The association between undergraduate nursing students' health literacy and bullying and cyberbullying victimization.

BACKGROUND: Bullying and cyberbullying victimization are common among undergraduate nursing students. However, evidence regarding health literacy association with bullying and cyberbullying victimization is lacking. PURPOSE: To investigate the association between health literacy and bullying and cyberbullying victimization in undergraduate nursing students. METHODS: A cross-sectional design was used with a sample of undergraduate nursing students (N = 397). The students completed three data collection scales (Forms of Peer Victimization Scale, Florence Cyberbullying-Cybervictimization Scales, and Health Literacy Questionnaire) and a demographics questionnaire. Data analysis was performed using cluster analysis and independent samples t-test. RESULTS: The mean age of students was 20.93 (SD = 2.16). Cluster analysis revealed that there were two clusters; undergraduate nursing students in cluster 1 had lower scores on health literacy and higher scores on bullying and cyberbullying victimization. The t-test results showed that undergraduate nursing students with a history of bullying victimization had lower scores on health literacy scales than those who reported no exposure to bullying victimization (p < .05). The largest mean difference was found in the "social support for health" scale. CONCLUSION: The findings of this study provide evidence that health literacy is a key determinant of mitigating bullying and cyberbullying victimization in undergraduate nursing students.

The impact of the #MeToo movement on language at court A text-based causal inference approach.

This study assesses the effect of the #MeToo movement on the language used in judicial opinions on sexual violence related cases from 51 U.S. state and federal appellate courts. The study introduces various indicators to quantify the extent to which actors in courtrooms employ language that implicitly shifts responsibility away from the perpetrator and onto the victim. One indicator measures how frequently the victim is mentioned as the grammatical subject, as research in the field of psychology suggests that victims are assigned more blame the more often they are referred to as the grammatical subject. The other two indices designed to gauge the level of victim-blaming capture the sentiment of and the context in sentences referencing the perpetrator. Additionally, judicial opinions are transformed into bag-of-words and tf-idf vectors to facilitate the examination of the evolution of language over time. The causal effect of the #MeToo movement is estimated by means of a Difference-in-Differences approach comparing the development of the language in opinions on sexual offenses and other crimes against persons as well as a Panel Event Study approach. The results do not clearly identify a #MeToo-movement-induced change in the language in court but suggest that the movement may have accelerated the evolution of court language slightly, causing the effect to materialize with a significant time lag. Additionally, the study considers potential effect heterogeneity with respect to the judge's gender and political affiliation. The study combines causal inference with text quantification methods that are commonly used for classification as well as with indicators that rely on sentiment analysis, word embedding models and grammatical tagging.

Validation of the Chinese version of the coping strategies for victims of cyberbullying scale.

BACKGROUND: Although abundant evidence has confirmed cyberbullying as a global online risk, little is known about the coping strategies employed by victims and those who experiencing bullying. A validated scale for coping with cyberbullying could inform evidence-based social services and enable comparative studies of this phenomenon among victims from different backgrounds. This study aims to validate the Coping Strategies for Victims of Cyberbullying (CSVC) scale among Chinese adolescents and to compare its effectiveness between victims and bully-victims (individuals with dual roles). METHODS: A 25-item CSVC scale was translated and adapted for cultural relevance in the Chinese context. A sample of 1,716 adolescents, aged 13-18 years, from two middle schools and one high school in China, was recruited. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. RESULTS: The EFA revealed that the Chinese version of the CSVC scale had satisfactory validity. The CFA demonstrated a good fit for the eight-factor model in assessing different coping strategies for cyberbullying. Differences in the selection of coping strategies were observed between the general adolescent population and sexual and gender minorities. CONCLUSIONS: Future intervention studies may use this validated scale to educate adolescents, both those affected by cyberbullying and those who are not, to learn a broader range of coping strategies and to choose more effective ones.

Impact of the COVID-19 Pandemic on Swedish Adolescents' Mental Health, Psychosocial Functioning, Risk Behaviours, and Victimisation: Gender Differences and Implications.

