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Foster AA, Zabel M, Schober M. Youth Crisis: The Current State and Future Directions. Psychiatr Clin North Am 2024; 47:595-611. [PMID: 39122348 DOI: 10.1016/j.psc.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
The number of children and youth experiencing behavioral health crisis in the United States is substantially increasing. Currently, there are shortages to home-based and community-based services as well as psychiatric outpatient and inpatient pediatric care, leading to high emergency department utilization. This article introduces a proposed crisis continuum of care, highlights existing evidence, and provides opportunities for further research and advocacy.
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Affiliation(s)
- Ashley A Foster
- Department of Emergency Medicine, University of California, San Francisco, 550 16th Street, Box 0649, San Francisco, CA 94143, USA.
| | - Michelle Zabel
- Innovations Institute, University of Connecticut School of Social Work, 38 Prospect Street, Hartford, CT 06103, USA
| | - Melissa Schober
- Innovations Institute, University of Connecticut School of Social Work, 38 Prospect Street, Hartford, CT 06103, USA
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Pauwels K, De Jaegere E, Vanderreydt P, Aerts S, Vande Gaer E, Portzky G. Assessing a Suicide Prevention Helpline's Impact on Caller Crisis Level and Suicidality. Arch Suicide Res 2024:1-16. [PMID: 39177448 DOI: 10.1080/13811118.2024.2394666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
OBJECTIVE Worldwide helplines are considered an important part of suicide prevention strategies. Nevertheless, evidence regarding the impact of suicide prevention helplines on the suicidality of its users remains limited and is frequently confronted with methodological issues. This study aimed to assess the impact of crisis calls on callers' levels of crisis and suicidality both immediately after the call and at follow-up compared to before the call. After the call, the satisfaction of the callers with the intervention was also assessed. METHODS A pre-post study, generated automatically by a telephone system, was conducted in order to compare the level of crisis and suicidality (operationalized by five indicators: hopelessness, entrapment, controllability, suicidal intent, and social support) experienced by callers before and immediately after the call and at follow-up (one to two weeks after the call). RESULTS Callers (n = 487) showed significant improvement in their level of crisis (p < .001, d = -0.31), hopelessness (p < .001, d = -0.22), entrapment (p < .001, d = -0.25), suicide intent (p < .001, d = -0.37), and social support (p < .001, d = 0.33) after the call compared to before the call. Improvements were also found at follow-up compared to pretest. The satisfaction of callers with the helpline was high. CONCLUSIONS This study adds to the growing evidence on suicide prevention helplines and addresses some important methodological issues in helpline research. Furthermore, it shows promising results regarding the potential supportive impact of helplines on callers who feel suicidal.
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Wu J, Zhang R, Zhao L, Yin Y, Min J, Ge Y, Luo Y, Li P, Li L, Tong Y. Risk factors for subsequent suicidal acts among 12-25-year-old high-risk callers to a suicide prevention hotline in China: a longitudinal study. Child Adolesc Psychiatry Ment Health 2024; 18:73. [PMID: 38898519 PMCID: PMC11188529 DOI: 10.1186/s13034-024-00765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND A few previous cross-sectional studies investigated correlated factors of suicidal ideation or suicide attempts among suicide prevention hotline callers; however, scarcely any evidence was from a longitudinal study. In addition, it is still unclear whether improvements in some suicide risk factors could reduce the occurrence of subsequent suicidal acts. This longitudinal study focusing on the risk factors for subsequent suicidal acts among adolescent and young adult callers with high suicide risk aims to fill this gap. METHODS This study recruited 12-25-year-old high-risk callers to a China nationwide suicide prevention hotline. Potential risk factors, including hopefulness, psychological distress, depression, history of suicide attempts, alcohol or substance misuse, and acute life events, were examined during the index calls, and improvements in hopefulness, psychological distress, and suicide intent were assessed before ending the index calls. The recruited callers were followed up 12 months after their index calls. The primary outcome was the occurrence of suicidal acts (suicide attempts or suicide death) during follow-up. Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards model were used. RESULTS During the follow-up period, 271 of 1656 high-risk adolescent and young adult callers attempted suicide, and seven callers died by suicide. After adjusting for demographic variables, low hopefulness (Hazard Ratio [HR] = 2.03, 95% Confidence Interval [CI]=[1.47, 2.80]) at the beginning of the index call was associated with a higher risk for subsequent suicidal acts, whereas improvements in psychological distress (HR = 0.61, 95%CI [0.41, 0.89]) and suicidal intent (HR = 0.56, 95%CI [0.38, 0.84]) during the index call reduced the risk of subsequent suicidal acts. In addition, alcohol or substance misuse (Model 2, HR = 1.65, 95%CI [1.11, 2.46]) and suicide attempt history(Model 1: one episode, HR = 1.96, 95%CI=[1.05, 3.66]; two or more episodes, HR = 2.81, 95%CI [1.59, 4.96]. Model 2: one episode, HR = 2.26, 95%CI [1.06, 4.82]; two or more episodes: HR = 3.28, 95%CI [1.63, 6.60]) were risk factors for subsequent suicidal acts. CONCLUSIONS While suicide prevention hotline operators deliver brief psychological interventions to high-risk adolescent and young adult callers, priority should be given to callers with low hopefulness and to the alleviation of callers' high psychological distress and suicide intent.
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Affiliation(s)
- Jianlan Wu
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Ruoyun Zhang
- Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
| | - Liting Zhao
- Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
| | - Yi Yin
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Jing Min
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yiming Ge
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yang Luo
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Peiyao Li
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Lingling Li
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yongsheng Tong
- Peking University Huilongguan Clinical Medical School, Beijing, China, 7 Nan Dian Road, Changping, 100096.
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China.
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Hornstein S, Scharfenberger J, Lueken U, Wundrack R, Hilbert K. Predicting recurrent chat contact in a psychological intervention for the youth using natural language processing. NPJ Digit Med 2024; 7:132. [PMID: 38762694 PMCID: PMC11102489 DOI: 10.1038/s41746-024-01121-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/23/2024] [Indexed: 05/20/2024] Open
Abstract
Chat-based counseling hotlines emerged as a promising low-threshold intervention for youth mental health. However, despite the resulting availability of large text corpora, little work has investigated Natural Language Processing (NLP) applications within this setting. Therefore, this preregistered approach (OSF: XA4PN) utilizes a sample of approximately 19,000 children and young adults that received a chat consultation from a 24/7 crisis service in Germany. Around 800,000 messages were used to predict whether chatters would contact the service again, as this would allow the provision of or redirection to additional treatment. We trained an XGBoost Classifier on the words of the anonymized conversations, using repeated cross-validation and bayesian optimization for hyperparameter search. The best model was able to achieve an AUROC score of 0.68 (p < 0.01) on the previously unseen 3942 newest consultations. A shapely-based explainability approach revealed that words indicating younger age or female gender and terms related to self-harm and suicidal thoughts were associated with a higher chance of recontacting. We conclude that NLP-based predictions of recurrent contact are a promising path toward personalized care at chat hotlines.
