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LaMontagne AD, Åberg M, Blomqvist S, Glozier N, Greiner BA, Gullestrup J, Harvey SB, Kyron MJ, Madsen IEH, Hanson LM, Maheen H, Mustard C, Niedhammer I, Rugulies R, Smith PM, Taouk Y, Waters S, Witt K, King TL. Work-related suicide: Evolving understandings of etiology & intervention. Am J Ind Med 2024. [PMID: 38853462 DOI: 10.1002/ajim.23624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Previously published analyses of suicide case investigations suggest that work or working conditions contribute to 10%-13% of suicide deaths. Yet, the way in which work may increase suicide risk is an underdeveloped area of epidemiologic research. In this Commentary, we propose a definition of work-related suicide from an occupational health and safety perspective, and review the case investigation-based and epidemiologic evidence on work-related causes of suicide. We identified six broad categories of potential work-related causes of suicide, which are: (1) workplace chemical, physical, and psychosocial exposures; (2) exposure to trauma on the job; (3) access to means of suicide through work; (4) exposure to high-stigma work environments; (5) exposure to normative environments promoting extreme orientation to work; and (6) adverse experiences arising from work-related injury or illness. We summarise current evidence in a schema of potential work-related causes that can also be applied in workplace risk assessment and suicide case investigations. There are numerous implications of these findings for policy and practice. Various principle- and evidence-based workplace intervention strategies for suicide prevention exist, some of which have been shown to improve suicide-prevention literacy, reduce stigma, enhance helping behaviours, and in some instances maybe even reduce suicide rates. Prevailing practice in workplace suicide prevention, however, overly emphasises individual- and illness-directed interventions, with little attention directed to addressing the working conditions that may increase suicide risk. We conclude that a stronger emphasis on improving working conditions will be required for workplace suicide prevention to reach its full preventive potential.
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Affiliation(s)
- Anthony D LaMontagne
- Institute for Health Transformation & School of Health & Social Development, Deakin University, Geelong, Victoria, Australia
| | - Maria Åberg
- School of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Sandra Blomqvist
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Jorgen Gullestrup
- Institute for Health Transformation & School of Health & Social Development, Deakin University, Geelong, Victoria, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Michael J Kyron
- Suicide Prevention and Resilience Research Center (SPARRC), School of Psychological Science, Perth, Western Australia, Australia
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- National Institute of Public Health, Copenhagen, Denmark
| | - Linda Magnusson Hanson
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Humaira Maheen
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Isabelle Niedhammer
- Institut National de la Santé et de la Recherche Médicale (INSERM), Univ Angers, Angers, France
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Peter M Smith
- Instutute for Work & Health, Toronto, Ontario, Canada
| | - Yamna Taouk
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Waters
- School of Languages, Cultures and Societies, University of Leeds, Leeds, UK
| | - Katrina Witt
- Orygen Centre for Youth Mental Health, Parkville, Victoria, Australia
| | - Tania L King
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
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2
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Laker B, Weisz N, Vassolo R. Countercyclical approach to enhancing health and well-being in healthcare systems: strategies for economic resilience and sustainable care. BMJ LEADER 2024:leader-2023-000873. [PMID: 38408842 DOI: 10.1136/leader-2023-000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/20/2024] [Indexed: 02/28/2024]
Affiliation(s)
| | - Natalia Weisz
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
| | - Roberto Vassolo
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
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3
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Orellana JDY, de Souza MLP, Horta BL. Excess suicides in Brazil during the first 2 years of the COVID-19 pandemic: Gender, regional and age group inequalities. Int J Soc Psychiatry 2024; 70:99-112. [PMID: 37753792 DOI: 10.1177/00207640231196743] [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: 09/28/2023]
Abstract
BACKGROUND While the COVID-19 pandemic's total impact on global mortality is uncertain, an estimated 15 million excess deaths occurred during the first two pandemic years, suggesting that a broad impact, since several causes of death showed a substantial rise. AIMS To estimate excess suicides in Brazil and evaluate differences within and between subgroups during the first 2 years of the COVID-19 pandemic. METHOD Based on suicide data from the mortality information system of the Brazilian Ministry of Health, the expected number of suicides was estimated by age group, gender, 4-month periods and regions through quasi-Poisson generalized additive models. Analyses were performed in R software and RStudio. RESULTS Between March 2020 and February 2022, 29,295 suicides were reported in Brazil, close to what would be expected (30,116; 95% Confidence Interval (95% CI): [28,009, 32,224]), albeit in males and females aged 30 to 59 years and 60 years and over, there were excess suicides in at least one of the six 4-month periods evaluated, especially in the second pandemic year. In the Southeast region, a 28% increase was observed in women 60 years and older during the second year. In the North region, suicide increased 23% and 32% among women aged 30 to 59 years during the first and second pandemic years, respectively. The Northeast region had a 16% excess in suicides among men aged 30 to 59 years and 61% among women 60 years old and older during the second pandemic year, reaching 83% in July to October 2021. CONCLUSIONS During the first 2 pandemic years, the pattern of suicides was not homogeneous in Brazil. There were substantial excess suicides in women aged 30 to 59 years from the North and Northeast, while among the elderly and men there was a consistent pattern in several four-month periods throughout Brazil.
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Affiliation(s)
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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4
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Talamonti D, Schneider J, Gibson B, Forshaw M. The impact of national and international financial crises on mental health and well-being: a systematic review. J Ment Health 2023:1-38. [PMID: 37934869 DOI: 10.1080/09638237.2023.2278104] [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: 06/15/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Evidence suggests that financial crises and poor mental health are reciprocally related, but no systematic review has been conducted to synthesise the existing literature on the impact of national and international financial crises on population-level mental health and well-being. AIMS The aim of this study was to systematically review the available literature on the global impact of financial crises on mental health and well-being outcomes. METHODS After registration on PROSPERO, a systematic search was conducted in PsycINFO, MEDLINE, Wiley, and Web of Science for papers published until 21 November 2022. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, 98 papers were identified as meeting eligibility criteria. Included studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and results were presented in a formal narrative synthesis. RESULTS Our findings show that financial crises are significantly associated with well-being and occurrence of psychological conditions. Several socio-demographic, cultural, and country-specific characteristics played a crucial role in the prevention of population mental health decline in periods of financial crises. CONCLUSIONS Based on the findings of this review, evidence-based recommendations were developed to guide the design of policy actions that protect population mental health during and after financial crises.