The COVID-19 pandemic has shown varying effects on adolescents' mental health, psychosocial functioning, risk behaviours, and victimisation. This study aims to examine the changes reported by a sample of Swedish adolescents (N = 1607) at the end of the first year of the pandemic in relation to these factors. Data were collected with an electronic survey between September 2020 and February 2021, targeting upper-secondary high school students (aged 15-19 years). The results indicate a relatively low overall impact of the pandemic on Swedish upper-secondary school students, with notable gender differences. Compared to adolescent women, a higher percentage of adolescent men reported experiencing elevated levels of anxiety, depression, sleep disturbances, anger, and increased illicit drug use as consequences of the pandemic. In contrast, women demonstrated an increase in several salutogenic behaviours. Victimisation rates generally decreased during this period. These findings underscore the importance of heightened awareness among professionals within schools, social services, and healthcare settings regarding the distinct challenges encountered by a larger portion of adolescent men during the COVID-19 pandemic in Sweden.

Beyond the Initial Assault: Characterizing Revictimization in Intimate Partner Violence and Its Implications for Women's Health.

Recent research has emphasized the importance of addressing specific victim-related factors to reduce victims' vulnerability and prevent future revictimization experiences. This study aimed to analyze the vulnerability profiles of women who were victims of intimate partner violence, including those who had experienced a single incident of violence and those who had endured revictimization. Participants were 338 women with active judicial protection measures registered in the system of support for victims of gender violence (VioGén) in Madrid, Spain. The analysis considered sociodemographic characteristics, victimization history, perceived triggers of violence, women's responses and feelings, as well as clinical outcomes linked to revictimization history. The study revealed that many victims faced socioeconomic vulnerability. Furthermore, the findings underscored the intricate link between the likelihood of enduring chronic violence and women's awareness of early indicators of violence risk, their initial responses to aggression, communication skills, and recurrent behaviors in the context of an established violent dynamic. This study offers valuable insights for law enforcement to identify the risk of revictimization. Furthermore, findings raise awareness about the particularly vulnerable situation of some women to repeated victimization experiences and provide relevant information for clinical intervention.

Initial tweet valence, abuse volume, and observer Dark Tetrad characteristics influence perceptions of female celebrity abuse on Twitter.

Research into relationships between victim-generated content, abuse received, and observer characteristics when considering Twitter abuse has been limited to male victims. We evaluated participant perceptions of female celebrity victims and abuse received on Twitter. We used a 3 (Initial Tweet Valence; negative, neutral, positive) × 2 (Abuse Volume; low, high) repeated measures design and online survey method. Participants were shown tweets generated by six female celebrities, counterbalanced such that each participant saw each celebrity in one Valence-Volume condition. Stimuli were presented across six 'lists' such that celebrity 'victims' could be rotated across Valence-Volume pairings. Participants rated-per target stimulus-the level of blame attributable to the victim and the perceived severity of the incident. Furthermore, participants were asked to complete a Dark Tetrad scale-measuring their Machiavellianism, Narcissism, Psychopathy, and Sadism. Analyses determined that victim-blaming was influenced by victim Initial Tweet Valence (greater victim-blaming associated with more-negative content) and observer Machiavellianism. Perceived severity was influenced by victim Initial Tweet Valence, Volume of Abuse received, and observer Machiavellianism. Results were consistent with previous research involving male celebrity victims. Further research is needed to understand the contributions of participants' hostile and benevolent sexism, as well as the role of victim attractiveness.

Sociodemographic factors and lifestyle behaviours associated with bullying victimization and perpetration in a sample of Brazilian adolescents.

This article aims to identify the association of sociodemographic factors and lifestyle behaviours with bullying perpetration and victimization among high school students. The adolescents (n=852) answered a questionnaire about bullying (victims and perpetrators), sociodemographic factors (sex, age, maternal education, and participant's work status), tobacco use, alcohol use, illicit drug experimentation, physical activity, screen time, and sleep duration. Multilevel logistic regression models were performed. Older adolescents were less likely to be victims of bullying. Females were less likely to be perpetrators or victims of bullying. Adolescents who were working were more likely to be involved in bullying in both forms. Participation in non-sport activities and alcohol consumption were associated with higher odds of bullying victimization. We have identified specific populational subgroups that are more susceptible to being victims and/or perpetrators of bullying, which could support tailor-specific interventions to prevent bullying.

Victimisation in the life of persons with severe mental illness in Uganda: a pluralistic qualitative study.