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Affiliation(s)
- Silvan Hornstein
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany.
| | | | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin/Potsdam, Potsdam, Germany
| | - Richard Wundrack
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
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Edwards D, Carrier J, Csontos J, Evans N, Elliott M, Gillen E, Hannigan B, Lane R, Williams L. Review: Crisis responses for children and young people - a systematic review of effectiveness, experiences and service organisation (CAMH-Crisis). Child Adolesc Ment Health 2024; 29:70-83. [PMID: 36785997 DOI: 10.1111/camh.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND In England, one in six children aged 5-19 has a probable diagnosable mental health disorder. This is a major public health problem, with multiple agencies adopting varying approaches to care delivery for children and young people (CYP) in crisis. OBJECTIVES To examine the organisation of crisis services across education, health, social care and voluntary sectors; the experiences and perceptions of CYP, families and staff; the effectiveness of current approaches to care and the goals of crisis intervention. METHODS A systematic review of all relevant English language evidence regarding the provision and receipt of crisis support for CYP aged 5-25 (PROSPERO-CRD42019160134). Seventeen databases were searched from 1995 to 2021 and relevant UK-only grey literature was identified. Critical appraisal was conducted using appropriate design specific appraisal tools. A narrative approach to synthesis was conducted. RESULTS In total, 138 reports (48 reports covering 42 primary research studies; 36 reports covering 39 descriptive accounts of the organisation services and 54 UK-only grey literature reports) were included. The evidence suggests that crisis services were organised as follows: triage/assessment-only, digitally mediated support approaches, and intervention approaches and models. When looking at experiences of crisis care, four themes were identified: (a) barriers and facilitators to seeking and accessing appropriate support; (b) what children and young people want from crisis services; (c) children's, young people's and families' experiences of crisis services; and (d) service provision. In determining effectiveness, the findings are summarised by type of service and were generated from single heterogenous studies. The goals of crisis services were identified. DISCUSSION Despite a lack of high-quality international studies, findings suggest that support prior to reaching crisis point is important. From this work, various aspects of crisis care have been identified that can be incorporated into existing services across education, health, social care and the voluntary sector.
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Affiliation(s)
- Deborah Edwards
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Judith Carrier
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Judit Csontos
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Nicola Evans
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Mair Elliott
- Independent Service User Researcher, Cardiff, UK
| | - Elizabeth Gillen
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Ben Hannigan
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Rhiannon Lane
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Liz Williams
- Independent Service User Researcher, Cardiff, UK
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Mathiyazhagan S, Kulandai Raj F, Fitrianingsih K, Raja V, Mayom D. Addressing Socioeconomic Determinants of Youth Suicidal Ideation: Lessons from a Youth Development Approach in India. Community Ment Health J 2024; 60:340-353. [PMID: 37594696 DOI: 10.1007/s10597-023-01177-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/29/2023] [Indexed: 08/19/2023]
Abstract
Socioeconomic situations in young people's families and communities make them more vulnerable to suicidal ideations. The Youth Helpline has made a significant difference in youth's lives and livelihoods by addressing their social and economic needs with positive mental health support. The quantitative and qualitative data validate the micro- and macro-level impact of the Youth Helpline in Puducherry. However, the multi-stakeholder model faces challenges in ensuring accountability, particularly from government partners. This paper highlights how direct intervention on the socio-economic determinants of youth suicidal ideation has positively affected youth mental health and reduced suicidal ideation in Puducherry. Social identity-based inequalities and access and affordability to mental health services are the major contributors to youth mental health problems. This paper critically discusses the Youth Helpline's multi-stakeholder process and youth-led approach to addressing socio-economic determinants, as well as the Helpline's impact on youth mental health.
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Affiliation(s)
- Siva Mathiyazhagan
- Trust for Youth and Child Leadership (TYCL) International, 508 West 121st Street, 10027, New York, NY, USA.
| | | | | | - Vaiju Raja
- Trust for Youth and Child Leadership (TYCL) International, 508 West 121st Street, 10027, New York, NY, USA
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Rahmani M, Silverman AL, Thompson A, Pumariega A. Youth Suicidality in the Context of Disasters. Curr Psychiatry Rep 2023; 25:587-602. [PMID: 37768444 DOI: 10.1007/s11920-023-01454-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the current literature regarding youth suicidality (suicidal ideation, suicidal behavior, and completed suicide) in the context of disasters. RECENT FINDINGS There are fewer studies that examine the effect of disasters on suicidality specifically in children and youth than studies that focus on adults or general population. Numerous studies have reported on the effect of disasters on youth mental health in general without zeroing in on suicide risk. Some variables that have shown to increase suicide risk in children and youth after disasters include female gender, age at the time of disaster exposure, dependence on adults, attachments to places and caregivers, family functioning, and vulnerability to mistreatment. Several studies have demonstrated that youth suicidality fluctuates in response to disasters, at times increasing immediately post-disaster and at other times decreasing immediately post-disaster followed by an increase later. Exposure to natural disasters (e.g., earthquakes, typhoons, hurricanes, wildfires, and extremes of temperature and humidity), man-made disasters (e.g., armed conflict, global warming, and pollution), and unique disasters (e.g., the COVID-19 pandemic) have had significant impact on suicidality in children and adolescents. Although there are several promising interventions to mitigate the post-disaster suicide risk among youth, there is no consensus on a single intervention that is superior to others. More research is needed to study youth suicide risk in the context of disasters and develop culturally appropriate and evidence-based interventions.
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Affiliation(s)
- Mariam Rahmani
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.
| | - Andrew L Silverman
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andrew Thompson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andres Pumariega
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
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Goodman KL, Kamke K, Mullin TM. Online Help-Seeking Among Youth Victims of Sexual Violence Before and During COVID-19 (2016-2021): Analysis of Hotline Use Trends. JMIR Public Health Surveill 2023; 9:e44760. [PMID: 37566446 PMCID: PMC10457693 DOI: 10.2196/44760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/22/2023] [Accepted: 06/16/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Three years since the onset of COVID-19, pandemic-related trends in child sexual abuse (CSA) remain poorly understood. Common administrative surveillance metrics may have underestimated abuse during the pandemic, given youths' limited access to mandatory reporters. Research using anonymous service-use data showed increased violence-related online help-seeking but overlooked youth-specific help-seeking for CSA during COVID-19. Understanding pandemic-related trends in CSA can inform abuse detection practices and mental health service provision for youth victims. OBJECTIVE The purpose of this study was to harness anonymous help-seeking data from the National Sexual Assault Online Hotline (NSAOH) to glean insights about CSA occurrence in the United States during the COVID-19 pandemic. METHODS We used an archival sample of victims who contacted NSAOH from 2016 to 2021 (n=41,561). We examined differences in the proportion of youth and adult victims contacting NSAOH during the first COVID-19 year (March 2020 to February 2021) compared to the prior year (March 2019 to February 2020; n=11,719). Further, we compared key characteristics of hotline interactions among youth victims during the first COVID-19 year to the prior year (n=5913). Using joinpoint regression analysis, we examined linear trends in the number of monthly sampled youth and adult victims (excluding victims of unknown age) from 2016 to 2021 who discussed any victimization event (n=26,904) and who discussed recent events (ie, events occurring during the pandemic; n=9932). RESULTS Most youth victims were abused by family members prior to (1013/1677, 60.4%) and after (2658/3661, 72.6%) the onset of COVID-19. The number of youth victims contacting NSAOH spiked in March 2020 and peaked in November 2020 for all youth (slope=28.2, 95% CI 18.7-37.7) and those discussing recent events (slope=17.4, 95% CI 11.1-23.6). We observed a decline in youth victims into spring 2021 for all youth (slope=-56.9, 95% CI -91.4 to -22.3) and those discussing recent events (slope=-33.7, 95% 47.3 to -20.0). The number of adult victims discussing any victimization event increased steadily from January 2018 through May 2021 (slope=3.6; 95% CI 2.9-4.2) and then declined (slope=-13.8, 95% CI -22.8 to -4.7). Trends were stable for adults discussing recent events. CONCLUSIONS This study extends the use of hotline data to understand the implications of the pandemic on CSA. We observed increased youth help-seeking through the NSAOH coinciding with the onset of COVID-19. Trends persisted when limiting analyses to recent victimization events, suggesting increased help-seeking reflected increased CSA during COVID-19. These findings underscore the utility of anonymous online services for youth currently experiencing abuse. Further, the findings support calls for increased youth mental health services and efforts to incorporate online chat into youth-targeted services.