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Affiliation(s)
- Deborah Talamonti
- AXDEV Group Inc, Québec, Canada
- Université de Montréal, Montreal, Canada
| | - Jekaterina Schneider
- Centre for Appearance Research, School of Social Sciences, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Benjamin Gibson
- Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Mark Forshaw
- Department of Psychology, Edge Hill University, Ormskirk, UK
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5
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Burnett ACR, Wong Q, Zeritis S, Deady M, Torok M. Occupational class suicide risk: 12-year study of national coronial data. Br J Psychiatry 2023; 222:234-240. [PMID: 36927474 DOI: 10.1192/bjp.2023.22] [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: 03/18/2023]
Abstract
BACKGROUND Previous research showed that the Global Financial Crisis (GFC) was associated with a widening disparity in suicide rates between lower-class occupations and the highest-class occupations in Australia. There has been no research investigating whether this trend continued post-GFC. AIMS This study aimed to investigate suicide rates by occupational class among employed Australians aged 15 years and over, between 2007 and 2018. METHOD A population-level retrospective mortality study was conducted using data from the National Coronial Information System. Adjusted suicide rates were calculated over the period 2007 to 2018. Negative binomial regression models were used to assess the relationship between occupational class, gender and time, comparing post-GFC years (2010-2012, 2013-2015 and 2016-2018) with GFC years (2007-2009). RESULTS Relative to the GFC period of 2007-2009, a significant reduction in suicide disparity between managers and other occupation groups was only observed among male labourers (rate ratios (RR) = 0.65, 95% CI 0.49-0.86) and male technicians/trades workers (RR = 0.73, 95% CI 0.56-0.96) for the period 2013-2015. CONCLUSION Skilled manual and lower-skilled occupational classes remain at elevated risk of suicide in Australia. While a decreasing divergence in suicide rates was only observed between labourer and manager occupational classes post-GFC, this trend was not maintained over the later part of the study period (2016-2018). There is a need to further understand the relationship between contextual factors associated with suicide among the employed population, especially during periods of economic downturn.
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Affiliation(s)
| | - Quincy Wong
- Western Sydney University, Sydney, Australia
| | | | - Mark Deady
- University of NSW, Black Dog Institute, Sydney, Australia
| | - Michelle Torok
- University of NSW, Black Dog Institute, Sydney, Australia
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King TL, Maheen H, Taouk Y, LaMontagne AD. Precarious work and the covid-19 pandemic: the need for a gender equality focus. BMJ 2023; 380:e072872. [PMID: 36717131 DOI: 10.1136/bmj-2022-072872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Tania L King
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Victoria 3010, Australia
| | - Humaira Maheen
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Victoria 3010, Australia
| | - Yamna Taouk
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Victoria 3010, Australia
| | - Anthony D LaMontagne
- Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria 3220, Australia
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Ben Abderrahim S, Belhaj A, Bellali M, Hmandi O, Gharbaoui M, Harzallah H, Naceur Y, Ben Khelil M, Allouche M. Patterns of Unnatural Deaths Among Children and Adolescents: Autopsy Study (2011-2018). Pediatr Dev Pathol 2022; 25:635-644. [PMID: 36503303 DOI: 10.1177/10935266221132884] [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: 12/14/2022]
Abstract
BACKGROUND AND AIMS The problem of unnatural death in children is still relevant because of their vulnerability. This work aimed to describe the epidemiological profile and patterns of these medicolegal deaths in children and adolescents in northern Tunisia. METHODS We conducted a retrospective study from January 2011 to December 2018, within the Forensic Department of Charles Nicolle Hospital in Tunis. All children who died of unnatural causes were included (767 cases). RESULTS An overall male predominance was observed (sex ratio = 2.4). Accidental deaths represent the most common manner of death (81.4%) involving most frequently domestic accidents occurring in children aged between 1 and 4 years. In cases of suicide, the highest risk profile was a female child aged between 15 and 18 years. The suicide occurred most often in the victim's home with hanging representing the common means of suicide. For the criminal form, the most common means in those cases were stabbing and blunt injuries. CONCLUSION Our study delivered a broad picture of unnatural deaths among children in Tunisia. These deaths, largely absent from child survival initiatives presently on the global agenda, can be prevented if they are addressed strategically, as their injury prevention strategies differ from adults.
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Affiliation(s)
- Sarra Ben Abderrahim
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Azza Belhaj
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Mohamed Bellali
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Ons Hmandi
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Meriem Gharbaoui
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Hana Harzallah
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia.,Department of Forensic Medicine, Habib Bougatfa University Hospital, Bizerte, Tunisia
| | - Yomn Naceur
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia.,Regional Hospital Béja, Béja, Tunisia
| | - Mehdi Ben Khelil
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
| | - Mohamed Allouche
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis Faculty of Medicine, Tunis, Tunisia
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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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9
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Choi NG, Marti CN, Choi BY. Job loss, financial strain, and housing problems as suicide precipitants: Associations with other life stressors. SSM Popul Health 2022; 19:101243. [PMID: 36203475 PMCID: PMC9530609 DOI: 10.1016/j.ssmph.2022.101243] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 11/17/2022] Open
Abstract
Previous research has shown that job loss, financial strain, and/or loss of housing (JFH) in midlife elevate suicide risk. In this study based on the 2017–2019 National Violent Death Reporting System, we examined other suicide precipitants and contributors of decedents whose suicide was in part precipitated by JFH and the circumstances under which they died. First, we examined all adult decedents (N = 94,454; 74,042 males [78.4%] and 20,412 females [21.6%]) and then focused on decedents age 45–64 (N = 34,208; 25,640 males [75%] and 8568 females [25.0%]). The 45–64 age group had the highest rate of JFH (22.0% for males and 15.1% for females) as a suicide precipitant. The results of generalized linear models for all adult suicide decedents of both sexes showed that the 45–64 age group (IRR = 2.02, 95% CI = 1.89–2.16), compared to 65+ age group, and relationship problems, mental disorders, and alcohol problems were associated with significantly higher risk of JFH-precipitated suicide. In male decedents age 45–64, JFH was positively associated with depressed mood (IRR = 1.95, 95% CI = 1.85–2.06), alcohol problems (IRR = 1.14, 95% CI = 1.07–1.21), and number of crises (IRR = 1.48, 95% CI = 1.43–1.53). In female decedents age 45–64, JFH was positively associated with relationship problems (IRR = 1.19, 95% CI = 1.05–1.35), legal problems (IRR = 1.27, 95% CI = 1.06–1.54), depressed mood (IRR = 1.78, 95% CI = 1.59–1.99), and number of crises (IRR = 1.58, 95% CI = 1.48–1.68). In both sexes, the risk of JFH was also positively associated with a college education. In female decedents, JFH risk was higher among divorced or never-married individuals. Coroner/medical examiner and law enforcement agency reports show that some experienced depression and started misusing alcohol and/or other substances following a job loss, but others had these problems throughout life, which caused/contributed to JFH. These findings show the significance of suicide prevention approaches at both systemic (generous unemployment insurance, housing subsidies) and individual (treatment of depression and alcohol/substance misuse problems and social support/connection) levels. 16.2% of male and 13.0% of female suicide decedents age 18+ in 2017–2019 had job/finance/housing problems (JFH). Among decedents age 45–64, 22.0% of male and 15.1% of female had JFH. JFH was positively associated with number of crises, depressed mood, and relationship and alcohol problems in both sexes. Suicide prevention approaches are needed at both systemic and individual levels.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, 78712, USA
- Corresponding author. UT Steve Hicks School of Social Work, 1925 San Jacinto Blvd, Austin, TX 78712, USA.
