CDC releases first update for investigating, addressing suicide clusters since 1988

Key takeaways:

• The recommendations include processes for investigating and responding to suicide clusters.
• Social media can be a tool for responding to suicide clusters, but also poses risks.

In a three-part supplement series published in Morbidity and Mortality Weekly Report, the CDC released updated and expanded guidance for community assessment and response to suicide clusters for the first time since 1988.

The age-adjusted rates of suicide among all ages increased 36% from 10.4 suicides per 100,000 population in 2000 to 14.1 per 100,000 population in 2021, according to the CDC report. The researchers defined suicide clusters as a group of suicides or suicide attempts that occur closer in time, space or both than expected in a community.

“Suicide deaths are just one part of assessing the public health problem of suicide and its contributing factors,” Eva Trinh, PhD, MPH, a health scientist for suicide prevention at the CDC, and colleagues wrote. “Many more persons think about, plan and attempt suicide. Monitoring these suicide-related events is a key component of prevention and might reveal when an unusual pattern or a cluster of suicides or suicide attempts have occurred.”

In the first of the three-part series, Ballesteros and colleagues provided background about how the research teams gathered information and created the recommendations. Specifically, the researchers conducted a literature review, environmental scan and media review related to suicide and suicide clusters, identifying 166 relevant articles, and spoke with subject matter experts to create the recommendations.

The second and third reports within the supplement offer recommendations for assessing and investigating suicide clusters and advice for community response to these events.

When a potential suicide cluster is reported, the CDC recommends a three-step process for its initial assessment and investigation, consisting of:

• a preliminary assessment of the possible cluster that involves the collection of details and determining whether to conduct a formal assessment;
• a formal assessment that identifies the time frame and data sources to prepare for an investigation; and
• investigating possible links between cases and hypothesizing the cause of the cluster to inform the eventual community response.

After completing an investigation, the CDC recommends another three-step action plan for community response, starting with preparing for a response by engaging with community stakeholders and identifying available resources.

Next, the community should respond directly to those affected or at risk, as well as to the public through media sources, taking care to minimize sensationalism.

Finally, preventive action should be taken through identifying and eliminating any environmental factors that could lead to future suicides or attempts, as well as taking care of long-term issues that were related to the cluster.

The most notable update to the guidelines is the addition of social media, which did not exist when the original recommendations were published in 1988.

“Since that time, these technological advances have served as both a suicide cluster response tool and a potential risk to the response,” Asha Z. Ivey-Stephenson, PhD, behavioral scientist and epidemiologist for the CDC’s National Center for Injury Prevention and Control, and colleagues wrote in the third report.

According to the report, social media can serve as a platform for those affected to talk to each other, and it allows community leaders to release accurate and timely information to the community. However, it can also become a breeding ground for misinformation and sensationalism.

“CDC’s vision is no lives lost to suicide,” the researchers concluded. “To advance this vision, CDC is using data, science, and partnerships and the best available evidence to prevent suicide, with a focus on upstream prevention as well as interventions designed to lessen the immediate and long-term harms associated with suicide and suicide attempts.”

References:

• Ballesteros MF, et al. MMWR Suppl. 2024;doi:10.15585/mmwr.su7302a1.
• Ivey-Stephenson AZ, et al. MMWR Suppl. 2024;doi:10.15585/mmwr.su7302a3.