Identification and Analysis of Critical Suicide Sites and Factors in Castilla-La Mancha (2020–2024): Forensic and Healthcare Collaboration for Prevention

Abstract

Suicide is a major public health concern worldwide, and identifying the spatial patterns associated with its occurrence is essential for designing effective preventive strategies. This study aimed to identify and characterize suicide locations in two provinces of Castilla-La Mancha, Spain, using a descriptive and retrospective analysis of 421 cases recorded by the Institutes of Legal Medicine and Forensic Sciences of Toledo and Albacete between 2020 and 2024. Locations were classified as critical or non-critical based on recurrence and public accessibility, and logistic regression was used to explore predictors of suicide in public settings. Results showed that 82% of cases involved men, yielding a 5:1 male-to-female ratio that exceeds the national average; the mean age was 56.6 years, and hanging was the most frequent method (56.1%). Most suicides occurred in private environments, and only one location met the criteria for a critical site. These findings indicate that spatial clustering plays a minimal role in the regional suicide burden and that prevention efforts should prioritize means restriction and early detection in private settings, along with broader measures for dispersed public cases rather than hotspot-focused interventions. The study underscores the importance of systematically incorporating spatial information into forensic records to improve regional suicide surveillance and inform more targeted, context-sensitive prevention policies.