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, 78712, USA
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth, Dover, DE, 19901, USA
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Mathieu S, Treloar A, Hawgood J, Ross V, Kõlves K. The Role of Unemployment, Financial Hardship, and Economic Recession on Suicidal Behaviors and Interventions to Mitigate Their Impact: A Review. Front Public Health 2022; 10:907052. [PMID: 35875017 PMCID: PMC9298506 DOI: 10.3389/fpubh.2022.907052] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/14/2022] [Indexed: 12/02/2022] Open
Abstract
Understanding the social determinants and risk factors for suicidal behaviors underlies the development of effective suicide prevention interventions. This review focused on recently published literature (2010 onwards), with the aim to determine the role of economic factors (at the individual and population level) on suicidal behaviors and ideation as well as the effectiveness of interventions addressing these factors in reducing suicidal behaviors and ideation. Where available, literature examining the economic impact of COVID-19 was highlighted. Economic recession and unemployment are associated with increased risk of suicidal behavior at the population and individual level. Additionally, personal financial problems such as debt and financial strain are associated with increased risk of suicidal behavior and ideation at the individual level. Regarding interventions, unemployment benefits, employment protection legislation, higher minimum wage and active labor market programs may reduce suicide at the population level. However, it is not clear what impact they have at the individual level, nor in relation to suicide attempts, self-harm, or suicidal ideation. There was a lack of evidence as to the effectiveness of financially focused suicide prevention interventions at either level. Current findings were contextualized within, and advance, prominent social theoretical models. Recommendations focused on future areas of research, including the unfolding economic impact of COVID-19, as well as the co-design and evaluation of tailored interventions and/or gatekeeper training for those in the financial and welfare sector, and enhanced early education aimed at increasing financial literacy in young people before onset or exacerbation of financial hardship.
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Affiliation(s)
| | | | | | | | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention and WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
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11
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LaMontagne AD, King T, Taouk Y. Submission to the Australian Senate Select Committee on Job Security on the Impact of Insecure or Precarious Employment on the Economy, Wages, Social Cohesion, and Workplace Rights and Conditions. New Solut 2022; 31:469-474. [PMID: 34266331 DOI: 10.1177/10482911211032946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Australian Senate announced a Select Committee in December of 2020 "to inquire into and report on the impact of insecure or precarious employment on the economy, wages, social cohesion and workplace rights and conditions." This New Solutions "Document" is a submission to the Australian Senate from independent Australian researchers focusing on the role of perceived job (in)security in this context, acknowledging that it only briefly addresses the role of unemployment, precarious employment, and other aspects of the broader phenomenon of insecure work. Submissions closed in March of 2021, and the Australian Senate is due to report its findings on 30 November 2021.
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Affiliation(s)
- Anthony D LaMontagne
- School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tania King
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Yamna Taouk
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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12
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Waters S, Palmer H. Dying at work. Work-related suicide – how does the UK regulatory context measure up? JOURNAL OF PUBLIC MENTAL HEALTH 2022. [DOI: 10.1108/jpmh-09-2021-0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine how work-related suicides are monitored, investigated and regulated in the UK, examining a small selection of cases and drawing on international comparison with other countries. Effective data collection and regulation are the cornerstone of suicide prevention, and this paper aims to consider whether the UK’s current regulatory framework provides an effective basis for preventing work-related suicides.
Design/methodology/approach
This study draws on qualitative sociological methods and is based on an in-depth analysis of 12 suicide cases occurring between 2015 and 2020. In each case, work-related causal factors had been previously identified by at least one official source (police enquiry, coroner or employer’s investigation). This study analysed multiple sources of documentation and undertook interviews with individuals close to each suicide case. The aim of this study was to consider the organisational response of three stakeholder organisations to the suicides: the Health and Safety Executive (HSE), the coroner and the employer.
Findings
The study points to serious shortcomings in the UK’s regulatory response to work-related suicides. Suicides are currently not recorded, investigated or regulated. Whereas the fracture of an arm or leg in the workplace needs to be reported to the HSE for further investigation, a suicide occurring in the workplace or that is work-related does not need to be reported to any public agency. Employers are not required to investigate an employee suicide or make any changes to workplace policies and practices in the aftermath of a suicide. The work-related factors that may have caused one suicide may, therefore, continue to pose health and safety risks to other employees.
Originality/value
Whereas some recent studies have examined work-related suicides within specific occupations in the UK, to the best of the authors’ knowledge, this is the first study to analyse the UK’s regulatory framework for work-related suicides. The study on which the paper is based produced a set of recommendations that were targeted at key stakeholder organisations.