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Affiliation(s)
| | - Kristyn Kamke
- Rape, Abuse, and Incest National Network, Washington, DC, United States
| | - Tara M Mullin
- Rape, Abuse, and Incest National Network, Washington, DC, United States
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Baldofski S, Kohls E, Efe Z, Eckert M, Saee S, Thomas J, Wundrack R, Rummel-Kluge C. The Impact of a Messenger-Based Psychosocial Chat Counseling Service on Further Help-Seeking Among Children and Young Adults: Longitudinal Study. JMIR Ment Health 2023; 10:e43780. [PMID: 37195747 DOI: 10.2196/43780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/21/2022] [Accepted: 03/22/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Mental crises have high prevalences in adolescence. Early interventions appear to be highly important to diminish the risk of the deterioration, recurrence, or chronification of symptoms. In recent years, various providers have started offering live chat support in psychological crises. The messenger-based psychological counseling service krisenchat aims to support young people in crises and, if necessary, provide a recommendation for a referral to the health care system or to seek further help from a trusted adult person. OBJECTIVE This study aimed to investigate the impact of using the counseling service of krisenchat on the further help-seeking behavior of young people, and to identify associated factors of further help-seeking. METHODS This longitudinal study analyzed anonymous data from 247 individuals who used krisenchat between October 2021 and March 2022, and received a recommendation for further help-seeking. An online survey directly after the chat assessed the perceived helpfulness of the chat and well-being after the chat. After 4 weeks, further help-seeking, facilitators and barriers to help-seeking, and self-efficacy were assessed in an online follow-up survey. RESULTS The most frequently recommended services or persons to seek further help from included a psychotherapist or social psychiatric service (75/225, 33.3%), a school psychologist or school social worker (52/225, 23.1%), and the user's parents (45/225, 20.0%). Of the 247 users, 120 (48.6%) indicated that they contacted the recommended service or person, and of these, 87 (72.5%) stated that they already had an appointment (or talk) with the respective service or person or that an appointment (or talk) was scheduled. The most frequently reported facilitators for further help-seeking were mental health literacy (54/120, 45.0%), improvement of self-efficacy (55/120, 45.8%), and symptom recognition (40/120, 33.3%). In users not displaying further help-seeking behavior, the most frequent barriers included stigmatization (60/127, 47.2%), lack of mental health literacy (59/127, 46.5%), need for self-reliance and autonomy (53/127, 41.7%), and negative family beliefs regarding help services (53/127, 41.7%). Subgroup comparisons indicated significantly higher levels of self-efficacy in users displaying further help-seeking behavior than in those not displaying further help-seeking behavior. Both subgroups did not differ in gender, age, recommended service or person, chat topics, perceived helpfulness, and well-being. CONCLUSIONS The findings of this study indicate that children and young adults receiving counseling on krisenchat benefit in terms of seeking further help. Further help-seeking seems to be associated with higher levels of self-efficacy. TRIAL REGISTRATION Deutsches Register Klinischer Studien DRKS00026671; https://tinyurl.com/4fm5xe68.
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Affiliation(s)
- Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
| | - Zeki Efe
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | | | | | | | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
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Zabelski S, Kaniuka AR, A Robertson R, Cramer RJ. Crisis Lines: Current Status and Recommendations for Research and Policy. Psychiatr Serv 2022; 74:505-512. [PMID: 36475827 DOI: 10.1176/appi.ps.20220294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The 988 telephone number was established by the National Suicide Hotline Designation Act of 2020 and implemented in July 2022 as a more accessible way to reach the National Suicide Prevention Lifeline. Current financial and training resources, however, are insufficient to ensure effective implementation. METHODS To better understand the state of the literature on crisis support lines in light of the 988 transition, the authors summarized research on suicidal and nonsuicidal outcomes of callers, research on other types of crisis support services, and the benefits of text- and chat-based crisis lines. RESULTS Overall, existing evidence for the effectiveness of crisis lines has been weak and has primarily focused on short-term improvements in user distress and on user satisfaction. In addition, research on crisis lines specifically targeted to marginalized populations (e.g., sexual minority groups) and on text- or chat-based crisis lines is lacking. CONCLUSIONS The policy-focused recommendations derived from this review include the need for additional research on crisis lines, design and evaluation of culturally tailored training for volunteers and staff, and ethical oversight of private data collected from crisis services. Scaling up state-level planning and comprehensive crisis systems is necessary to successfully implement 988 and to fill current training and research gaps.
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Affiliation(s)
- Sasha Zabelski
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
| | - Andréa R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
| | - Ryan A Robertson
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
| | - Robert J Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
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O'Riordan M, Ma JS, Mazzer K, Batterham P, Kõlves K, Woodward A, Klein B, Larsen M, Goecke R, Gould M, Rickwood D. Help-seeker expectations and outcomes of a crisis support service: Comparison of suicide-related and non-suicide-related contacts to lifeline Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4535-e4544. [PMID: 35676830 PMCID: PMC10946508 DOI: 10.1111/hsc.13857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/29/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Lifeline Australia aims to prevent suicide and support community members in personal crisis via the provision of free anonymous telephone, online chat and text message services. This study aimed to identify the expectations and outcomes of Lifeline help-seekers, including whether there are differences between suicide-related and non-suicide-related contacts. Help-seekers (N = 553) who had previously contacted Lifeline via telephone, online chat, or text message crisis services were recruited via social media and a link provided after Lifeline service use, who completed an online survey about their awareness, expectations and outcomes of Lifeline's services. The responses from help-seekers who self-reported suicide-related and non-suicide-related reasons for contact were compared. Participants were highly aware of Lifeline's services, particularly the phone service. The main expectations of all help-seekers were to feel heard and listened to, feel less upset and feel understood. There were 59.5% of the sample that reported suicidality as a reason for contact. Suicide-related contacts endorsed more reasons for contact than non-suicide-related contacts. Expectations of suicide-related help-seekers were greater, but they were less likely to report that their expectations were met. The high expectations and complexity of suicide-related contacts reveal the challenges in meeting the needs of this high-priority group, particularly within the context of the multiple demands on crisis support services.
