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Rodriguez TR, Bandel SL, Daruwala SE, Anestis MD, Anestis JC. Predictors and patterns of suicidal ideation disclosures among American adults. Suicide Life Threat Behav 2024. [PMID: 39221660 DOI: 10.1111/sltb.13126] [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: 03/18/2024] [Revised: 05/22/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION When experiencing suicidal thoughts, many individuals do not tell others, making it difficult to ensure suicide prevention resources reach those who need it. METHODS The current study utilizes a large sample of US adults who have experienced suicidal ideation in their lifetime (n = 1074) to examine predictors of disclosures. We also explore who participants disclose to and how helpful these disclosures are rated. RESULTS A majority (n = 812, 75.6%) reported disclosing. Black and Hispanic participants were less likely to disclose than White participants. Those who were never married were more likely to disclose, as were those who have attempted suicide. Mental healthcare utilization and favorable attitudes toward mental healthcare were also positive predictors of disclosure. More participants reported disclosing to a personal connection (n = 532, 65.5%) than a mental health professional (n = 282, 34.8%). On average, most sources were rated as neither helpful nor harmful. CONCLUSION The study highlights those who may be at a higher risk of experiencing suicidal thoughts but going unidentified. To increase helpfulness of disclosures, suicide prevention programming should emphasize training for laypersons and professionals on how to effectively respond when someone reveals that they are thinking of suicide.
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Affiliation(s)
- Taylor R Rodriguez
- The New Jersey Gun Violence Research Center, Rutgers University, Piscataway, New Jersy, USA
- Department of Psychology, Rutgers University, Piscataway, New Jersy, USA
| | - Shelby L Bandel
- The New Jersey Gun Violence Research Center, Rutgers University, Piscataway, New Jersy, USA
- Department of Psychology, Rutgers University, Piscataway, New Jersy, USA
| | | | - Michael D Anestis
- The New Jersey Gun Violence Research Center, Rutgers University, Piscataway, New Jersy, USA
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Piscataway, New Jersy, USA
| | - Joye C Anestis
- Department of Health Behavior, Society, and Policy, School of Public Health, Rutgers University, Piscataway, New Jersy, USA
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Hallford D, Rusanov D, Winestone B, Kaplan R, Fuller-Tyszkiewicz M, Melvin G. Disclosure of suicidal ideation and behaviours: A systematic review and meta-analysis of prevalence. Clin Psychol Rev 2023; 101:102272. [PMID: 37001469 DOI: 10.1016/j.cpr.2023.102272] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/30/2023] [Accepted: 03/24/2023] [Indexed: 03/28/2023]
Abstract
Disclosure of suicidal ideation and behaviours, defined as thoughts, plans, or attempts, to other people provides opportunity for intervention and prevention. This study is the first to meta-analyze all available studies to estimate the prevalence of disclosure, to whom people disclose, and examine factors that influence disclosure. Databases were searched for studies reporting samples of people who had experienced suicidal ideation or behaviours (including those who had died by suicide) and whether they had disclosed this. Almost 100 studies (k = 94, N participants = 1,044,629) were included in the overall prevalance analysis. The results showed less than half of people disclosed suicidal ideation or behaviour: 45.9% (95%CI 41.9-49.9%, PI 12.3-81.8%; k = 94). High heterogeneity, common to prevalence studies, was found (Q[93] = 130,584, p < .001; I2 = 99.9%). No publication bias was detected. Removing outliers did not change the prevalence estimate, but provided tighter prediction intervals: 45.6% (95%CI 43.4-47.9%, PI 35.8-55.7%; k = 33). Disclosure was related to higher prevalence of psychiatric disorders, female gender, and a longer timeframe of suicidal ideation or behaviour. Prevalence of disclosure was lower among people who died by suicide, relative to community samples, and lower when reported verbally rather than written online. Disclosure, and proportions of disclosures, to family members, was numerically higher than to friends or professionals, but could not be directly compared. In conclusion, between 50 and 60% of people do not disclose their suicidal ideation and behaviours to other people, and therefore remain unidentified and potentially untreated.