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13
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Burnett ACR, Wong Q, Rheinberger D, Zeritis S, McGillivray L, Torok MH. Suicide among hospitality workers in Australia, 2006-2017. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1039-1047. [PMID: 35022820 PMCID: PMC8755406 DOI: 10.1007/s00127-022-02229-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/06/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Suicide among hospitality workers has recently attracted attention in the media. To date, little is known about suicide among hospitality workers in Australia. METHODS Suicide data were obtained from the National Coronial Information System (NCIS). Occupational suicide rates were calculated using the Australian Bureau of Statistics population-level data from the 2011 census. Negative binomial regression, univariate logistic regression, and multivariate logistic regression were used to estimate the association between suicide and employment as a hospitality worker over the period 2006-2017, compared to all other occupations. RESULTS Suicide rates for chefs was significantly higher than for persons in non-hospitality occupations [incidence rate ratio (IRR), 3.93; 95% CI 2.53-5.79; P < 0.001]. The interaction between occupation and sex was examined with follow-up testing. Suicide rates for female chefs were significantly higher than for females in non-hospitality occupations (IRR, 3.93; 95% CI 2.60-5.94). Suicide rates for male chefs were also significantly higher than males in non-hospitality occupations (IRR, 1.38; 95% CI 1.14-1.67). Compared with non-hospitality occupations, hospitality workers who died by suicide had significantly greater odds of being female (OR 0.63, 95% CI 0.50-0.79), residing in residential Socio-Economic Indexes for Areas (SEIFA) classified as most disadvantaged (OR 1.62, 95% CI 1.19-2.20), and being born outside of Australia (OR 1.74, 95% CI 1.34-2.25). CONCLUSION Results indicate the need for targeted prevention of suicide by Australian hospitality workers. Overall, results suggest that specific hospitality occupations present a higher risk of suicidal behaviour than other non-hospitality occupations.
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Affiliation(s)
| | - Q Wong
- Western Sydney University, Sydney, Australia
| | - D Rheinberger
- Black Dog Institute, University of NSW, Sydney, Australia
| | - S Zeritis
- Black Dog Institute, University of NSW, Sydney, Australia
| | - L McGillivray
- Black Dog Institute, University of NSW, Sydney, Australia
| | - M H Torok
- Black Dog Institute, University of NSW, Sydney, Australia
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Guerra O, Eboreime E. The Impact of Economic Recessions on Depression, Anxiety, and Trauma-Related Disorders and Illness Outcomes-A Scoping Review. Behav Sci (Basel) 2021; 11:119. [PMID: 34562956 PMCID: PMC8464685 DOI: 10.3390/bs11090119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
In the wake of a global economic recession secondary to the COVID-19 pandemic, this scoping review seeks to summarize the current quantitative research on the impact of economic recessions on depression, anxiety, traumatic disorders, self-harm, and suicide. Seven research databases (PsycINFO, MEDLINE, Embase, Web of Science: Core Collection, National Library of Medicine PubMed, PubMed Central, and Google Scholar) were searched for keywords returning 3412 preliminary results published since 2008 in Organisation for Economic Coordination and Development (OECD)nations. These were screened by both authors for inclusion/exclusion criteria resulting in 127 included articles. Articles included were quantitative studies in OECD countries assessing select mental disorders (depression, anxiety, and trauma-/stress-related disorders) and illness outcomes (self-harm and suicide) during periods of economic recession. Articles were limited to publication from 2008 to 2020, available online in English, and utilizing outcome measures specific to the disorders and outcomes specified above. A significant relationship was found between periods of economic recession and increased depressive symptoms, self-harming behaviour, and suicide during and following periods of recession. Results suggest that existing models for mental health support and strategies for suicide prevention may be less effective than they are in non-recession times. It may be prudent to focus public education and medical treatments on raising awareness and access to supports for populations at higher risk, including those vulnerable to the impacts of job or income loss due to low socioeconomic status preceding the recession or high levels of financial strain, those supporting others financially, approaching retirement, and those in countries with limited social safety nets. Policy makers should be aware of the potential protective nature of unemployment safeguards and labour program investment in mitigating these negative impacts. Limited or inconclusive data were found on the relationship with traumatic disorders and symptoms of anxiety. In addition, research has focused primarily on the working-age adult population with limited data available on children, adolescents, and older adults, leaving room for further research in these areas.
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Affiliation(s)
- Olivia Guerra
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
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15
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Cunningham R, Milner A, Gibb S, Rijnberg V, Disney G, Kavanagh AM. Gendered experiences of unemployment, suicide and self-harm: a population-level record linkage study. Psychol Med 2021; 52:1-9. [PMID: 33875022 DOI: 10.1017/s0033291721000994] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Unemployment and being not in the labour force (NILF) are risk factors for suicide, but their association with self-harm is unclear, and there is continuing debate about the role of confounding by prior mental health conditions. We examine associations between employment status and self-harm and suicide in a prospective cohort, taking into account prior mental-health-related factors. METHODS We used linked data from the New Zealand Integrated Data Infrastructure. The outcomes were chosen to be hospital presentation for self-harm and death by suicide. The exposure was employment status, defined as employed, unemployed, or NILF, measured at the 2013 Census. Confounders included demographic factors and mental health history (use of antidepressant medication, use of mental health services, and prior self-harm). Logistic regression was used to model effects. Analyses were stratified by gender. RESULTS For males, unemployment was associated with an increased risk of suicide [odds ratio (OR): 1.48, 95% confidence interval (CI): 1.20-1.84] and self-harm (OR: 1.55, 95% CI: 1.45-1.68) after full adjustment for confounders. NILF was associated with an increased risk of self-harm (OR: 1.43, 95% CI: 1.32-1.55), but less of an association was seen with suicide (OR: 1.19, 95% CI: 0.94-1.49). For females, unemployment was associated with an increased risk of suicide (OR: 1.30, 95% CI: 0.93-1.80) and of self-harm (OR: 1.52, 95% CI: 1.43-1.62), and NILF was associated with a similar increase in risk for suicide (OR: 1.31, 95% CI: 0.98-1.75) and self-harm (OR: 1.32, 95% CI: 1.26-1.40). DISCUSSION Exclusion from employment is associated with a considerably heightened risk of suicide and self-harm for both men and women, even among those without prior mental health problems.
