Table 1.

Precipitating and Other Preceding Circumstances of Suicide—National Violent Death Reporting System

Precipitating circumstances

Current depressed mood or mental health problem: decedent was perceived by self or others to be depressed or has been identified as having a mental health disorder or syndrome listed in the Diagnostic and Statistical Manual, version IV (DSM-IV)

Alcohol or other substance abuse problems or suspected intoxication: decedent was perceived by self or others to have a problem with, or to be addicted to, alcohol or other drugs. Or, the decedent was believed to be intoxicated at the time of death

Physical health problem: decedent was experiencing physical health problems that were believed to have contributed to the suicide (e.g., a recent cancer diagnosis or chronic pain)

Crisis during previous 2 weeks: a very current crisis or an acute precipitating event appeared to have contributed to the suicide. The crisis event must have occurred in the previous 2 weeks or be impending in the following 2 weeks (e.g., a trial for a criminal offense begins the following week)

Criminal or civil legal problems: decedent was facing criminal legal problems or civil legal problems (e.g., a child custody or civil lawsuit) that appeared to be associated with the suicide

Job problem: decedent was either experiencing a recent problem at work or was having a problem with joblessness

Financial problem: decedent was experiencing problems such as bankruptcy, overwhelming debt, or foreclosure of a home or business

Intimate partner problem: problems with a current or former intimate partner that appeared to have contributed to the suicide

Other relationship problem: problems with a family member, friend, or an associate (other than an intimate partner) that appeared to have contributed to the suicide.

Other relevant preceding circumstances

Current treatment for mental illness: decedent was currently receiving mental health treatment as evidenced by a current psychotropic medication or visited to a mental health professional in the previous 2 months

History of suicide attempts: decedent was known to have made previous attempts, regardless of the severity of those attempts

Person left a suicide note: decedent left a note, e-mail message, video, or other communication indicating an intent to die by suicide

Disclosed intent to die by suicide: decedent had previously expressed suicidal feelings to another person with time for that person to intervene; disclosure only at the time of the event, with no opportunity to intervene, is not coded as “disclosed intent to commit suicide”