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How The Misunderstanding That Heroin Addiction Is A Choice And The Stigma Surrounding Medication-Assisted Treatment Leads To More Overdose Deaths, Margaret M. Drew Oct 2018

How The Misunderstanding That Heroin Addiction Is A Choice And The Stigma Surrounding Medication-Assisted Treatment Leads To More Overdose Deaths, Margaret M. Drew

Student Publications

Heroin is an opioid that commonly appears as white or brown powder. Eventually a person can become physically dependent on heroin, meaning the body begins to expect the drug. A sudden withdrawal from the drug can cause intense symptoms such as vomiting, muscle pain, and cravings, often leading to relapse (Shannon, p. 172). Although the initial decision to try heroin may be up to the addict, due to the dependence one develops when using heroin, addiction eventually morphs into an involuntary compulsion. There are many factors out of an individual’s control that influence their likelihood of trying heroin and becoming …


Lifetime Economic Burden Of Intimate Partner Violence Among U.S. Adults, Cora Peterson, Megan C. Kearns, Wendy Likamwa Mcintosh, Lianne Fuino Estefen, Christina Nicolaidis, Kathryn E. Mccollister, Amy Gordon, Curtis Florence Oct 2018

Lifetime Economic Burden Of Intimate Partner Violence Among U.S. Adults, Cora Peterson, Megan C. Kearns, Wendy Likamwa Mcintosh, Lianne Fuino Estefen, Christina Nicolaidis, Kathryn E. Mccollister, Amy Gordon, Curtis Florence

School of Social Work Faculty Publications and Presentations


Introduction: This study estimated the U.S. lifetime per-victim cost and economic burden of intimate partner violence.

Methods: Data from previous studies were combined with 2012 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Intimate partner violence was defined as contact sexual violence, physical violence, or stalking victimization with related impact (e.g., missed work days). Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Mean age at first victimization was assessed as 25 years. Future costs were discounted by 3%. The main outcome measures were the mean per-victim (female and …


Implementation And Evaluation Of A Physical Activity And Dietary Program In Federal Incarcerated Females, Rosemary A. Johnson, Kerry A. Milner, Christine Heng, Anna E. Greer, Susan M. Denisco Oct 2018

Implementation And Evaluation Of A Physical Activity And Dietary Program In Federal Incarcerated Females, Rosemary A. Johnson, Kerry A. Milner, Christine Heng, Anna E. Greer, Susan M. Denisco

Nursing Faculty Publications

The purpose of this 3-month quasi-experimental pilot study was to examine the effect of a physical activity and dietary education program on body mass index (BMI) and resilience. Participants were given data-storing pedometers to record their physical activity, attended classes on healthy eating, and used portion control tools from http://ChooseMyPlate.gov . MyPlate usage and commissary purchases were collected weekly. BMI and resilience scores were measured at baseline, 6 weeks, and 12 weeks. Twenty-nine female prisoners completed the study. There was a statistically significant reduction in BMI after 12 weeks (χ2 = 7.56, p = .023) and resilience levels increased but …


What Do Urban College Students Really Think About Health Insurance? A Qualitative Study, P. Christopher Palmedo, Eleni K. Murphy, Katrina F. Mateo, Jennifer Gallo Sep 2018

What Do Urban College Students Really Think About Health Insurance? A Qualitative Study, P. Christopher Palmedo, Eleni K. Murphy, Katrina F. Mateo, Jennifer Gallo

Publications and Research

Objective: To determine barriers and opportunities to health insurance enrollment among an undergraduate students at a large urban university. Participants: Participants were 31 college students enrolled in 4-year and community colleges in the City University of New York (CUNY), and six health services and insurance enrollment specialists who facilitate and assist in the health insurance enrollment process for CUNY students. Methods: Focus groups were conducted with students and in-depth interviews with key informants in May 2017. Results: The research revealed important insights into how students perceive and value insurance and yielded recommendations for the university to improve enrollment of its …


Addicted To Hope: Abating The Opioid Epidemic And Seeking Redress From Opioid Distributors For Creating A Public Nuisance, Nathan R. Hamons Sep 2018

Addicted To Hope: Abating The Opioid Epidemic And Seeking Redress From Opioid Distributors For Creating A Public Nuisance, Nathan R. Hamons

West Virginia Law Review

No abstract provided.