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Affiliation(s)
- R Cunningham
- Department of Public Health, University of Otago Wellington, Newtown Wellington, New Zealand
| | - A Milner
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - S Gibb
- Department of Public Health, University of Otago Wellington, Newtown Wellington, New Zealand
| | - V Rijnberg
- Department of Public Health, University of Otago Wellington, Newtown Wellington, New Zealand
| | - G Disney
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - A M Kavanagh
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
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Kavanagh SA, LaMontagne AD, Brennan-Olsen S. The COVID-19 response: the health impacts of austerity measures. Med J Aust 2021; 214:142-142.e1. [PMID: 33486785 PMCID: PMC8014153 DOI: 10.5694/mja2.50925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Anthony D LaMontagne
- Deakin University, Geelong, VIC.,Institute for Health Transformation, Deakin University, Geelong, VIC
| | - Sharon Brennan-Olsen
- Deakin University, Geelong, VIC.,Institute for Health Transformation, Deakin University, Geelong, VIC
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17
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Abstract
PURPOSE OF REVIEW The ability to effectively prepare for and respond to the psychological fallout from large-scale disasters is a core competency of military mental health providers, as well as civilian emergency response teams. Disaster planning should be situation specific and data driven; vague, broad-spectrum planning can contribute to unprepared mental health teams and underserved patient populations. Herein, we review data on mental health sequelae from the twenty-first century pandemics, including SARS-CoV2 (COVID-19), and offer explanations for observed trends, insights regarding anticipated needs, and recommendations for preliminary planning on how to best allocate limited mental health resources. RECENT FINDINGS Anxiety and distress, often attributed to isolation, were the most prominent mental health complaints during previous pandemics and with COVID-19. Additionally, post-traumatic stress was surprisingly common and possibly more enduring than depression, insomnia, and alcohol misuse. Predictions regarding COVID-19's economic impact suggest that depression and suicide rates may increase over time. Available data suggest that the mental health sequelae of COVID-19 will mirror those of previous pandemics. Clinicians and mental health leaders should focus planning efforts on the negative effects of isolation, particularly anxiety and distress, as well as post-traumatic stress symptoms.
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Affiliation(s)
- Rachel H Han
- Walter Reed National Military Medical Center, Behavioral Health Consultation and Education, 8960 Brown Drive, Building 7 Room 5309, Bethesda, MD, 20889, USA.
| | | | - Wendi M Waits
- Walter Reed National Military Medical Center, Behavioral Health Consultation and Education, 8960 Brown Drive, Building 7 Room 5309, Bethesda, MD, 20889, USA
| | - Alexa K C Bell
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Tashina L Miller
- Walter Reed National Military Medical Center, Behavioral Health Consultation and Education, 8960 Brown Drive, Building 7 Room 5309, Bethesda, MD, 20889, USA
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18
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Deady M, Tan L, Kugenthiran N, Collins D, Christensen H, Harvey SB. Unemployment, suicide and COVID-19: using the evidence to plan for prevention. Med J Aust 2020; 213:153-154.e1. [PMID: 32729145 DOI: 10.5694/mja2.50715] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Leona Tan
- Black Dog Institute, UNSW, Sydney, NSW.,UNSW, Sydney, NSW
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19
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Niedhammer I, Bèque M, Chastang JF, Bertrais S. Psychosocial work exposures and suicide ideation: a study of multiple exposures using the French national working conditions survey. BMC Public Health 2020; 20:895. [PMID: 32517747 PMCID: PMC7285589 DOI: 10.1186/s12889-020-09019-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/01/2020] [Indexed: 11/21/2022] Open
Abstract
Background Our study aimed to explore the associations between psychosocial work exposures, as well as other occupational exposures, and suicide ideation in the French national working population. An additional objective was to study the cumulative role of occupational exposures in this outcome. Methods The study was based on a nationally representative sample of the French working population of 20,430 employees, 8579 men and 11,851 women (2016 French national Working Conditions survey). Occupational exposures included 21 psychosocial work factors, 4 factors related to working time/hours and 4 factors related to the physical work environment. Suicide ideation within the last 12 months was the outcome. The associations between exposures and outcome were studied using weighted logistic regression models adjusted for covariates. Results The 12-month prevalence of suicide ideation was 5.2% among men and 5.7% among women. Among the occupational exposures, psychosocial work factors were found to be associated with suicide ideation: quantitative and cognitive demands, low influence and possibilities for development, low meaning at work, low sense of community, role conflict, job insecurity, temporary employment, changes at work, and internal violence. Some rare differences in these associations were observed between genders. Linear associations were observed between the number of psychosocial work exposures and suicide ideation. Conclusions Psychosocial work factors were found to play a major role in suicide ideation, and their effects were cumulative on this outcome. More research on multiple and cumulative exposures and suicide ideation and more prevention towards the psychosocial work environment are needed.
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Affiliation(s)
- Isabelle Niedhammer
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, 28 rue Roger Amsler, CS 74521, 49045, Angers, France.
| | | | - Jean-François Chastang
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, 28 rue Roger Amsler, CS 74521, 49045, Angers, France
| | - Sandrine Bertrais
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, 28 rue Roger Amsler, CS 74521, 49045, Angers, France
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20
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Guseva Canu I, Bovio N, Mediouni Z, Bochud M, Wild P. Suicide mortality follow-up of the Swiss National Cohort (1990-2014): sex-specific risk estimates by occupational socio-economic group in working-age population. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1483-1495. [PMID: 31127347 DOI: 10.1007/s00127-019-01728-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/13/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To identify occupations and socio-economic groups with detrimental or protective effect on suicide mortality. METHODS For every occupation and economic activity/industry, we computed directly age-standardized mortality rates (DSRs) using the age structure of the European population (2010) and standardized mortality ratios (SMRs) for suicide using national cause-specific mortality rates. We further stratified analyses by socio-economic variables, job-skill level, and by three calendar periods (1990-1998/1999-2006/2007-2014). RESULTS The study sample comprised 5,834,618 participants (94,918,456 person-years). The highest DSRs were observed among unemployed/job-seeking group, in agricultural, fishery and related male workers, and in health and social activities female workers. The lowest DSRs were observed in real estate and renting, research and development, IT and other business activities in men and in agriculture, hunting and forestry industry in women. A consistent reduction in DSRs across three calendar periods was observed in men. In female corporate managers, DSRs increased over the 2007-2014 period compared with 1999-2006. Compared to general working-age population, unemployed/job-seeking people, manufacturing labourers, personal care and related workers, and motor vehicle drivers of both sexes were identified at risk of suicide. Moreover, an excess of suicide was observed among male material recording and transport clerks; nursing and midwife-associated professionals; and agricultural workers as well as among female writers and performing artists. CONCLUSIONS The findings suggest the detrimental effect of low socioeconomic positions, including unemployment, with respect to suicide mortality and a relationship between suicide and poor psychosocial working conditions in elementary occupations. Sex-specific results need further investigation.