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Affiliation(s)
| | - Jennifer S. Ma
- Faculty of HealthUniversity of CanberraCanberraAustralia
| | - Kelly Mazzer
- Faculty of HealthUniversity of CanberraCanberraAustralia
| | - Philip Batterham
- Centre for Mental Health ResearchAustralian National UniversityCanberraAustralia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, School of Applied PsychologyGriffith UniversityBrisbaneAustralia
| | - Alan Woodward
- Centre for Mental HealthUniversity of MelbourneMelbourneAustralia
| | - Britt Klein
- Health Innovation and Transformation CentreFederation University AustraliaChurchillAustralia
| | - Mark Larsen
- Black Dog InstituteUniversity of New South WalesSydneyAustralia
| | - Roland Goecke
- Faculty of Science and TechnologyUniversity of CanberraCanberraAustralia
| | - Madelyn Gould
- Columbia University Medical Centre, Columbia UniversityNew YorkUSA
| | - Debra Rickwood
- Faculty of HealthUniversity of CanberraCanberraAustralia
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12
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Matthews S, Cantor JH, Brooks Holliday S, Eberhart NK, Breslau J, Bialas A, McBain RK. Mental Health Emergency Hotlines in the United States: A Scoping Review (2012-2021). Psychiatr Serv 2022; 74:513-522. [PMID: 36254453 DOI: 10.1176/appi.ps.20220128] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mental health emergency hotlines provide clinical supports and connection to services. This scoping review describes the current literature on hotlines in the United States, including which populations they do and do not reach, typical call volumes and engagement levels, barriers to and facilitators of implementation, and common call outcomes. The review also identifies gaps in the literature and presents recommendations. METHODS A systematic search of peer-reviewed articles on U.S.-based telephone, text, and chat hotlines published between January 2012 and December 2021 retrieved 1,049 articles. In total, 96 articles met criteria for full-text review, of which 53 met full inclusion criteria. RESULTS Approximately half of the included studies (N=25) focused on descriptive information of callers, most of whom were females, younger adults, and White; veteran hotlines typically reached older men. Common reasons for calling were suicidality, depression, and interpersonal problems. Of studies examining intervention effects (N=20), few assessed hotlines as interventions (N=6), and few evaluated caller behavioral outcomes (N=4), reporting reduced distress and suicidality among callers after hotline engagement. However, these studies also suggested areas for improvement, including reaching underrepresented high-risk populations. Six studies reported implementation needs, such as investments in data collection and evaluation, staff training, and sustainable funding. CONCLUSIONS Hotlines appear to be more effective at reaching some populations than others, indicating that more intensive outreach efforts may be necessary to engage underrepresented high-risk populations. The findings also indicated limited evidence on the relationship between use of hotlines-particularly local text and chat hotlines-and caller outcomes, highlighting an area for further investigation.
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Affiliation(s)
- Samantha Matthews
- RAND Corporation, Santa Monica, California (Matthews, Cantor, Brooks Holliday, Eberhart), Pittsburgh (Breslau, Bialas), and Washington, D.C. (McBain)
| | - Jonathan H Cantor
- RAND Corporation, Santa Monica, California (Matthews, Cantor, Brooks Holliday, Eberhart), Pittsburgh (Breslau, Bialas), and Washington, D.C. (McBain)
| | - Stephanie Brooks Holliday
- RAND Corporation, Santa Monica, California (Matthews, Cantor, Brooks Holliday, Eberhart), Pittsburgh (Breslau, Bialas), and Washington, D.C. (McBain)
| | - Nicole K Eberhart
- RAND Corporation, Santa Monica, California (Matthews, Cantor, Brooks Holliday, Eberhart), Pittsburgh (Breslau, Bialas), and Washington, D.C. (McBain)
| | - Joshua Breslau
- RAND Corporation, Santa Monica, California (Matthews, Cantor, Brooks Holliday, Eberhart), Pittsburgh (Breslau, Bialas), and Washington, D.C. (McBain)
| | - Armenda Bialas
- RAND Corporation, Santa Monica, California (Matthews, Cantor, Brooks Holliday, Eberhart), Pittsburgh (Breslau, Bialas), and Washington, D.C. (McBain)
| | - Ryan K McBain
- RAND Corporation, Santa Monica, California (Matthews, Cantor, Brooks Holliday, Eberhart), Pittsburgh (Breslau, Bialas), and Washington, D.C. (McBain)
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13
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Bright MA, Ortega D, Finkelhor D, Walsh K. Moving school-based CSA prevention education online: Advantages and challenges of the "new normal". CHILD ABUSE & NEGLECT 2022; 132:105807. [PMID: 35926249 PMCID: PMC9341426 DOI: 10.1016/j.chiabu.2022.105807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
One of the many outcomes of the COVID-19 pandemic was a shift in the delivery of elementary (primary) education. Schools transitioned swiftly to e-learning and prioritized education that was already or could be easily adapted to virtual formats. Given the paucity of online content available, it is not likely that child sexual abuse (CSA) prevention education was prioritized. Given that CSA prevention education has demonstrated success in increasing knowledge, protective behaviors, and disclosures, and the potential long-term need for e-learning options, there is a demand for an exploration of how CSA prevention can be implemented using e-learning strategies. In the current discussion, we explore how school-based CSA prevention education could be implemented in a "new normal" context of e-learning. We first present the existing e-learning content for CSA prevention education. We then describe how best practices for prevention education can be applied to e-learning. Finally, we present considerations for the use of e-learning specifically for CSA prevention education. In short, implementing CSA prevention programs through e-learning offers many affordances for program accessibility and reach, flexibility in implementation and opportunities for greater exposure to content, and a wide range of ways to demonstrate effective skills and engage children in cycles of practice and feedback. E-learning, may also, however, limit important conversations between children and trained instructors that lead to disclosures. The extant literature leaves us unsure as to whether implementing CSA prevention programs through e-learning will result in better or worse outcomes for children. However, given the increasing demand for e-learning options, and the promise of some new e-learning programs, further research on the effectiveness of e-learning CSA prevention programs is warranted.