Adolescent’S Knowledge And Skill To Refuse Drugs, Lucky Herawati, Johan Arief Budiman, Haryono Haryono Aug 2018

Adolescent’S Knowledge And Skill To Refuse Drugs, Lucky Herawati, Johan Arief Budiman, Haryono Haryono

Kesmas

Berbagai upaya telah dilakukan untuk mencegah remaja dari penggunaan narkoba, kendatipun evaluasi pengetahuan dan keterampilan remaja menolak narkoba belum pernah dilakukan. Penelitian ini dilakukan pada 300 remaja, siswa kelas 7 atau setara usia 12-15 tahun di dua kota di Provinsi Daerah Istimewa Yogyakarta. Penelitian analitik bertujuan mengetahui gambaran pengetahuan, keterampilan remaja menolak narkoba, dan hubungan keduanya dengan karakteristik remaja. Variabel yang diteliti adalah pengetahuan remaja tentang narkoba, keterampilan menolak narkoba, dan karakteristik remaja, yang dikumpulkan dengan menggunakan kuesioner (self-reported questionnaire). Data dianalisis dengan uji korelasi Pearson dan Spearman rho, dengan tingkat signifikansi 95 persen. Hasil penelitian menunjukkan bahwa rata-rata nilai …


Past, Present, Future: A Program Development Exploring Post Traumatic Slave Syndrome (Ptss) Using Experimental Learning And Dance/Movement Therapy Based Approaches, Bria Campbell Aug 2018

Past, Present, Future: A Program Development Exploring Post Traumatic Slave Syndrome (Ptss) Using Experimental Learning And Dance/Movement Therapy Based Approaches, Bria Campbell

Creative Arts Therapies Theses

The purpose of this program development project was to create a program that utilizes dance/movement therapy concepts integrated with Dr. Joy DeGruy's Post Traumatic Slave Syndrome (PTSS) theory, specifically with suggestions for healing PTSS, to help African American Adolescents in Chicago's Roseland neighborhood understand, explore and heal from PTSS. The Delphi Methods was used to gather information from collaborators via individual interviews and follow up surveys. Collaborators, all experienced community leaders with African American adolescents in the Roseland neighborhood and similar neighborhoods, included one African American dance/movement therapist, one program developer, an arts and education director and an arts education …


Effectively Integrating Dance/Movement Therapy And Restorative Justice Into High School Programs, Tia Vegemast Aug 2018

Effectively Integrating Dance/Movement Therapy And Restorative Justice Into High School Programs, Tia Vegemast

Creative Arts Therapies Theses

The purpose of the thesis is to develop a stand-alone program that has added dance/movement therapy informed interventions to an existing restorative justice program for high schools to implement. The high school program is designed to support youth in repairing damaged relationships caused by different behavioral issues. As schools are transitioning from punitive punishment to a more restorative approach to discipline, this program provides a new way of incorporating a more holistic approach to restorative justice and the healing process using movement of the body to further empathic understanding. Students will be able to learn from their mistakes and understand …


Measuring Inequity: A Systematic Review Of Methods Used To Quantify Structural Racism, Maya Groos, Maeve Wallace, Rachel Hardeman, Katherine P. Theall Aug 2018

Measuring Inequity: A Systematic Review Of Methods Used To Quantify Structural Racism, Maya Groos, Maeve Wallace, Rachel Hardeman, Katherine P. Theall

Journal of Health Disparities Research and Practice

Abstract

Objective: To summarize the ways in which researchers have quantified measures of structural racism for the purposes of empirical, quantitative investigation of its associations with physical and mental health outcomes.

Methods: Systematic review of literature published January 1, 2007-June 30, 2017. We searched PubMed and EMBASE databases for studies including at least one of the following search terms in the title or abstract: “structural racism”, “systemic racism”, “institutional racism”, “institutionalized racism”. Excluded studies were not original research, not US based, did not quantify an explicitly named indicator of structural racism, or were qualitative designs. Data from full …


Developing An Opioid Use Disorder Treatment Cascade: A Review Of Quality Measures, Arthur Robin Williams, Edward V. Nunes, Adam Bisaga, Harold A. Pincus, Kimberly A. Johnson, Aimee N. Campbell, Remien Remien, Stephen Crystal, Peter D. Friedmann, Frances R. Levin, Mark Olfson Aug 2018

