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CDC recommendations for a community plan for the prevention and containment of suicide clusters
  • Published Date:
    August 19, 1988
  • Status:
    current
  • Source:
    MMWR. Morbidity and mortality weekly report. 1988; 37 Suppl 6:1-12.
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Details:
  • Corporate Authors:
    National Center for Injury Prevention and Control (U.S.). Division of Violence Prevention. ; National Institute of Mental Health (U.S.) ; United States. Indian Health Service. ; ... More ▼
  • Description:
    Recent suicide clusters among teenagers and young adults have received national attention, and public concern about this issue is growing. Unfortunately, our understanding of the causes and means of preventing suicide clusters is far from complete. A suicide cluster may be defined as a group of suicides or suicide attempts, or both, that occur closer together in time and space than would normally be expected in a given community. A statistical analysis of national mortality data indicates that clusters of completed suicide occur predominantly among adolescents and young adults, and that such clusters account for approximately 1%-5% of all suicides in this age group. Suicide clusters are thought by many to occur through a process of "contagion," but this hypothesis has not yet been formally tested. Nevertheless, a great deal of anecdotal evidence suggests that, in any given suicide cluster, suicides occurring later in the cluster often appear to have been influenced by suicides occurring earlier in the cluster. Ecologic evidence also suggests that exposure of the general population to suicide through television may increase the risk of suicide for certain susceptible individuals, although this effect has not been found in all studies.

    The Centers for Disease Control (CDC) has assisted several state and local health departments in investigating and responding to apparent clusters of suicide and suicide attempts. These clusters created a crisis atmosphere in the communities in which they occurred and engendered intense concern on the part of parents, students, school officials, and others. In the midst of these clusters of suicides or suicide attempts, community leaders were faced with the simultaneous tasks of trying to prevent the cluster from expanding and trying to manage the crisis that already existed. Potential opportunities for prevention were often missed during the early stages of response as community leaders searched for information on how best to respond to suicide clusters.

    The recommendations contained in this report were developed to assist community leaders in public health, mental health, education, and other fields to develop a community response plan for suicide clusters or for situations that might develop into suicide clusters. A workshop for developing these recommendations was jointly sponsored by the New Jersey State Department of Health and CDC on November 16-17, 1987, in Newark, New Jersey.* Participants in that workshop included persons who had played key roles in community responses to nine different suicide clusters. They were from a variety of different sectors including education, medicine, local government, community mental health, local crisis centers, and state public health and mental health. Also participating in this workshop were representatives from the National Institute of Mental Health (NIMH), the Indian Health Service (IHS), the American Association of Suicidology (AAS), and the Association of State and Territorial Health Officials (ASTHO).

    These recommendations should not be considered explicit instructions to be followed by every community in the event of a suicide cluster. Rather, they are meant to provide community leaders with a conceptual framework for developing their own suicide-cluster-response plans, adapted to the particular needs, resources, and cultural characteristics of their communities. These recommendations will be revised periodically to reflect new knowledge in the field of suicide prevention and experience acquired in using this plan.

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