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Affiliation(s)
- Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), University of Lausanne, Lausanne, Switzerland.
| | - Nicolas Bovio
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), University of Lausanne, Lausanne, Switzerland
| | - Zakia Mediouni
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), University of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (unisanté), University of Lausanne, Lausanne, Switzerland
| | - Pascal Wild
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), University of Lausanne, Lausanne, Switzerland.,INRS, Rue du Morvan, CS 60027, 54519, Vandoeuvre Les Nancy Cedex, France
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21
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Milner A, Aitken Z, Law PCF, LaMontagne AD, Mann C, Cooper T, Witt K. The relationship between an electronic mental health stigma campaign and suicidal thoughts and behaviours: a two-arm randomized controlled trial in the Australian construction industry. Health Promot Int 2019; 35:478-485. [DOI: 10.1093/heapro/daz034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Males employed in the construction industry are at greater risk of suicide than other employed males. It is plausible that a high level of stigma against mental health problems explains the elevated rates of suicide among this group. This study sought to test the effectiveness of an electronic mental health stigma intervention on suicide ideation, communication about suicide and attempts. Participants were randomly assigned to receive either a series of brief contact interventions over a 6-week period or a wait list control. Suicidal ideation, communication about suicide and suicide attempts were assessed using the Suicidal Behaviors Questionnaire-Revised at post-intervention. We used linear regression to assess effectiveness at post-intervention, adjusting for relevant covariates using both conventional methods and a propensity score approach. Results indicate that the intervention had no significant impact on suicidal thoughts, communication or suicide attempts. There was some indication that individuals in the intervention group reported a slight increase in attempts and communication about suicide. These observations underscore an urgent need for more research to understand the complex and nuanced relationship between stigma and suicide in non-clinical populations.
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Affiliation(s)
- A Milner
- Melbourne School of Population and Global Health, Centre for Health Equity, University of Melbourne, Australia
| | - Z Aitken
- Melbourne School of Population and Global Health, Centre for Health Equity, University of Melbourne, Australia
| | - P C F Law
- Melbourne School of Population and Global Health, Centre for Health Equity, University of Melbourne, Australia
| | - A D LaMontagne
- School of Health and Social Development, Centre for Population Health Research, Deakin University, Australia
| | - C Mann
- Incolink – Victoria, 1 Pelham Street, Carlton, VIC 3053, Australia
| | - T Cooper
- Incolink – Victoria, 1 Pelham Street, Carlton, VIC 3053, Australia
| | - K Witt
- Turning Point, Eastern Health Clinical School, Monash University, Australia
- Orygen, the National Centre of Excellence in Youth Mental Health, Australia
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22
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Huikari S, Miettunen J, Korhonen M. Economic crises and suicides between 1970 and 2011: time trend study in 21 developed countries. J Epidemiol Community Health 2019; 73:311-316. [DOI: 10.1136/jech-2018-210781] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 10/28/2018] [Accepted: 12/13/2018] [Indexed: 11/03/2022]
Abstract
BackgroundExisting research on the relationship between economic recessions and suicides has almost completely concentrated on the most recent global financial crisis (2008). We provide the most comprehensive explanation to date of how different types of economic/financial crises since 1970 have affected suicides in developed countries.MethodsNegative binomial regressions were used to estimate what the suicide rates would have been during and 1 year after each crisis began in 21 Organisation for Economic Co-operation and Development countries from 1970 to 2011 if the suicide rates had followed the pre-crisis trends.ResultsWe found that every economic/financial crisis since 1970, except the European Exchange Rate Mechanism crisis in 1992, led to excess suicides in developed countries. Among males, the excess suicide rate (per 100 000 persons) varied from 1.1 (95% CI 0.7 to 1.5) to 9.5 (7.6 to 11.2) and, among females, from 0 to 2.4 (1.9 to 2.9). For both sexes, suicides increased mostly due to stock market crashes and banking crises. In terms of actual numbers, the post-1969 economic/financial crises caused >60 000 excess suicides in the 21 developed countries. The Asian financial crisis in 1997 was the most damaging crisis when assessed based on excess suicides.ConclusionsEvidence indicates that, when considered in terms of effects on suicide mortality, the most recent global financial crisis is not particularly severe compared with previous global economic/financial crises. The distinct types of crises (ie, banking, currency and inflation crises, and stock market crashes) have different effects on suicide.
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23
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Milner A, Bollier AM, Emerson E, Kavanagh A. The relationship between disability and suicide: prospective evidence from the Ten to Men cohort. J Public Health (Oxf) 2018; 41:707-713. [DOI: 10.1093/pubmed/fdy197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/23/2018] [Accepted: 10/15/2018] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
People with disabilities often face a range of social and economic adversities. Evidence suggests that these disadvantages result in poorer mental health. Some research also indicates that people with disabilities are more likely experience thoughts about suicide than people without disability, although most of this research is based on small cross-sectional samples.
Methods
We explored the relationship between self-reported disability (measured at baseline) and likelihood of reporting thoughts of suicide (measured at follow up) using a large longitudinal cohort of Australian males. A logistic regression model was conducted with thoughts of suicide within the past 12 months (yes or no) as the outcome and disability as the exposure. The models adjusted for relevant confounders, including mental health using the SF-12 MCS, and excluded males who reported thoughts of suicide at baseline.
Results
After adjustment, there was a 1.48 (95% CI: 0.98–2.23, P = 0.063) increase in the odds of thoughts of suicide among men who also reported a disability. The size of association was similar to that of being unemployed.
Conclusions
Males reporting disability may also suffer from thoughts of suicide. We speculate that discrimination may be one explanation for the observed association. More research on this topic is needed.