Developing An Opioid Use Disorder Treatment Cascade: A Review Of Quality Measures, Arthur Robin Williams, Edward V. Nunes, Adam Bisaga, Harold A. Pincus, Kimberly A. Johnson, Aimee N. Campbell, Remien Remien, Stephen Crystal, Peter D. Friedmann, Frances R. Levin, Mark Olfson

Mental Health Law & Policy Faculty Publications

Background: Despite increasing opioid overdose mortality, problems persist in the availability and quality of treatment for opioid use disorder (OUD). Three FDA-approved medications (methadone, buprenorphine, and naltrexone) have high quality evidence supporting their use, but most individuals with OUD do not receive them and many experience relapse following care episodes. Developing and organizing quality measures under a unified framework such as a Cascade of Care could improve system level practice and treatment outcomes. In this context, a review was performed of existing quality measures relevant to the treatment of OUD and the literature assessing the utility of these measures in …


Rape Prevention And Education: Finding What Works, Mina White, Francisco Michel, Sabrina Boyce, Ruvani Fonseka, Ricardo Vera-Monroy, Jay Silverman Aug 2018

Rape Prevention And Education: Finding What Works, Mina White, Francisco Michel, Sabrina Boyce, Ruvani Fonseka, Ricardo Vera-Monroy, Jay Silverman

Faculty Research, Scholarly, and Creative Activity

No abstract provided.


Combatting The Opioid Crisis On College Campuses: A Harm Reduction Approach, Corey L. Lepoudre Jul 2018

Combatting The Opioid Crisis On College Campuses: A Harm Reduction Approach, Corey L. Lepoudre

Celebration of Learning

College aged people are at a high risk of opioid misuse due to several risks including: an increased opioid misuse in people between the ages of 18-25, those who experience daily elevated stress, and those who live in metropolitan areas or in the Midwest region of the United States. Due to these risks, a harm reduction initiative geared toward college populations is beneficial to prevent a further increase in opioid misuse and overdose. A harm reduction approach was used to develop an educational toolkit for Quad City Harm Reduction to conduct a one-hour workshop for college faculty and students. Harm …


Potential Biases And Social Stigmas Toward Mental Health On Georgia Southern’S Campus, Brandi N. Hawkins Jul 2018

Potential Biases And Social Stigmas Toward Mental Health On Georgia Southern’S Campus, Brandi N. Hawkins

Honors College Theses

Aims: The purpose of this study is to examine the potential biases and social stigmas toward mental health on Georgia Southern’s campus. The research questions explored are as follows: (1) Are there mental health biases on campus? (2) Are there any differences between college, class status, marital status, race, age, or gender in terms of mental health bias? (3) Do students feel as though there are available resources on campus? (4) Do students feel comfortable reaching out for help?

Methods: Data was collected from 350 undergraduate students over the age of 18 via a Likert-style questionnaire. The questionnaire …


Analyzing The Medical Definition Of Death In Criminal Homicide Prosecution, Mariah Wood Jul 2018

Analyzing The Medical Definition Of Death In Criminal Homicide Prosecution, Mariah Wood

Nursing ETDs

I investigated the use of the medical definition of human death in the criminal justice system and the impact of this definition on the prosecution of criminal homicide. The units of design for this research were two violent crimes cases investigated by the Homicide Unit of the Albuquerque Police Department. Data was collected from officer interviews, case files, Office of the Medical Investigator reports, media and social media.

I identified the themes of pursuit of justice, frustration, and family from the collected data. Key findings include that the medical definition of human death causes confusion and delay in the criminal …


Combatting Domestic Minor Sex Trafficking: An Evaluation Of The My Life, My Choice Program In Kentucky, Chelsea M. Dyer Jul 2018

Combatting Domestic Minor Sex Trafficking: An Evaluation Of The My Life, My Choice Program In Kentucky, Chelsea M. Dyer

Morehead State Theses and Dissertations

A thesis presented to the faculty of the Caudill College of Arts, Humanities, and Social Sciences at Morehead State University in partial fulfillment of the requirements for the degree of Master of Arts by Chelsea M. Dyer on July 11, 2018.