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Nakamura K, Batterham PJ, Reynolds J. Professional help-seeking for suicide in Japan: Modifiable factors influencing help-seeking beliefs, attitudes, and intentions. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Fulginiti A, Pahwa R, Frey LM. Sharing suicidal thoughts in social networks: a multi-level perspective of disclosure among people with serious mental illness in India. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2019.1664259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Anthony Fulginiti
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Rohini Pahwa
- Silver School of Social Work, New York University, New York, NY, USA
| | - Laura M. Frey
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
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Han J, Batterham PJ, Calear AL, Randall R. Factors Influencing Professional Help-Seeking for Suicidality. CRISIS 2017; 39:175-196. [PMID: 29052431 DOI: 10.1027/0227-5910/a000485] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Evidence suggests that the majority of people with suicidality do not seek help. Little systematic evaluation of factors influencing professional help-seeking has been done. AIMS To systematically evaluate the factors that influence professional help-seeking for suicidality. METHOD Published quantitative and qualitative studies in Medline and PsycInfo databases were reviewed following PRISMA. RESULTS In all, 55 relevant studies were identified. Of these, 15 studies examined professional help-seeking intentions for perceived suicidal ideation, among people with or without suicidality; 21 studies examined professional help-seeking behavior among people with suicidality; and 19 studies examined suicidal decedents' health services use. Several potential important barriers were identified including high self-reliance, lack of perceived need for treatment, and stigmatizing attitudes toward suicide, toward mental health issues, and toward seeking professional treatment. The presence of suicidality and mental health issues was found to generally decrease help-seeking intentions for perceived suicidal ideation while facilitating actual service use. Social support and informal support from family and friends also played an important role in professional help-seeking. LIMITATIONS Although the majority of the included studies were of sound quality, some of the factors identified in the review were assessed in relatively few studies, and most of the included studies were conducted in industrialized countries. CONCLUSION Further quantitative and qualitative studies examining the potential important factors in broader community samples, especially in developing countries, are needed.
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Affiliation(s)
- Jin Han
- 1 Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Philip J Batterham
- 1 Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Alison L Calear
- 1 Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Rebecca Randall
- 1 Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
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Grimholt TK, Jacobsen D, Haavet OR, Sandvik L, Jorgensen T, Norheim AB, Ekeberg O. Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial. BMC Psychiatry 2015; 15:245. [PMID: 26467530 PMCID: PMC4604741 DOI: 10.1186/s12888-015-0635-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 10/05/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND General Practitioners (GPs) play an important role in the follow-up of patients after deliberate self-poisoning (DSP). The aim was to examine whether structured follow-up by GPs increased the content of, adherence to, and satisfaction with treatment after discharge from emergency departments. METHODS This was a multicentre, randomised trial with blinded assignment. Five emergency departments and general practices in the catchment area participated. 202 patients discharged from emergency departments after DSP were assigned. The intervention was structured follow-up by the GP over a 6-month period with a minimum of five consultations, accompanied by written guidelines for the GPs with suggestions for motivating patients to follow treatment, assessing personal problems and suicidal ideation, and availability in the case of suicidal crisis. Outcome measures were data retrieved from the Register for the control and payment of reimbursements to health service providers (KUHR) and by questionnaires mailed to patients and GPs. After 3 and 6 months, the frequency and content of GP contact, and adherence to GP consultations and treatment in general were registered. Satisfaction with general treatment received and with the GP was measured by the EUROPEP scale. RESULTS Patients in the intervention group received significantly more consultations than the control group (mean 6.7 vs. 4.5 (p = 0.004)). The intervention group was significantly more satisfied with the time their GP took to listen to their personal problems (93.1% vs. 59.4% (p = 0.002)) and with the fact that the GP included them in medical decisions (87.5% vs. 54. 8% (p = 0.009)). The intervention group was significantly more satisfied with the treatment in general than the control group (79% vs. 51% (p = 0.026)). CONCLUSIONS Guidelines and structured, enhanced follow-up by the GP after the discharge of the DSP patient increased the number of consultations and satisfaction with aftercare in general practice. Consistently with previous research, there is still a need for interventional studies. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01342809. Registered 18 April 2011.
