CONTEXT

Multiple risk factors contribute to suicides; however, patterns of co-occurrence among these factors have not been fully identified.

OBJECTIVES

To assess patterns of known suicide-related risk factors, classify suicide decedents by these patterns, track class proportions during a 6-year period, and characterize decedents across the classes to help focus prevention strategies.

DESIGN, SETTING, AND PARTICIPANTS: Latent class analysis was conducted using 2003-2008 data from the National Violent Death Reporting System. The population included 28 703 suicide decedents from 12 US states.

MAIN OUTCOME MEASURES

The known risk factors included having the following: mental health conditions; a sad or depressed mood; substance abuse problems; medical problems; recent crises; financial, job, and legal problems; intimate partner and other relationship problems; and perpetrated interpersonal violence.

RESULTS

Nine distinct patterns of risk factors emerged. Of these classes, 1 only endorsed mental health-related factors and 1 only endorsed alcohol- and substance abuse-related factors; however, 7 classes of decedents had distinct patterns of factors that spanned multiple domains. For example, 5 of these classes had mental health factors with other risks (eg, substance abuse, financial problems, relationship problems, a recent crisis, and medical problems). Two classes had recent crises with relationship problems; one of these classes also had high probabilities for criminal problems and interpersonal violence. Class proportions differed during the 6 years. Differences across classes by demographic and event characteristics were also found.

CONCLUSIONS

Most suicide decedents could be classified by patterns of risk factors. Furthermore, most classes revealed a need for more connected services across medical, mental health/substance abuse, and court/social service systems. Reducing fragmentation across these agencies and recruiting family, friend, and community support for individuals experiencing mental health problems and/or other stress might significantly reduce suicides.