Why The Uk Needs A Separate Justice System For People With Mental Illness, Karen A. Snedker Jul 2018

Why The Uk Needs A Separate Justice System For People With Mental Illness, Karen A. Snedker

Sociology Faculty Articles and Research

"Severe mental illness is on the rise in the UK, and an increasing number of people with mental illness are behind bars and supported by inadequate mental health services. This is a situation that could be improved by the introduction of courts specifically geared for hearing cases involving defendants with mental health issues."


Stigma At Every Turn: Health Services Experiences Among People Who Inject Drugs, Catherine E. Paquette, Jennifer L. Syvertsen, Robin A. Pollini Jul 2018

Stigma At Every Turn: Health Services Experiences Among People Who Inject Drugs, Catherine E. Paquette, Jennifer L. Syvertsen, Robin A. Pollini

Clinical and Translational Science Institute

Background—People who inject drugs (PWID) encounter varying forms of stigma in health services contexts, which can contribute to adverse outcomes. We explored the lived experience of stigma among PWID to elucidate pathways by which stigma influences health care access and utilization. Methods—We conducted 46 qualitative interviews with PWID in California’s Central Valley between March and December 2015, as part of a multi-phase, multi-method study examining implementation of a new pharmacy syringe access law. A “risk environment” framework guided our data collection and we used a deductive/inductive approach to analyze the qualitative data. Results—Participants repeatedly cited the impact of stigma on …


Injection Drug Use, Hiv/Hcv, And Related Services In Nonurban Areas Of The United States: A Systematic Review, Catherine E. Paquette, Robin A. Pollini Jul 2018

Injection Drug Use, Hiv/Hcv, And Related Services In Nonurban Areas Of The United States: A Systematic Review, Catherine E. Paquette, Robin A. Pollini

Clinical and Translational Science Institute

Background—Injection drug use (IDU) in nonurban areas of the United States is a growing public health concern, but there has been no comprehensive assessment of existing research on injection-related HIV and hepatitis C (HCV) in nonurban communities. We conducted a systematic review to assess the current literature and identify knowledge gaps. Methods—We systematically searched six databases for relevant articles published between January 1990 and June 2016 and screened, extracted, and analyzed the resulting data. Studies were included if they reported original findings from the nonurban U.S. related to 1) IDU and its role in HIV/HCV transmission, and/or 2) HIV/HCV services …


Inpatient Initiated Methadone For Chronic Non-Cancer Pain At The University Of New Mexico, Steven Fishburn Jul 2018

Inpatient Initiated Methadone For Chronic Non-Cancer Pain At The University Of New Mexico, Steven Fishburn

Biomedical Sciences ETDs

Introduction

Inpatient initiation of methadone is ideal due to associated risks of cardiac arrhythmias and a high incidence of overdose. Evidence based guidelines have been developed for initiation of methadone for chronic noncancer pain (CNCP). The purpose of this study is to describe the frequency of pretreatment testing and high-risk prescribing in patients initiated on methadone at the University of New Mexico Hospital (UNMH).

Methods

A retrospective observational study was conducted using electronic health record data from UNMH, a southwest tertiary care center. We collected data on frequency of (1) pretreatment testing and (2) discharges with concomitant high-risk prescriptions. We …


Sexual Violence Victimization, Mental Health, And University-Based Health Service Use Among College Females, Julie E. Stoner Jul 2018

Sexual Violence Victimization, Mental Health, And University-Based Health Service Use Among College Females, Julie E. Stoner

Health Services Research Dissertations

Females between the ages of 18 and 24 consistently experience higher rates of sexual violence compared to females in any other age group (Sinozich & Langton, 2014). Approximately one in five college women experience sexual violence victimization (SVV; Krebs, Lindquist, Berzofsky, Shook-Sa & Peterson, 2016) during the academic year. Among undergraduate female students, 23.1% are victims of sexual violence due to physical force, violence or incapacitation (Cantor et al., 2015). Sexual victimization has been associated with several short- and long-term psychological health consequences, accounting for enhanced symptoms of depression, anxiety, PTSD, and suicide risk (Basile, Smith, Breiding, Black & Mahendra, …


Perspectives From The Society For Pediatric Research: Interventions Targeting Social Needs In Pediatric Clinical Care., Andrew F. Beck, Alicia J. Cohen, Jeffrey D. Colvin, Caroline M. Fichtenberg, Eric W. Fleegler, Arvin Garg, Laura M. Gottlieb, Matthew S S. Pantell, Megan T. Sandel, Adam Schickedanz, Robert S. Kahn Jul 2018