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Affiliation(s)
- Allison Milner
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Australia
| | - Anne-Marie Bollier
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Australia
| | - Eric Emerson
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Anne Kavanagh
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Australia
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Study on association of working hours and occupational physical activity with the occurrence of coronary heart disease in a Chinese population. PLoS One 2017; 12:e0185598. [PMID: 29049313 PMCID: PMC5648113 DOI: 10.1371/journal.pone.0185598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/15/2017] [Indexed: 11/19/2022] Open
Abstract
Objective To explore the association of working hours and occupational physical activity (OPA) with the occurrence of coronary heart disease (CHD) in a Chinese population. Methods A total of 595 participants (354 and 241 patients with and without CHD, respectively) aged between 24 and 65 were enrolled in our study, which was conducted at the First Affiliated Hospital of Nanjing Medical University between December 2015 and October 2016. Participant characteristics were collected from face-to-face questionnaires, and logistic regression analysis was conducted to examine the association of working hours and OPA with the occurrence of CHD. Results Compared with non-employed people, long working hours (especially ≥55 hours/week) contributed to the occurrence of CHD (adjusted odds ratio[OR] = 2.213, 95% confidence interval [CI]: 1.125, 4.355, P = 0.021) after multivariate adjustment in the Chinese population. With the extension of worktime, the CHD risk increased (P for the dose-response trend = 0.022). Meanwhile, even after adjusting for engagement in physical activity during leisure time, sedentary behavior at work had an adverse effect on CHD risk (adjusted OR = 2.794, 95%CI: 1.526, 5.115, P = 0.001), and a linear relationship was also found between OPA and CHD (P for the trend = 0.005). Conclusions Long working hours and sedentary behavior at work are associated with a high risk of CHD. In addition, prolonged working hours in sedentary occupations increases the risk of CHD, independent of engagement in leisure time physical activity.
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Nakanishi M, Endo K. National Suicide Prevention, Local Mental Health Resources, and Suicide Rates in Japan. CRISIS 2017; 38:384-392. [PMID: 28748710 DOI: 10.1027/0227-5910/a000469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Suicide rates in Japan are relatively high in OECD countries. A national fund to help local authorities implement suicide prevention programs was launched in 2009. The national suicide prevention project was transferred from the Cabinet Office to the Ministry of Health, Labor, and Welfare on April 2016, with a greater focus on mental health promotion by local governments. AIMS The aim of the present study was to (a) identify local authorities' implementation of suicide prevention programs in terms of local health policies, and (b) examine the associations between local health resources and suicide rates in Japan. METHOD We investigated the types of programs implemented under the fund, and correlations with authorities' sociodemographic characteristics and mental health and welfare resources. RESULTS A majority of authorities implemented general suicide prevention programs. More focused programs addressing issues such as mental health in the workplace, alcohol problems, and attempted suicide were less frequently implemented. There were significantly fewer suicides in health regions with a higher ratio of psychiatrists to residents or a lower ratio of psychiatric beds. LIMITATIONS A causal relationship between suicide rates and characteristics of local authorities cannot be inferred from the data. CONCLUSION A community mental health system that operated in parallel to the current system may result in fewer inpatients and a reduction in Japan's suicide rate.
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Affiliation(s)
- Miharu Nakanishi
- 1 Mental Health and Nursing Research Team, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kaori Endo
- 2 Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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26
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Milner A, Maheen H, Currier D, LaMontagne AD. Male suicide among construction workers in Australia: a qualitative analysis of the major stressors precipitating death. BMC Public Health 2017. [PMID: 28629352 PMCID: PMC5477155 DOI: 10.1186/s12889-017-4500-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Suicide rates among those employed in male-dominated professions such as construction are elevated compared to other occupational groups. Thus far, past research has been mainly quantitative and has been unable to identify the complex range of risk and protective factors that surround these suicides. Methods We used a national coronial database to qualitatively study work and non-work related influences on male suicide occurring in construction workers in Australia. We randomly selected 34 cases according to specific sampling framework. Thematic analysis was used to develop a coding structure on the basis of pre-existing theories in job stress research. Results The following themes were established on the basis of mutual consensus: mental health issues prior to death, transient working experiences (i.e., the inability to obtain steady employment), workplace injury and chronic illness, work colleagues as a source of social support, financial and legal problems, relationship breakdown and child custody issues, and substance abuse. Conclusion Work and non-work factors were often interrelated pressures prior to death. Suicide prevention for construction workers needs to take a systematic approach, addressing work-level factors as well as helping those at-risk of suicide Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4500-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. .,Deakin Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Geelong, Australia.
| | - Humaira Maheen
- Deakin Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Geelong, Australia
| | - Dianne Currier
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Anthony D LaMontagne
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Deakin Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Geelong, Australia
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Abstract
Psychiatric disorders and in particular depression have increased during the "Great Recession". The aim of this study was to investigate the consumption of psychotropic drugs in people who lost their permanent employment, using administrative data. The study considered all of the subjects domiciled in Lombardy, Northern Italy, who lost a permanent employment between 2008 and 2010, not assuming psychotropic drugs and who did not find a new job within the following 12 months. The control group included people who did not lose permanent job in the study period, matched to the cases for gender, age, nationality, skill level, education and economic sector, using propensity score matching. The subjects who lost their permanent employment were 17 % more likely to receive one or more drug prescriptions than the controls, but the difference was significant only for males. Females, subjects aged >50 years, low skill level workers and Italians were more likely to have received a prescription for psychotropic drugs than respectively males, subjects aged 20-29 years or aged 30-39 years, low skill level workers and non-Italians. The average number of drugs prescribed for those who lost their job and those who continued working was respectively 2.9 and 3.1. In conclusion, losing a permanent job increases significantly psychotropic drugs consumption in males but not in females.