INTRODUCTION: Victimisation of persons with severe mental illness is recognised as an urgent global concern, with literature pointing to higher rates of violent victimisation of persons with severe mental illness than those of the general population. Yet, for low income countries, there is a huge gap in the literature on the risk, character and victims' in-depth experiences of victimisation of persons with severe mental illness. We explore the lived experiences and meanings of victimisation of persons with severe mental illness in Uganda, and discuss their implications for care of the mentally ill. METHODS: A pluralistic qualitative study was undertaken to explore victimisation among patients with severe mental illness. Patients who had suffered victimisation were purposively sampled from Butabika National Referral Mental Clinic and Masaka Regional Referral Hospital, following confirmation of symptom remission. In-depth interviews were held with 18 participants, comprising 13 females and 5 males from low to moderate socioeconomic status. Interpretative phenomenological analysis and thematic content analysis were conducted. RESULTS: Victimisation was exhibited in three main forms: (a) psychological, expressed in attitudes towards mentally ill family members as valueless and dispensable, and stigmatisation, (b) physical, as manifested in beatings, indoor confinement and tethering mostly by family members and (c) sexual victimisation, particularly rape. Also observed were victim's various responses that pointed to the negative impact of victimisation, including a heightened risk of suicide, social withdrawal, a sense of hatefulness and a predisposition to more victimisation. CONCLUSION: The family environment plays a predominant role in perpetrating victimisation of the mentally ill in some sub-Saharan African contexts such as Uganda. We propose a holistic framework for mental health interventions, incorporating biomedical but notably also social determinants of mental health, and targeted at improving familial relationships, social support and a sense of belongingness both within the family and the broader community.

Bullying at School, Cyberbullying, and Loneliness: National Representative Study of Adolescents in Denmark.

AIMS: The aim was to examine how loneliness was associated with bullying victimization at school and online. METHODS: We used data from the Danish arm of the international Health Behavior in School-aged Children (HBSC) study from 2022. The study population was a nationally representative sample of 11-15-year-olds who completed the internationally standardized HBSC questionnaire at school, n = 5382. Multilevel logistic regression was applied to study the associations between bullying victimization and loneliness. RESULTS: The prevalence of reporting loneliness often or very often was 9.0%; 6.3% of the sample experienced habitual bullying victimization at school, and 4.8% incurred cyberbullying. There was a strong and graded association between loneliness and bullying victimization at school and cyberbullying. The associations were significant for boys and girls, and the association between exposure to bullying at school and loneliness was steeper for boys than girls. The gradients were steeper for physical bullying than for cyberbullying. Students exposed to habitual bullying in both contexts had an adjusted OR (95% CI) of 11.21 (6.99-17.98) for loneliness. CONCLUSION: Exposure to bullying at school and cyberbullying are strongly associated with loneliness. It is important to reduce bullying at school and on the internet and to promote effective interventions to reduce continuing loneliness.

The relationship between bullying victimization and problematic behaviors: A focus on the intrapersonal emotional competence and interpersonal social competence.

BACKGROUND: Evidence consistently demonstrated that bullying victimization was associated with problematic behaviors among adolescents. However, scant attention has been given to simultaneous comparisons of the impacts of two distinct forms of victimization, traditional bullying victimization and cyberbullying victimization. In addition, the mechanisms underlying the relationship between bullying victimization and problem behavior remain inadequately explored. OBJECTIVE: This study aimed to examine the correlation between bullying victimization and problematic behaviors, as well as the mediating roles of intrapersonal emotional competence and interpersonal social competence. PARTICIPANTS AND SETTING: A sample of 26,450 adolescents with a mean age of 15.44 (SD = 0.56) across nine countries was derived from the Study on Social and Emotional Skills (SSES). METHODS: Data analysis was conducted using structural equation modeling, comprising three key components: the measurement model, the structural model, and the bootstrapping analysis for mediating effects. RESULTS: Both traditional bullying and cyberbullying victimization exhibited positive correlations with problematic behaviors, with cyberbullying victimization demonstrating a stronger effect. The mediating effects of intrapersonal emotional competence and interpersonal social competence were observed in the correlation between bullying victimization and problematic behaviors. CONCLUSIONS: This study not only contributed to our comprehension of the underlying mechanisms connecting bullying victimization and adolescent problematic behaviors, but also holds significance for policy development and practice.

Longitudinal associations between childhood victimization and neuroticism from middle childhood to early adolescence.