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Affiliation(s)
- Melissa A Bright
- Center for Violence Prevention Research, USA; Crimes against Children Research Center, University of New Hampshire, USA.
| | | | - David Finkelhor
- Crimes against Children Research Center, University of New Hampshire, USA; Department of Sociology, University of New Hampshire, USA
| | - Kerryann Walsh
- Faculty of Creative Industries, Education & Social Justice, Queensland University of Technology, Australia
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14
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Elliott SA, Goodman KL, Bardwell ES, Mullin TM. Reactions to the disclosure of intrafamilial childhood sexual abuse: Findings from the National Sexual Assault Online Hotline. CHILD ABUSE & NEGLECT 2022; 127:105567. [PMID: 35278820 DOI: 10.1016/j.chiabu.2022.105567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION For child sexual abuse (CSA) victims, disclosure can be helpful or harmful depending on how recipients respond. Despite a growing body of literature examining reactions to disclosure, little is known about the experiences of current CSA victims, particularly those abused by family. OBJECTIVE We aimed to describe and explore the initial disclosure experiences of intrafamilial CSA victims, and whether reactions varied based on the type of disclosure recipient. PARTICIPANTS AND SETTING This study utilized anonymous, archival data from the US-based National Sexual Assault Online Hotline (NSAOH), and focused on a sample of 224 intrafamilial CSA victims who had previously disclosed to one type of recipient. METHODS NSAOH staff summarized children's disclosure experiences via an open-ended survey field. Data were independently coded using the Social Reactions Questionnaire. RESULTS Nearly three-fourths (73%) of children described receiving a negative reaction to disclosure. Negative reactions included distracting or dismissing the victim (33%), not believing the victim (29%), or retaliating or responding violently following disclosure (10%). Children most frequently disclosed abuse to non-offending family (66%), friends (17%), and formal support providers (12%). Relative to friends and intimate partners, victims were more likely to discuss negative reactions from family (49% v 87%, respectively, Cramer's V = 0.33, p < 0.001). CONCLUSIONS Disclosing to non-offending family may be unproductive and potentially harmful for some children. This study has implications for disclosure-related planning protocols on anonymous hotlines. Findings underscore the importance of educating the public, and parents in particular, about how to respond to CSA disclosures.
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Affiliation(s)
- Shannon A Elliott
- Rape, Abuse & Incest National Network (RAINN), Research and Evaluation, 1220 L St NW, Washington, DC 20005, United States of America.
| | - Kimberly L Goodman
- Rape, Abuse & Incest National Network (RAINN), Research and Evaluation, 1220 L St NW, Washington, DC 20005, United States of America.
| | - Emma S Bardwell
- Rape, Abuse & Incest National Network (RAINN), Research and Evaluation, 1220 L St NW, Washington, DC 20005, United States of America.
| | - Tara M Mullin
- Rape, Abuse & Incest National Network (RAINN), Research and Evaluation, 1220 L St NW, Washington, DC 20005, United States of America.
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15
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Trail K, Baptiste PJ, Hunt T, Brooks A. Conducting Research in Crisis Helpline Settings. CRISIS 2022; 43:263-269. [PMID: 35438001 DOI: 10.1027/0227-5910/a000858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Katherine Trail
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC, Australia
| | - Paris J Baptiste
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Tara Hunt
- Lifeline Research Foundation, Lifeline Australia, Sydney, NSW, Australia
| | - Anna Brooks
- Lifeline Research Foundation, Lifeline Australia, Sydney, NSW, Australia
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16
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Shaw C, Stuart J, Thomas T, Kõlves K. Suicidal behaviour and ideation in Guyana: A systematic literature review. LANCET REGIONAL HEALTH. AMERICAS 2022; 11:100253. [PMID: 36778929 PMCID: PMC9903603 DOI: 10.1016/j.lana.2022.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background The suicide rate in Guyana has consistently ranked as one of the highest in the world. This systematic review synthesises and critically analyses the existing literature on suicidal behaviours and ideation in Guyana. Methods Systematic review with narrative synthesis was conducted following PRISMA guidelines. PubMed, PsychInfo, CINAHL and SCOPUS databases were searched until 31st March 2021. Articles which included the analysis of suicidal behaviour or suicidal ideation using data collected in Guyana were eligible for inclusion. Articles relating to the Jonestown mass murder-suicide event were excluded. This review was pre-registered with PROSPERO [CRD42021247669]. Findings The search resulted in 318 articles, of which 24 met eligibility for inclusion. The majority were quantitative (n=18), relating to suicide mortality (n=9), and suicide attempt and suicidal ideation (n=9). Additionally, qualitative (n=5) and mixed-method (n=1) papers investigated the experiences of those bereaved by suicide, gatekeepers of suicidality, and adolescent students. Eleven studies were multinational, whilst 13 focused on Guyana. The quality of the publications varied. Interpretation Despite high annual suicide rates in Guyana, published research is very limited. This review found preliminary evidence for key risk groups; males, female youth, and Indo-Guyanese ethnicity. Pesticide poisoning was identified as the most common method for suicide in Guyana. There is a need for local research investigating the context and narrative of suicide to inform culturally tailored prevention strategies. This study was limited to a narrative synthesis and may be impacted by publication bias. Funding This research was supported by an Australian Government Research Training Program Scholarship through Griffith University Australia. Registration Pre-registered in PROSPERO [CRD42021247669].
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Affiliation(s)
- Charlotte Shaw
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Level 1, Building M24 Psychology, 176 Messines Ridge Road, Mt Gravatt Campus, Brisbane, QLD 4122, Australia,Corresponding author.
| | - Jaimee Stuart
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Troy Thomas
- Faculty of Natural Sciences, University of Guyana, Guyana
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Level 1, Building M24 Psychology, 176 Messines Ridge Road, Mt Gravatt Campus, Brisbane, QLD 4122, Australia
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17
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Eckert M, Efe Z, Guenthner L, Baldofski S, Kuehne K, Wundrack R, Thomas J, Saee S, Kohls E, Rummel-Kluge C. Acceptability and feasibility of a messenger-based psychological chat counselling service for children and young adults ("krisenchat"): A cross-sectional study. Internet Interv 2022; 27:100508. [PMID: 35242589 PMCID: PMC8857586 DOI: 10.1016/j.invent.2022.100508] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adolescence represents a vulnerable period to experience personal crises or mental health problems. However, many concerns stay unnoticed due to the hesitance of young people to seek help and the unavailability and inaccessibility of appropriate help services. Contemporary interventions have been developed incorporating with target group specific needs and preferred modes of communication. krisenchat (German for "crisis chat") is a German low-threshold chat-based psychosocial crisis counselling service that is available around-the-clock. Despite the growing number of online support services, there is a dearth of research regarding the acceptability, usability, and feasibility. METHODS The present cross-sectional study analyzed retrospective anonymous data on sociodemographic variables, utilization behavior, and user satisfaction of all krisenchat users between May 2020 and July 2021. Predictors of user satisfaction were identified using exploratory multiple regression analysis. Subgroup analyses were conducted using chi-square-tests to identify differences in user satisfaction. RESULTS Data of N = 6962 users was included in the analysis. More than 50% of those reported not having contacted the professional health care system before. The mean user of krisenchat was 17 years old (M = 16.6, SD = 3.5), female (female: 83.4%, male: 14.7%, diverse: 1.8%), and first approached the service at 4 PM (M = 4:03 PM, SD = 5:44 h). More than 60% of the users contacted the service between 4 PM and 12 AM, 10% even between 12 AM and 8 AM. The most frequent chat topics were concerns regarding psychiatric symptoms (60.1%), psychosocial (34.0%) or emotional distress (30.2%). The majority of the users (64.7%) reported high levels of satisfaction and 88.3% a high likelihood (60% or more) of recommending krisenchat to others. Also, the results indicate that the number of messages and their respective length differed between users and counsellors, with users writing several, but shorter messages and counsellors replying with fewer, but longer messages. CONCLUSION The results of the present study imply a high acceptability and feasibility of krisenchat. Overall, there is a high need for a 24/7 messenger-based chat counselling service in crises for children and young adults. Currently, there is no other online service for youth that is available after 7 PM or at weekends, which indicates the great importance of krisenchat and its function to bridge a current gap in the mental health care system. A need for further research emerges e.g., for subgroup differences regarding utilization patterns and also for further insights regarding help-seeking behavior via social media in youth. STUDY REGISTRATION DRKS00026671.