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Affiliation(s)
- TK Grimholt
- Department of Acute Medicine, Oslo University Hospital, Pb. 4950 Nydalen, 0424 Oslo, Norway ,Regional Centre of Violence, Traumatic Stress and Suicide Prevention, Eastern Norway, Norway
| | - D. Jacobsen
- Department of Acute Medicine, Oslo University Hospital, Pb. 4950 Nydalen, 0424 Oslo, Norway
| | - OR Haavet
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - L. Sandvik
- Department of Biostatistics Oslo University Hospital, Oslo, Norway
| | - T. Jorgensen
- Psychiatric Consultation Team, Akershus University Hospital, Akershus, Norway
| | - AB Norheim
- Regional Centre of Violence, Traumatic Stress and Suicide Prevention, Eastern Norway, Norway ,Diakonhjemmet Hospital, Oslo, Norway
| | - O. Ekeberg
- Department of Acute Medicine, Oslo University Hospital, Pb. 4950 Nydalen, 0424 Oslo, Norway ,Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences. Faculty of Medicine, University of Oslo, Oslo, Norway
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Rassool SB, Nel PW. Experiences of causing an accidental death: an interpretative phenomenological analysis. DEATH STUDIES 2012; 36:832-857. [PMID: 24563930 DOI: 10.1080/07481187.2011.610559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Accidentally killing or feeling responsible for another person's death constitutes an event that is different from many typical traumatic stressors in that the responsibility for causing the trauma is located in the person themselves, rather than another person or persons. Research exploring the perspective of those who have accidentally caused a death is extremely sparse. This study aimed to gain an insight into the lived experiences of people who have caused an accidental death. Five participants were recruited through an on-line advertisement; all were drivers directly involved in a road traffic accident that occurred unexpectedly, without intention and resulted in a person's death. An interpretive phenomenological approach was used to analyse data collected through semi-structured interviews. Three main themes emerged from the participants' accounts: trying to make sense of a life changing moment; struggling to cope with the trauma of causing a death, and a changed sense of self. These findings highlight the considerable and enduring trauma associated with causing an accidental death, and emphasise the need to develop appropriate interventions to help alleviate this psychological distress.
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Affiliation(s)
- Sara B Rassool
- South Essex Partnership University, NHS Foundation Trust, Disability Resource Centre, Dunstable, Bedfordshire, UK.
| | - Pieter W Nel
- School of Psychology, University of Hertfordshire, Hatfield, Hertfordshire, UK
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Voros V, Osvath P, Fekete S. Assessing and managing suicidal behaviour in the primary care setting: A model for an integrated regional suicide prevention strategy. Int J Psychiatry Clin Pract 2009; 13:307-11. [PMID: 24916942 DOI: 10.3109/13651500903056541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although suicide rates are decreasing in most countries, suicide is still a major health concern. Our aim was to introduce a complex, integrative, regional suicide prevention strategy. Based on reviewing the literature and on our previous studies we developed a suicide prevention model, which includes recognition, risk assessment and intervention. The main steps of the model are the recognition of warning signs (communicative or behavioural), exploration of crisis situation and/or psychopathologic symptoms, assessment of protective and risk factors, estimation of suicide risk and a plan for management of suicidal patients through different levels of interventions. In the management of suicidal behaviour, the complex stress-diathesis model has to be adjusted by considering biological markers and psycho-social factors. Only after the assessment of these factors can primary care professionals, as gatekeepers, manage suicidal patients effectively by using adequate psychopharmacotherapeutic and psychotherapeutic interventions in the recognition, treatment and prevention of suicidal behaviour.
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Affiliation(s)
- Viktor Voros
- Department of Psychiatry and Psychotherapy, University of Pecs, Pecs, Hungary
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