Perspectives From The Society For Pediatric Research: Interventions Targeting Social Needs In Pediatric Clinical Care., Andrew F. Beck, Alicia J. Cohen, Jeffrey D. Colvin, Caroline M. Fichtenberg, Eric W. Fleegler, Arvin Garg, Laura M. Gottlieb, Matthew S S. Pantell, Megan T. Sandel, Adam Schickedanz, Robert S. Kahn

Manuscripts, Articles, Book Chapters and Other Papers

The social determinants of health (SDoH) are defined by the World Health Organization as the "conditions in which people are born, grow, live, work, and age." Within pediatrics, studies have highlighted links between these underlying social, economic, and environmental conditions, and a range of health outcomes related to both acute and chronic disease. Additionally, within the adult literature, multiple studies have shown significant links between social problems experienced during childhood and "adult diseases" such as diabetes mellitus and hypertension. A variety of potential mechanisms for such links have been explored including differential access to care, exposure to carcinogens and pathogens, …


Care For Inmates With Mental Illness: What Can Nurses Do?, Rebecca K. Sakai Jun 2018

Care For Inmates With Mental Illness: What Can Nurses Do?, Rebecca K. Sakai

Honors Projects

This paper serves to inform nurses of the medical and psychiatric treatment that inmates with mental illness receive and to offer suggestions for treatment interventions. Current practice includes mental health screens, psychotropic medication administration, psychiatric departments, and administrative segregation. The recommended interventions include providing therapy (including Cognitive Behavioral Therapy and Group Therapy), decreasing administrative segregation, implementing reintegration programs, and training and collaborating with correctional officers.


Using Mhealth To Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2care): Protocol For A Randomized Controlled Trial, Jennifer M. Reingle Gonzalez, Michael S. Businelle, Darla Kendzor, Michele Staton, Carol S. North, Michael Swartz Jun 2018

Using Mhealth To Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2care): Protocol For A Randomized Controlled Trial, Jennifer M. Reingle Gonzalez, Michael S. Businelle, Darla Kendzor, Michele Staton, Carol S. North, Michael Swartz

Behavioral Science Faculty Publications

Background: There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid). …


Integrated Models Of Care For Individuals With Opioid Use Disorder: How Do We Prevent Hiv And Hcv?, Katherine M. Rich, Joshua Bia, Frederick L. Altice, Judith Feinberg Jun 2018

Integrated Models Of Care For Individuals With Opioid Use Disorder: How Do We Prevent Hiv And Hcv?, Katherine M. Rich, Joshua Bia, Frederick L. Altice, Judith Feinberg

Clinical and Translational Science Institute

Purpose of Review To describe models of integrated and co-located care for opioid use disorder (OUD), hepatitis C (HCV), and HIV. Recent Findings The design and scale-up of multidisciplinary care models that engage, retain, and treat individuals with HIV, HCV, and OUD are critical to preventing continued spread of HIV and HCV. We identified 17 models within primary care (N = 3), HIV specialty care (N = 5), opioid treatment programs (N = 6), transitional clinics (N = 2), and community-based harm reduction programs (N = 1), as well as two emerging models. Summary Key components of such models are …


An Analysis Of Self-Reported Suicide Attempts And Ideation In A National Sample Of Incarcerated Sex Offenders, Kseniya Katsman Jun 2018

An Analysis Of Self-Reported Suicide Attempts And Ideation In A National Sample Of Incarcerated Sex Offenders, Kseniya Katsman

Student Theses

Suicide is the leading cause of preventable death in US jails and prisons, with rates three to nine times higher than those of the general population. Although suicide in correctional settings has been recognized as a serious problem, the research on suicide among incarcerated individuals remains limited. While the majority of suicide risk factors may be common across all offender types, sex offenders may be at a particularly elevated risk. Specifically, sex offenders have been found to report high rates of hopelessness and depressive mood, which are known predictors of suicidal behavior, and approximately 14% of incarcerated sex offenders have …


"Understanding Lgbtq+ Intimate Partner Violence & Challenges In, Dr. Juanita Yates Jun 2018

"Understanding Lgbtq+ Intimate Partner Violence & Challenges In, Dr. Juanita Yates