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Affiliation(s)
- Melanie Eckert
- Krisenchat gGmbH, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Zeki Efe
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Lukas Guenthner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Katharina Kuehne
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Richard Wundrack
- Krisenchat gGmbH, Berlin, Germany
- Department of Psychology, Chair of Personality Psychology, Humboldt University zu Berlin, Germany
| | | | | | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
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18
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Brody C, Reno R, Chhoun P, Ith S, Tep S, Tuot S, Yi S. Developing a WhatsApp hotline for female entertainment workers in Cambodia: a qualitative study. Mhealth 2022; 8:5. [PMID: 35178436 PMCID: PMC8800199 DOI: 10.21037/mhealth-21-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/30/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Female entertainment workers (FEWs) in Cambodia experience high levels of stress due to economic hardship, exposure to violence, and harassment by law enforcement due to their employment. This study aims to gather qualitative data on stressors, coping strategies, and preferences for chatline functions to inform the development of a WhatsApp hotline (chatline) for FEWs in Cambodia. METHODS This qualitative study includes data from 5 focus groups and 10 in-depth interviews (IDIs), at which point data collectors felt we approached saturation. Participants were asked to respond to open-ended questions, a comic strip showing how the hotline might work and an audio recording of a hypothetical hotline conversation. Primary structural coding was used to identify the preferred functions and type of support participants want to receive from hotline staff. As more secondary themes arose during codebook development, an inductive thematic analytical approach was selected to categorize these data. RESULTS Participants identified several stressors associated with female entertainment work, including concerns about physical and mental health, fear related to experiences with the police or threat of arrest, and exposure to violence. Passive/avoidance and active coping strategies were also identified. Participants preferred a 24 h chatline that provides emotional support from a kind and comforting female staff person. The types of support participants were looking for were advice about personal problems, encouragement to achieve their goals and address depression, and immediate help for violence. Most participants felt that the hotline could bring them a sense of relief and safety and improve their mood. Some stated that the hotline alone would not alleviate the stressors they were exposed to, particularly related to violence and called for more transformational change. CONCLUSIONS This study offers textured evidence to inform the WhatsApp hotline development and staff training tailored to meet the needs of this specific population. Linking this hotline with crisis response, legal support, and longer-term in-depth counseling and using information gathered from this project to inform more extensive structural and policy-level changes should also be part a foundational part of this project.
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Affiliation(s)
- Carinne Brody
- Public Health Program, Center for Global Health Research, Touro University California, Vallejo, CA, USA
| | | | - Pheak Chhoun
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Sopherean Ith
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Sovanvorleak Tep
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Siyan Yi
- Public Health Program, Center for Global Health Research, Touro University California, Vallejo, CA, USA
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Kohls E, Guenthner L, Baldofski S, Eckert M, Efe Z, Kuehne K, Saee S, Thomas J, Wundrack R, Rummel-Kluge C. Suicidal Ideation Among Children and Young Adults in a 24/7 Messenger-Based Psychological Chat Counseling Service. Front Psychiatry 2022; 13:862298. [PMID: 35418889 PMCID: PMC8995430 DOI: 10.3389/fpsyt.2022.862298] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/07/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Suicidality in children and young adults is a pervasive problem: approximately 40% of respondents in epidemiological surveys in German schools reported suicidal ideation, while up to 9% reported a suicide attempt in the past. While there is compelling evidence for the effectiveness of telephone-based hotline services, an increasing preference of adolescents for messenger-based counseling services can be observed. Therefore, the present study aims to investigate the utilization behavior and user satisfaction of users contacting a German messenger-based chat counseling service ("krisenchat") regarding suicidal ideation. METHODS The present cross-sectional study analyzed retrospective anonymous data on sociodemographic variables, utilization behavior, and user satisfaction of krisenchat users who used the service between May 2020 and July 2021. Chi-square-tests were used to identify associations of sociodemographic characteristics and utilization behavior with suicidal ideation. Mann-Whitney-U-tests were used to compare the user satisfaction and the recommendation-to-others-rate between suicidal and non-suicidal krisenchat-users. RESULTS In total, chat data of N = 11,031 users were collected. Of the n = 6,962 users included in the final analysis, n = 1,444 (20.7%) contacted krisenchat because of suicidal ideation. The average user experiencing suicidal ideation was 17 years old, female and currently not receiving other treatment. Further, suicidal ideation was significantly and positively associated with age and non-suicidal self-injury. Regarding utilization patterns, there were significant positive associations between suicidal ideation and counseling session count, mean amount of messages sent, and mean amount of words used per message by the user. User satisfaction was high, with 64.7% (n = 413) of users that answered the feedback survey and experiencing suicidal ideation rating the help they received as at least "good" and a recommendation rate of 89.6% (n = 571). Most importantly, no differences were found between users reporting suicidal ideation and those that do not regarding satisfaction and the probability of recommending the service. CONCLUSION Results imply satisfaction with the counseling service among users with suicidal ideation. Nevertheless, there is a need for further research into messenger-based counseling services regarding the prevention of suicidal behavior in children, youths, and young adults. Longitudinal studies are especially needed to assess the effectiveness of messenger-based interventions. STUDY REGISTRATION DRKS00026671.
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Affiliation(s)
- Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
| | - Lukas Guenthner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | - Zeki Efe
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Katharina Kuehne
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | | | - Richard Wundrack
- krisenchat gGmbH, Berlin, Germany.,Department of Psychology, Chair of Personality Psychology, Humboldt Universität zu Berlin, Berlin, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
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20
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Van Meter A, Agrawal N. LovesCompany: evaluating the safety and feasibility of a mental health-focused online community for adolescents. J Child Adolesc Ment Health 2022; 34:83-100. [PMID: 38504652 DOI: 10.2989/17280583.2023.2283030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Background: Adolescents are at risk for mental health (MH) disorders but are unlikely to seek services and may be reluctant to talk about their MH. An anonymous, online MH-focused community could help reduce suffering. However, online forums can also promote negative behaviours such as cyberbullying. This study aimed to evaluate the safety and feasibility of an online community - LovesCompany - to improve MH outcomes for adolescents.Methods: American adolescents (14-17 years) were recruited through social media. Eligible participants were randomised to LovesCompany or a placebo MH resource site. Outcomes were assessed every other week for six months, and at twelve months. Multilevel models assessed group differences in depression, anxiety, and suicidal ideation. A subgroup of participants participated in qualitative interviews.Results: Participants (N = 202) were mostly female (70%), White non-Hispanic (69%), and cisgender (80%). There were no instances of inappropriate behaviour such as bullying or posting explicit content. Symptoms for both groups improved over time. Participants appreciated hearing others' experiences and valued the opportunity to offer support.Conclusion: Although adolescents are often resistant to MH treatment, they appear to be interested in anonymous, online, MH-focused conversation, and can benefit from giving and seeking support. Finding a balance between an appealing user experience, ethical considerations, and resource needs is challenging.