BACKGROUND: Previous cross-sectional and unidirectional longitudinal studies have identified positive associations between childhood victimization and neuroticism in children. However, these studies have not simultaneously examined multiple common sources of childhood victimization (family abuse, teacher abuse, and peer victimization) in relation to neuroticism nor have they distinguished between- and within-person effects. Moreover, the moderating role of child sex in their associations has yet to be fully evaluated. OBJECTIVE: This study examined the within-person longitudinal associations between three common sources of childhood victimization and neuroticism in Chinese children and whether these effects differed between boys and girls. PARTICIPANTS AND SETTING: The sample included 4315 children (55.1 % boys) with an average age of 9.93 (SD = 0.73) years from a large city in China. METHODS: Participants completed self-report measures on five occasions across two years, employing six-month intervals. Random Intercept Cross-Lagged Panel Models (RI-CLPMs) were used to distinguish between-person and within-person effects. RESULTS: Results included: (a) Family abuse (excluding sexual abuse) and peer victimization directly predicted subsequent increases in neuroticism at the within-person level and vice versa, whereas teacher abuse and neuroticism did not reveal significant longitudinal relations at the within-person level; (b) The effect of family abuse on neuroticism at the within-person level was stronger in boys, while the effect of peer victimization on neuroticism at the within-person level was stronger in girls. CONCLUSIONS: Prevention and intervention strategies targeting high neuroticism and childhood victimization should consider the roles of both family and peer systems.

Sexual exploitation of young men: Background characteristics and needs from a life-course perspective.

BACKGROUND: Sexually exploited young men are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent young men to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame. OBJECTIVE: By gaining more insight into the background characteristics of young men who experienced sexual exploitation and their needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts. METHODS: Twenty-six young men (age 14-32) who experienced sexual exploitation or other forms of sexual violence in their youth or were at high-risk, participated in this qualitative study that was conducted in The Netherlands. By means of semi-structured interviews and case-file analyses, data was collected to identify risk and protective factors in their life-course and support needs. RESULTS: Several vulnerabilities (e.g. previous experiences of abuse and neglect, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led young men into high-risk situations. Among these were involvement in pay dates, criminality and having to survive from day to day, which contributed to victimization. Prevailing gender norms and experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support. CONCLUSIONS: These results will contribute to adequate prevention and trauma-informed intervention strategies that meet the unique needs of young men at risk for, or victim of sexual exploitation.

The informant matters: Differences in bullying victim categorization rates assessed with self- and peer-reports in children with developmental language disorder and reading difficulties.

BACKGROUND: Children with Developmental Language Disorder (DLD) and Reading Difficulties (RD) can show more peer relation problems depending on the informant. AIMS: (1) To explore bullying victims' categorization, evaluated by self- and peer-reports, in children with DLD and RD; and (2) to assess agreement rates between informants. METHOD AND PROCEDURES: Victimization was assessed using a self-report (EBIP-Q) and a peer-report sociogram (CESC) in a sample of 83 participants (9-12 years; 10.5 ± 1.1 years), comprising of DLD (n = 19), RD (n = 32), and Control (n = 32) groups. OUTCOMES AND RESULTS: We found a higher frequency of the rejected sociometric profile in the DLD and RD groups, a higher peer-reported victimization in the DLD group, and more severe self-reported victimization in the DLD and RD groups. Odds of being classified as victimized were higher for self-report except in the DLD group. Informants' agreement was high using the most restrictive EBIP-Q criterion (7 points) for both the Control and the RD groups, being non-significant for the DLD group regardless of the criteria used. CONCLUSIONS AND IMPLICATIONS: We found a higher victimization risk in children with language difficulties, although self-assessment seems to under-detect children with DLD according to the agreement rates, pointing out the need to combine assessments and informants. WHAT DOES THIS PAPER ADD?: Several studies have shown that children with DLD or RD obtain higher scores of victimization and score lower on several scales of social skills with continuous data. Although continuous analyses are usual in research, professional decisions are usually based on cut-off criteria more than how high or low a score is in contrast to another group. This is one of the first works that analyses victimization following the cut-off criteria of self and peer assessments that professionals used in the school settings in children with DLD and RD. Our results will raise awareness among school professionals based on the evidence about the high risk of victimization, especially in children with DLD, and the implications of selecting between several measures of victimization, in this group of children. We think that our results would help to better detect and prevent bullying in schools for children with DLD.