Dissertations

This research project is a focus on Intimate Partner Violence (IPV) within LGBTQ+

community and the challenges associated with seeking family support. IPV is defined as a violent

or aggressive behavior within the home, typically involving the violent abuse of an intimate spouse

or partner. However, IPV can happen on the street, in one’s home or even in a public place. Those

exposed to IPV can be children, men and women. IPV is a prevalent issue in our society (Bright

2008). According to Ristock (2005), violence in LGBTQ+ relationships may be referred to as

partner violence, relationship violence, or LGBTQ+ …


Correctional Officers’ Perceptions And Attitudes Toward Mental Health Within The Prison System, Alexandra Rose Serafini Jun 2018

Correctional Officers’ Perceptions And Attitudes Toward Mental Health Within The Prison System, Alexandra Rose Serafini

Electronic Theses, Projects, and Dissertations

This research explored correction officers’ perceptions and attitudes in relation to inmates with mental health issues. In a qualitative fashion, semi-structured interviews were conducted with five correction officers in Southern California (N = 5) during the Winter 2018 Quarter. Using thematic analysis, this study identified six major themes from the interview data: mental health has remained a prominent issue within the prison population; correction officers were fairly knowledgeable about mental health; correction officers perceived themselves as having to play a limited role in the rehabilitation of inmates with mental health problems; constant prompts in daily activities and medication management were …


Zolpidem Facilitated Sexual Assaults: A Hair Method Validation, Danielle N. Chasworth Jun 2018

Zolpidem Facilitated Sexual Assaults: A Hair Method Validation, Danielle N. Chasworth

Student Theses

A liquid chromatography tandem mass spectrometry (LC-MSMS) method was developed and validated to detect for the presence of zolpidem in human hair samples. Zolpidem is a sedative hypnotic whose adverse effects make it a common drug found in drug facilitated crimes (DFC). It is important to be able to detect and quantitate the drug after a long period of time due to the victim’s delayed reporting of the crime. Hair’s long window of detection makes it a useful matrix for DFC investigations. The linear range of the assay was targeted at 2 pg/mg to 1,000 pg/mg and experiments designed to …


Law Enforcement Trauma Informed Response Training In Adult Sexual Assault Cases, Chelsie Lawter, Julie Valentine May 2018

Law Enforcement Trauma Informed Response Training In Adult Sexual Assault Cases, Chelsie Lawter, Julie Valentine

Journal of Undergraduate Research

Sexual assault (SA) is one of the most common crimes in the state, affecting one in three Utah women (Mitchell & Peterson, 2008). Despite this, shockingly low numbers of Utah SA victims see their cases progress to prosecution; for example, in Salt Lake County from 2003-2011, only 6% of SA cases were successfully prosecuted (Valentine, Shaw, Lark & Campbell, 2016). These numbers reflect an urgent need in Utah to identify barriers to prosecution and take steps to eliminate those barriers. Police officers, as first responders when victims seek to report an incidence of SA, have an important role in determining …


Method Overtness, Forensic Autopsy, And The Evidentiary Suicide Note: A Multilevel National Violent Death Reporting System Analysis, Ian R. H. Rockett, Eric D. Caine, Steven Stack, Hilary S. Connery, Kurt B. Nolte, Christa L. Lilly, Ted R. Miller, Lewis S. Nelson, Sandra L. Putnam, Paul S. Nestadt, Haomiao Jia May 2018

Method Overtness, Forensic Autopsy, And The Evidentiary Suicide Note: A Multilevel National Violent Death Reporting System Analysis, Ian R. H. Rockett, Eric D. Caine, Steven Stack, Hilary S. Connery, Kurt B. Nolte, Christa L. Lilly, Ted R. Miller, Lewis S. Nelson, Sandra L. Putnam, Paul S. Nestadt, Haomiao Jia

Clinical and Translational Science Institute

Objective Higher prevalence of suicide notes could signify more conservatism in accounting and greater proneness to undercounting of suicide by method. We tested two hypotheses: (1) an evidentiary suicide note is more likely to accompany suicides by drug-intoxication and by other poisoning, as less violent and less forensically overt methods, than suicides by firearm and hanging/suffocation; and (2) performance of a forensic autopsy attenuates any observed association between overtness of method and the reported presence of a note. Methods This multilevel (individual/county), multivariable analysis employed a generalized linear mixed model (GLMM). Representing the 17 states participating in the United States …