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Affiliation(s)
- Anna Van Meter
- Department of Child and Adolescent Psychiatry, Grossman School of Medicine, New York University Langone Health, New York, USA
- Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Neha Agrawal
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
- Community West Treatment Center, Los Angeles, USA
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21
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Yip PSF, Chan WL, Chan CS, He L, Xu Y, Chan E, Chau YC, Cheng Q, Cheng SH, Cheung F, Chow J, Chow S, Fung J, Hsu SM, Law YW, Lo B, Miu SM, Ng WM, Ngai K, Tsang C, Xiong C, Xu Z. The Opportunities and Challenges of the First Three Years of Open Up, an Online Text-Based Counselling Service for Youth and Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13194. [PMID: 34948802 PMCID: PMC8701729 DOI: 10.3390/ijerph182413194] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/06/2021] [Accepted: 12/11/2021] [Indexed: 11/22/2022]
Abstract
We present the opportunities and challenges of Open Up, a free, 24/7 online text-based counselling service to support youth in Hong Kong. The number of youths served more than doubled within the first three years since its inception in 2018 in response to increasing youth suicidality and mental health needs. Good practice models are being developed in order to sustain and further scale up the service. We discuss the structure of the operation, usage pattern and its effectiveness, the use of AI to improve users experience, and the role of volunteer in the operation. We also present the challenges in further enhancing the operation, calling for more research, especially on the identification of the optimal number of users that can be concurrently served by a counsellor, the effective approach to respond to a small percentage of repeated users who has taken up a disproportional volume of service, and the way to optimize the use of big data analytics and AI technology to enhance the service. These advancements will benefit not only Open Up but also similar services across the globe.
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Affiliation(s)
- Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China;
| | - Wai-Leung Chan
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Christian S. Chan
- Department of Psychology, The University of Hong Kong, Hong Kong, China;
| | - Lihong He
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Yucan Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Evangeline Chan
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Yui Chi Chau
- Head Office, Hong Kong Children and Youth Services, Hong Kong, China;
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China;
| | | | - Florence Cheung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - James Chow
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Shirley Chow
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Jerry Fung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Siu-Man Hsu
- Headquarter, The Hong Kong Federation of Youth Groups, Hong Kong, China;
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China;
| | - Billie Lo
- IT Unit, The Hong Kong Federation of Youth Groups, Hong Kong, China;
| | - Sze-Man Miu
- Jockey Club Online Youth Emotional Support, The Boys’ and Girls’ Clubs Association of Hong Kong, Hong Kong, China;
| | - Wai Man Ng
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Ken Ngai
- Independent Researcher, Hong Kong, China;
| | - Christy Tsang
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Cynthia Xiong
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Zhongzhi Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
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22
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Xu Y, Chan CS, Tsang C, Cheung F, Chan E, Fung J, Chow J, He L, Xu Z, Yip PS. Detecting premature departure in online text-based counseling using logic-based pattern matching. Internet Interv 2021; 26:100486. [PMID: 34877263 PMCID: PMC8632835 DOI: 10.1016/j.invent.2021.100486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/29/2021] [Accepted: 11/18/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND More so than face-to-face counseling, users of online text-based services might drop out from a session before establishing a clear closure or expressing the intention to leave. Such premature departure may be indicative of heightened risk or dissatisfaction with the service or counselor. However, there is no systematic way to identify this understudied phenomenon. PURPOSE This study has two objectives. First, we developed a set of rules and used logic-based pattern matching techniques to systematically identify premature departures in an online text-based counseling service. Second, we validated the importance of premature departure by examining its association with user satisfaction. We hypothesized that the users who rated the session as less helpful were more likely to have departed prematurely. METHOD We developed and tested a classification model using a sample of 575 human-annotated sessions from an online text-based counseling platform. We used 80% of the dataset to train and develop the model and 20% of the dataset to evaluate the model performance. We further applied the model to the full dataset (34,821 sessions). We compared user satisfaction between premature departure and completed sessions based on data from a post-session survey. RESULTS The resulting model achieved 97% and 92% F1 score in detecting premature departure cases in the training and test sets, respectively, suggesting it is highly consistent with the judgment of human coders. When applied to the full dataset, the model classified 15,150 (43.5%) sessions as premature departure and the remaining 19,671 (56.5%) as completed sessions. Completed cases (15.2%) were more likely to fill the post-chat survey than premature departure cases (4.0%). Premature departure was significantly associated with lower perceived helpfulness and effectiveness in distress reduction. CONCLUSIONS The model is the first that systematically and accurately identifies premature departure in online text-based counseling. It can be readily modified and transferred to other contexts for the purpose of risk mitigation and service evaluation and improvement.
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Affiliation(s)
- Yucan Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Christian S. Chan
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong
- Corresponding author.
| | - Christy Tsang
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Florence Cheung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Evangeline Chan
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Jerry Fung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Chow
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Lihong He
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Zhongzhi Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Paul S.F. Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
- Correspondence to: P.S.F. Yip, Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong.
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Mathieu S, de Leo D, Koo YW, Leske S, Goodfellow B, Kõlves K. Suicide and suicide attempts in the Pacific Islands: A Systematic Literature Review. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 17:100283. [PMID: 34734201 PMCID: PMC8495100 DOI: 10.1016/j.lanwpc.2021.100283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/19/2021] [Accepted: 09/03/2021] [Indexed: 11/17/2022]
Abstract
Background The Pacific Islands have some of the highest rates of suicide in the Western Pacific region. The purpose of this study was to systematically review the literature on suicidal behaviour in the Pacific Islands. Methods A comprehensive search of Web of Science, PubMed, PsycINFO, Cochrane, CINAHL and Embase databases was conducted for all articles published until 1st February 2021. Inclusion criteria included papers that referred to a pre-specified list of Pacific Islands. Papers referring exclusively to other countries were excluded. Other exclusion criteria included not being about suicide or suicide attempts or not presenting original research. Narrative synthesis was applied without meta-analysis. The review followed PRISMA guidelines. Findings A total of 36 papers were included for review. Of the Pacific Islands, Kiribati has the highest age-standardised rate of suicide mortality. Key risk groups across the Islands included youth, people of Indian ethnicity in Fiji (a prominent ethnic group in Fiji), and Indigenous peoples across other Islands. Prominent methods were self-poisoning and hanging. A distinct lack of intervention studies was found. Interpretation Overall, the Pacific Islands appear to have relatively high rates of suicide and suicide attempts compared to other countries in the region. This was particularly striking among youth. This review provides important directions for future suicide prevention activities, including means restriction, sensitive media/community coverage, enhanced surveillance, and the development and evaluation of interventions tailored to the needs of young people and other cultural groups. Funding None.
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Affiliation(s)
- Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Diego de Leo
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Yu Wen Koo
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Stuart Leske
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Benjamin Goodfellow
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
- Centre Hospitalsier Spécialisé Albert Bousquet, Nouméa, New Caledonia
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
- Correspondence: Associate Professor Kairi Kõlves; Level 1, Building M24 Psychology, 176 Messines Ridge Road, Mt Gravatt Campus, Griffith University, QLD, Australia, 4222.