Problematic social media use mediates the effect of cyberbullying victimisation on psychosomatic complaints in adolescents.

Adolescent psychosomatic complaints remain a public health issue globally. Studies suggest that cyberbullying victimisation, particularly on social media, could heighten the risk of psychosomatic complaints. However, the mechanisms underlying the associations between cyberbullying victimisation and psychosomatic complaints remain unclear. This cross-cultural study examines the mediating effect of problematic social media use (PSMU) on the association between cyberbullying victimisation and psychosomatic complaints among adolescents in high income countries. We analysed data on adolescents aged 11-16.5 years (weighted N = 142,298) in 35 countries participating in the 2018 Health Behaviour in School-aged Children (HBSC) study. Path analysis using bootstrapping technique tested the hypothesised mediating role of PSMU. Results from the sequential binary mixed effects logit models showed that adolescents who were victims of cyberbullying were 2.39 times significantly more likely to report psychosomatic complaints than those who never experienced cyberbullying (AOR = 2.39; 95%CI = 2.29, 2.49). PSMU partially mediated the association between cyberbullying victimisation and psychosomatic complaints accounting for 12% ( ß  = 0.01162, 95%CI = 0.0110, 0.0120) of the total effect. Additional analysis revealed a moderation effect of PSMU on the association between cyberbullying victimisation and psychosomatic complaints. Our findings suggest that while cyberbullying victimisation substantially influences psychosomatic complaints, the association is partially explained by PSMU. Policy and public health interventions for cyberbullying-related psychosomatic complaints in adolescents should target safe social media use.

Comparison of Clinical Characteristics, Gender Perceptions, and Rape-Related Beliefs of People Assessed for Criminal Liability for Rape Against Children and Adults. / Çocuga ve Eriskine Yönelik Tecavüz Suçu Nedeniyle Ceza Sorumlulugu Degerlendirilen Kisilerin Klinik Özelliklerinin, Toplumsal Cinsiyet Algilarinin ve Tecavüze Iliskin Inançlarinin Karsilastirilmasi.

OBJECTIVE: This study aimed to compare the criminal, sociodemographic and clinical characteristics, paraphilic behaviors, sexual attitudes, gender perceptions, and rape-related beliefs of people assessed for criminal liability for rape against adults and children. METHOD: The study compared 40 people investigated for criminal liability for rape against an adult (RAA) with 40 individuals investigated for criminal liability for crime of rape against a child (RAC), and 43 age, sex and education matched individuals without any sexual crime history using the Structured Clinical Interview form for DSM-5 disorders, Hendrick Brief Sexual Attitude Scale, Gender Perception Scale, Illinois Rape Myth Acceptance Scale, and Barratt Impulsiveness Scale-11. RESULTS: All participants were male. There was no difference between the groups in terms of lifelong or existing psychiatric diseases. All participants had full criminal responsibility during the crime. No participant in any group was diagnosed with a paraphilic disorder. It was determined that people in both RAC and RAA groups tended to use sexuality as a tool, paid less attention to birth control methods, had a far less egalitarian perception of gender, and their myths about rape were significantly higher compared to the control group. The control group was much more impulsive than the sex offenders. CONCLUSION: Our results show that the act of sexual assault should not be explained only by impulsivity or psychiatric disorders, and that gender perception and sexual myths may also be influential. The fact that all individuals had full criminal responsibility emphasizes the need for more research on the social and cultural origins of sexual violence.

Bullying victimization among adolescents: Prevalence, associated factors and correlation with mental health outcomes.

