studies was found. Interpretation: Overall, the Pacific Islands appear to have relatively high rates of suicide and suicide attempts compared to other countries in the region. This was particularly striking among youth. This review provides important directions for future suicide prevention activities, including means restriction, sensitive media/community coverage, enhanced surveillance, and the development and evaluation of interventions tailored to the needs of young people and other cultural groups.

Prospective memory (PM) is the ability to perform a planned action at a future time. Older adults have shown moderate declines in PM, which are thought to be driven by age-related changes in the prefrontal cortex. However, an age-PM paradox is often reported, whereby deficits are evident in laboratory-based PM tasks, but not naturalistic PM tasks. The key aims of this study were to: (1) examine the age-PM paradox using the same sample across laboratory and ecological settings; and (2) determine whether self-reported PM and cognitive factors such as working memory and IQ are associated PM performance. Two PM tasks were administered (ecological vs. laboratory) to a sample of 23 community-dwelling older adults (Mage = 72.30, SDage = 5.62) and 28 young adults (Mage = 20.18, SDage = 3.30). Participants also completed measures of general cognitive function, working memory, IQ, and self-reported memory. Our results did not support the existence of the age-PM paradox. Strong age effects across both laboratory and ecological PM tasks were observed in which older adults consistently performed worse on the PM tasks than young adults. In addition, PM performance was significantly associated with self-reported PM measures in young adults. For older adults, IQ was associated with time-based PM. These findings suggest that the age-PM paradox is more complex than first thought and there are differential predictors of PM performance for younger and older adults.