Who Leaves Suicide Notes? A Six‐Year Population‐Based Study

Abstract

Popular culture insists on the significance of suicide notes, but research has yielded conflicting results about who leaves notes. Utilizing 6 years of suicides from a comprehensive statewide data surveillance system, differences were examined between cases with suicide notes and those without in terms of demographics, circumstances of the suicide, and precipitating circumstances. Of the 2,936 suicides, 18.25% included a note. Demographics and circumstances did not differ for cases with a note compared to cases with no note. Results have implications for working with people bereaved by suicide in helping understand that the notes are uncommon and not systematic. However, it is also possible that for some individuals, the content of a note is meaningful and can help or hinder their course of bereavement.

Last Words: Are There Differences in Psychosocial and Clinical Antecedents Among Suicide Decedents Who Leave E‐Notes, Paper Notes, or No Note?

“…To date, the literature comparing suicide decedents who do and do not leave a note has reported conflicting findings with the prevalence of suicide note-leaving varying considerably across cultures, ethnicities, race, age, gender, socioeconomic status, and literacy. Of those who died by suicide, 15%-61% left a suicide note (Carpenter et al, 2016;Cerel et al, 2015;Meyer et al, 2017;O'Donnell et al, 1993;Salib et al, 2002). While Carpenter et al (2016) reported the highest rate of note-leaving, they have broadened the definition of suicide note to include verbal threats.…”

“…Studies that included in their analyses psychiatric histories and psychiatric hospitalizations reported contradictory findings. Several international studies reported that suicide decedents who had known mental health issues such as mental disorder, history of self-harm, or recent or prior psychiatric hospitalization were less likely to leave behind a note (Carpenter et al, 2016;Chia, Chia, & Tai, 2008;Demirel, Akar, Sayin, Candansayar, & Leenaars, 2008;Ho et al, 1998;Howard & Surtees, 2016;Kuwabara et al, 2006;Paraschakis et al, 2012;Salib et al, 2002;Wong, Yeung, Chan, Yip, & Tang, 2009). Stack and Rockett (2016), in their analysis of US data from the National Violent Death Reporting System, found that those with current mental health issues or depression were more likely to have left a suicide note (OR = 1.11 & OR = 1.22, respectively); however, those with current mental health treatment and alcohol abuse-related problems (15% and 24%, respectively) were less likely to have left a note.…”

“…Limited differences have been reported between decedents who left suicide notes and those who did not (Callanan & Davis, ; Cerel, Moore, Brown, Venne, & Brown, ; Olson, Wahab, Thompson, & Durrant, ); however, several general findings have emerged from this literature. Firstly, not all suicide decedents leave a suicide note; the incidence of note‐leaving varies considerably ranging from a low of 15% among adults in the London Underground railway system to a high of 61% among suicide decedents in Queensland, Australia (Carpenter et al., ; Cerel et al., ; Meyer, Irani, Hermes, & Yung, ; O'Donnell, Farmer, & Catalan, ; Salib, Cawley, & Healy, ), and the incidence of note‐leaving does not appear to be associated with fluctuations in the rate of suicide (Shioiri et al., ). Secondly, note‐leaving may be contingent on other factors and not directly related to suicide ideation, such as education and physical ability to read and write (Salib & Maximous, ).…”

“…Secondly, note‐leaving may be contingent on other factors and not directly related to suicide ideation, such as education and physical ability to read and write (Salib & Maximous, ). Thirdly, characteristics of decedents who left notes and those who did not have yielded at times conflicting and inconclusive findings in terms of sex, age, and history of suicide behavior, mental and physical health problems (e.g., depression and anxiety), and interpersonal relationship issues [e.g., relationship dissolution (Callanan & Davis, ; Cerel et al., ; Haines, Williams, & Lester, ; Ho, Yip, Chiu, & Halliday, ; Kuwabara et al., )].…”

Characteristics of suicides in Navarra by gender (2010-2013)

“…Por lo que respecta a las notas suicidas, los resultados son muy semejantes a los encontrados en muestras gallegas 37 y norteamericanas 38 . En todos los casos un 18% de las personas que se suicidaron dejaron una nota suicida.…”