INTRODUCTION: Knowledge of the risk factors of bullying victimization in adolescents is crucial for the implementation of preventive measures. This study aimed to determine the prevalence and associated factors of bullying victimization and to identify its correlation with mental health outcomes among middle school students in Tunisia. METHODS: A cross-sectional study was conducted using a multi-stage cluster sampling technique to recruit a sample of 1111 students from 10 middle schools in El kef (Tunisia). The revised Olweus Bully/Victim Questionnaire was used to assess the prevalence and types of bullying victimization and the perceived efforts of others to counteract bullying. The Strengths and Difficulties Questionnaire (SDQ) was used for screening emotional and behavioral problems. Multivariate logistic regression analysis was conducted to determine associated factors of bullying victimization. Additionally, we tested whether emotional and behavioral problems were present for bullying victims. RESULTS: The findings reported that 45.8% (95%CI = 45.5-46.0), of the total number of participants experienced school bullying victimization. Multivariate logistic regression analysis, revealed that repeating a grade (OR = 1.82, 95%CI = 1.31-2.54), having a working father (OR = 17.68; 95%CI = 2.29-136,15), and having a working mother (OR = 1.88, 95%CI = 1.39-2.53) were the factors significantly associated with bullying victimization. Nevertheless, a higher mother's educational level (OR = 0.76, 95%CI = 0.67-0.88) was a protective factor against bullying victimization. The self-reported SDQ revealed that the total difficulties score was significantly higher among victims (17.46 ± 5.30 vs. 20.86 ± 5.06, p<0.01). CONCLUSIONS: This study showed that the prevalence of bullying in middle schools was high and it significantly led to mental health problems. National policies for bullying prevention within schools are potentially needed. Improving students' problem-solving and soft skills is also essential.

The effect of aggressive fantasizing on aggressive inclinations: Moderating effects of dispositional anger expression.

Experiencing victimization or mistreatment often induces feelings of anger. The catharsis hypothesis suggests that venting anger may aid in alleviating these negative emotions. Although this hypothesis has faced criticism, therapeutic interventions rooted in catharsis are employed to assist victims in managing their anger. One notable application of the catharsis principle in psychotherapeutic practice with victims involves engaging in aggressive fantasies: Victims who harbor aggressive fantasies against their offenders are supported in working with these fantasies to navigate the complex emotions arising from their victimization. Research investigating the effects of aggressive fantasizing on victims has yielded inconsistent findings, with some studies indicating positive and others suggesting negative outcomes. Herein, we examine whether (instructed) aggressive fantasizing diminishes (catharsis hypothesis) or heightens (escalation hypothesis) subsequent aggressive inclinations compared to non-aggressive fantasizing. Additionally, the moderating role of victims' dispositional tendencies to express anger, specifically Anger Expression-out and Anger Expression-control, in the relationship between aggressive fantasizing and aggressive inclinations was examined. We recruited individuals (N = 245) who had experienced victimization through highly unfair treatment and instructed them to imagine confronting their wrongdoer using either aggressive or non-aggressive communication. Participants then reported their aggressive inclinations. Data supported the escalation hypothesis, revealing that aggressive fantasizing amplifies subsequent aggressive inclinations. Importantly, individuals with higher Anger Expression-out demonstrated greater susceptibility to this effect; whereas, Anger Expression-control did not moderate the link between aggressive fantasizing and inclinations. These findings further challenge the catharsis hypothesis and underscore the role of dispositional anger expression tendencies on the effects of aggressive fantasizing.

Fatal Police Shootings of Victims with Mental Health Crises: A Descriptive Analysis of Data from the 2014-2015 National Violent Death Reporting System.

One in five fatal police shooting victims may have been experiencing a mental health crisis (MHC) at the time of their death [1]. We use data on fatal police shootings from the National Violent Death Reporting System (2014-2015) to (a) identify incidents where the victim is reported to have experienced an MHC at the time of their death, (b) describe the characteristics of these incidents, and (c) compare the characteristics of MHC to fatal police shootings where the victim was not experiencing an MHC at the time of their death. We systematically coded 633 fatal police shootings from 27 states. Descriptive statistics characterized fatal police shootings, including victim characteristics; their mental health status; and contextual information regarding the police encounter (e.g., reason for police call). Overall, 203 of 633 fatal police encounters (32%) involved victims who showed signs of an MHC at the time of their death. Victims were predominantly white, male, and in possession of a firearm. In 3 of 4 cases, the MHC manifested as suicidal ideation despite any relevant documented history among most victims. Among half of suicidal victims, suicidal ideation was expressed verbally and in-person to a family member/intimate partner who subsequently called the police. Dispatch was aware of the MHC in 1 of 4 of total police calls. Overall, fatal police encounters involving those experiencing an MHC accounted for 1 in 3 of our caseloads. Approximately, 3 of 4 mental health calls involved a suicidal person who mainly expressed intent to a loved one in-person.