Spatial Assesment of Suicide Sites and Related Determinants in Castilla-La Mancha, Spain (2020-2024): a Forensic-Public Health Perspective

Abstract

Suicide remains a major public health challenge worldwide, and understanding its geographical distribution is essential for developing targeted preventive actions. This retrospective analysis examines 421 suicide cases registered between 2020 and 2024 in the provinces of Toledo and Albacete (Castilla-La Mancha, Spain), based on data obtained from the Institutes of Legal Medicine and Forensic Sciences. Locations were categorized as critical or non-critical depending on frequency of occurrence and degree of public access. Men accounted for 82% of the cases (male-to-female ratio 5:1, exceeding the national average), with a mean age of 56.6 years. Hanging was the most frequently used method (56.1%). While the majority of deaths occurred in private environments, only one location fulfilled the criteria established for a critical site. These findings indicate that geographical concentration has a limited impact on the overall regional suicide burden. Preventive strategies should therefore prioritize early identification of individuals at risk and restriction of access to lethal means within private contexts, while also addressing isolated incidents in public areas. The study underscores the importance of systematically integrating spatial data into forensic documentation systems in order to strengthen regional monitoring and support the development of context-sensitive and evidence-based prevention policies.