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24
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Ramchand R. Editorial: Research Will Help Prepare America for the Rollout of Its New Crisis Hotline. J Am Acad Child Adolesc Psychiatry 2021; 60:1176-1177. [PMID: 33600938 DOI: 10.1016/j.jaac.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
In Mathieu and colleagues'1 recent systematic review, the authors present important research insights about young people who call hotlines, why they call them, the types of services that callers receive, and the quality of this care. Albeit important on its own, it is particularly timely for American practitioners and policymakers. In December 2020, US President Donald J. Trump signed the National Suicide Designation Act of 2020 into law, designating 9-8-8 as the universal telephone number for accessing the national suicide prevention and mental health crisis hotline. In this editorial, I highlight how the insights provided by Mathieu et al.1 have implications for the rollout of the new 9-8-8 number.
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25
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Watling D, Batchelor S, Collyer B, Mathieu S, Ross V, Spence SH, Kõlves K. Help-Seeking from a National Youth Helpline in Australia: An Analysis of Kids Helpline Contacts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116024. [PMID: 34205148 PMCID: PMC8199956 DOI: 10.3390/ijerph18116024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022]
Abstract
Counselling helplines or hotlines are key support services for young people with mental health concerns or in suicide and self-harm crises. We aimed to describe young peoples' use of a national youth helpline (Kids Helpline, Australia, KHL) to understand how usage changed over time. A descriptive analysis was conducted on 1,415,228 answered contacts between 2012-2018. We described the trend of service usage over the observed period, the types of youth who used the service, and the problems young people contacted the service about. Phone (APC = -9.1, KHL: -10.4 to -7.8, p < 0.001) and email (APC = -13.7, 95%CI: -17.1 to -10.2, p < 0.001) contacts decreased over time whereas webchat contacts increased (APC = 16.7, 95%CI: 11.7 to 22.0, p < 0.001). With this increase in webchat contacts, there was an associated increase in total webchat contact duration. Concerns raised in contacts to the service were primarily related to emotional wellbeing and mental health concerns (53.2% phone, 57.3% webchat, 58.2% email) followed by social relationship issues (20.4% phone, 20.3% webchat, 16.8% email) and family relationships (19.4% phone, 17.2% webchat, 21.8% email). The increased preference for online text-based information and counselling services can help inform development of services for young people and allocation of staff/service training and resources.
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Affiliation(s)
- David Watling
- W.H.O Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane 4122, Australia; (D.W.); (S.M.); (V.R.); (S.H.S.)
| | - Samantha Batchelor
- Advocacy and Research Division, Yourtown, Brisbane 4064, Australia; (S.B.); (B.C.)
| | - Brian Collyer
- Advocacy and Research Division, Yourtown, Brisbane 4064, Australia; (S.B.); (B.C.)
| | - Sharna Mathieu
- W.H.O Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane 4122, Australia; (D.W.); (S.M.); (V.R.); (S.H.S.)
| | - Victoria Ross
- W.H.O Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane 4122, Australia; (D.W.); (S.M.); (V.R.); (S.H.S.)
| | - Susan H. Spence
- W.H.O Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane 4122, Australia; (D.W.); (S.M.); (V.R.); (S.H.S.)
| | - Kairi Kõlves
- W.H.O Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane 4122, Australia; (D.W.); (S.M.); (V.R.); (S.H.S.)
- Correspondence: ; Tel.: +61-7-3735 3380
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Impacts of Dual-Income Household Rate on Suicide Mortalities in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115670. [PMID: 34070685 PMCID: PMC8199206 DOI: 10.3390/ijerph18115670] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023]
Abstract
To explore impact of enhancing social advancement of females in Japan, this study determined the effects of the dual-income household rate on suicide mortalities disaggregated by attributes of gender, age, and motives between 2009 and 2017 in Japan. This study analysed impact of dual-income household rate, other household-related factors (savings, liabilities and yearly incomes per household, minors and elderly rate per household), and social/employment factors (complete unemployment rate, employment rate, temporary male and female employment rates and certification rate of long-term care insurance) on suicide mortalities disaggregated by attributes of gender, age, and motives using hierarchical linear-regression model. Dual-income household rate was significantly/negatively related to suicide mortality of the working-age female population, but significantly/positively related to that of the elderly female population. Suicide mortalities of the working-age male population and the elderly male population were significantly/positively related to dual-income household rate. Male suicide mortalities caused by family-, health-, economy- and employment-related motives were significantly/positively related to dual-income household rate; however, the dual-income household rate was significantly/positively related to female suicide mortalities caused by family-, health-, economy- and school-related motives, but significantly/negatively related to suicide mortalities caused by romance-related motives. Dual-income households suppress social-isolation and develop economical/psychological independence of females, leading to reduced suicide mortality in working-age females. However, elderly and school-age populations, who are supported by the working-age female, suffer from isolation. Working-age males also suffer from inability to adapt from the traditional concept of work–life and work–family balances to the novel work–family balance concept adapted to dual-income households. These results suggest occurrence of new social/family problems in the 21st century due to vulnerability of traditional Japanese culture and life–working–family balance concepts as well as novel sociofamilial disturbances induced by declining birth rate and ageing population in Japan.
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Nakano T, Hasegawa T, Okada M. Analysing the Impacts of Financial Support for Regional Suicide Prevention Programmes on Suicide Mortality Caused by Major Suicide Motives in Japan Using Statistical Government Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073414. [PMID: 33806105 PMCID: PMC8036759 DOI: 10.3390/ijerph18073414] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/17/2021] [Accepted: 03/21/2021] [Indexed: 11/24/2022]
Abstract
To improve and plan regional suicide prevention programmes that utilise more cost-effective governmental financial support compared with previous programmes, the present study determined the effects of the amount of financial support provided for regional suicide prevention programmes, such as the Emergency Fund to Enhance Community-Based Suicide Countermeasures (EFECBSC), on the trends of suicide mortalities caused by six major suicide motives between 2009 and 2018, using forward multiple regression analysis. The ranking order of motives for male suicide was health, economy, family, employment, romance and school (in that order), whereas the ranking order for females was health, family, economy, romance, employment and school. Male suicide mortality caused by economy-related motives was significantly/inversely related to prefectural intervention programmes, whereas mortality caused by health-related motives was also significantly/inversely related to prefectural intervention programmes, but significantly/positively related to prefectural personal consultation support programmes. Contrary to males, female suicide mortality caused by health-related motives was significantly/inversely related to the municipal development programmes of leaders/listeners, whereas mortality caused by family- and school-related motives was significantly/positively related to prefectural and municipal telephone consultation support programmes, respectively. Contrary to our expectations, school-aged female suicide mortality caused by school-related motives was significantly/positively related to prefectural personal consultation support, enlightenment and municipal telephone consultation support programmes. These results indicate that Japanese regional suicide prevention programmes probably affect the suppression of male suicide mortality. However, these programmes are possibly ineffective, or at least partially, have an adverse effect, in regard to the suicide mortalities of female and school-aged populations. Therefore, we should work to improve regional suicide prevention programmes, making them more cost-effective and targeted towards female and school-aged populations in the future.
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