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Witt K, Milner A, Allisey A, Davenport L, LaMontagne AD. Effectiveness of suicide prevention programs for emergency and protective services employees: A systematic review and meta-analysis. Am J Ind Med 2017; 60:394-407. [PMID: 28262959 DOI: 10.1002/ajim.22676] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND This brief report summarizes the international literature on the effectiveness of suicide prevention programs for protective and emergency services employees. METHODS A systematic search of 11 electronic databases was undertaken until June 30, 2015. Quantitative meta-analysis was undertaken to investigate the effectiveness of these programs on suicide rates at post-intervention. Qualitative analyses were also used to identify program components that may be associated with reductions in suicide rates. RESULTS A total of 13 studies were included. Only six reported sufficient information on suicide rates to enable inclusion in quantitative analyses, however. On average, these programs were associated with an approximate halving in suicide rates over an average follow-up period of 5.25 years (SD = 4.2; range: 1-11) (Incidence Rate Ratio 0.45, 95%CI 0.31-0.65; five studies; I2 14.8%). Few programs integrated activities at the primary prevention level. CONCLUSION A greater focus on the relatively neglected area of workplace primary prevention could further improve suicide prevention effectiveness. Am. J. Ind. Med. 60:394-407, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Katrina Witt
- Centre for Population Health Research, School of Health and Social Development; Deakin University; Burwood Victoria Australia
| | - Allison Milner
- Centre for Population Health Research, School of Health and Social Development; Deakin University; Burwood Victoria Australia
- Melbourne School of Population and Global Health; University of Melbourne; Melbourne Victoria Australia
| | - Amanda Allisey
- Centre for Population Health Research, School of Health and Social Development; Deakin University; Burwood Victoria Australia
- Faculty of Business and Law; Deakin University; Burwood Victoria Australia
| | - Lauren Davenport
- Centre for Population Health Research, School of Health and Social Development; Deakin University; Burwood Victoria Australia
| | - Anthony D. LaMontagne
- Centre for Population Health Research, School of Health and Social Development; Deakin University; Burwood Victoria Australia
- Melbourne School of Population and Global Health; University of Melbourne; Melbourne Victoria Australia
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Pirkis J, Currier D, Butterworth P, Milner A, Kavanagh A, Tibble H, Robinson J, Spittal MJ. Socio-Economic Position and Suicidal Ideation in Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040365. [PMID: 28362354 PMCID: PMC5409566 DOI: 10.3390/ijerph14040365] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/24/2022]
Abstract
People in low socio-economic positions are over-represented in suicide statistics and are at heightened risk for non-fatal suicidal thoughts and behaviours. Few studies have tried to tease out the relationship between individual-level and area-level socio-economic position, however. We used data from Ten to Men (the Australian Longitudinal Study on Male Health) to investigate the relationship between individual-level and area-level socio-economic position and suicidal thinking in 12,090 men. We used a measure of unemployment/employment and occupational skill level as our individual-level indicator of socio-economic position. We used the Index of Relative Socio-Economic Disadvantage (a composite multidimensional construct created by the Australian Bureau of Statistics that combines information from a range of area-level variables, including the prevalence of unemployment and employment in low skilled occupations) as our area-level indicator. We assessed suicidal thinking using the Patient Health Questionnaire (PHQ-9). We found that even after controlling for common predictors of suicidal thinking; low individual-level and area-level socio-economic position heightened risk. Individual-level socio-economic position appeared to exert the greater influence of the two; however. There is an onus on policy makers and planners from within and outside the mental health sector to take individual- and area-level socio-economic position into account when they are developing strategic initiatives.
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Affiliation(s)
- Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Dianne Currier
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Peter Butterworth
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Allison Milner
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Anne Kavanagh
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Holly Tibble
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Jo Robinson
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
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Milner A, Page A. A rise in Australian suicide? A reflection on the 2016 cause of death statistics. Aust N Z J Psychiatry 2017; 51:99-100. [PMID: 27422563 DOI: 10.1177/0004867416659366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Allison Milner
- 1 Work, Health and Wellbeing Unit, Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, Australia.,2 Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Andrew Page
- 3 Centre for Health Research, School of Medicine, Western Sydney University, Penrith, NSW, Australia
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Frasquilho D, Matos MG, Salonna F, Guerreiro D, Storti CC, Gaspar T, Caldas-de-Almeida JM. Mental health outcomes in times of economic recession: a systematic literature review. BMC Public Health 2016; 16:115. [PMID: 26847554 PMCID: PMC4741013 DOI: 10.1186/s12889-016-2720-y] [Citation(s) in RCA: 256] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 01/11/2016] [Indexed: 02/03/2023] Open
Abstract
Background Countries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations’ health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes. Methods Literature review of records identified through Medline, PsycINFO, SciELO, and EBSCO Host. Only original research papers, published between 2004 and 2014, peer-reviewed, non-qualitative research, and reporting on associations between economic factors and proxies of mental health were considered. Results One-hundred-one papers met the inclusion criteria. The evidence was consistent that economic recessions and mediators such as unemployment, income decline, and unmanageable debts are significantly associated with poor mental wellbeing, increased rates of common mental disorders, substance-related disorders, and suicidal behaviours. Conclusion On the basis of a thorough analysis of the selected investigations, we conclude that periods of economic recession are possibly associated with a higher prevalence of mental health problems, including common mental disorders, substance disorders, and ultimately suicidal behaviour. Most of the research is based on cross-sectional studies, which seriously limits causality inferences. Conclusions are summarised, taking into account international policy recommendations concerning the cost-effective measures that can possibly reduce the occurrence of negative mental health outcomes in populations during periods of economic recession.
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Affiliation(s)
| | | | - Ferdinand Salonna
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic.
| | - Diogo Guerreiro
- Psychiatry Department, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Cláudia C Storti
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Tânia Gaspar
- Aventura Social/ISAMB, University of Lisbon and Lisbon Lusíada University, Lisbon, Portugal
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Poverty and suicide research in low- and middle-income countries: systematic mapping of literature published in English and a proposed research agenda. Glob Ment Health (Camb) 2016; 3:e32. [PMID: 28596900 PMCID: PMC5454768 DOI: 10.1017/gmh.2016.27] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/03/2016] [Accepted: 10/14/2016] [Indexed: 11/06/2022] Open
Abstract
Approximately 75% of suicides occur in low- and middle-income countries (LMICs) where rates of poverty are high. Evidence suggests a relationship between economic variables and suicidal behaviour. To plan effective suicide prevention interventions in LMICs we need to understand the relationship between poverty and suicidal behaviour and how contextual factors may mediate this relationship. We conducted a systematic mapping of the English literature on poverty and suicidal behaviour in LMICs, to provide an overview of what is known about this topic, highlight gaps in literature, and consider the implications of current knowledge for research and policy. Eleven databases were searched using a combination of key words for suicidal ideation and behaviours, poverty and LMICs to identify articles published in English between January 2004 and April 2014. Narrative analysis was performed for the 84 studies meeting inclusion criteria. Most English studies in this area come from South Asia and Middle, East and North Africa, with a relative dearth of studies from countries in Sub-Saharan Africa. Most of the available evidence comes from upper middle-income countries; only 6% of studies come from low-income countries. Most studies focused on poverty measures such as unemployment and economic status, while neglecting dimensions such as debt, relative and absolute poverty, and support from welfare systems. Most studies are conducted within a risk-factor paradigm and employ descriptive statistics thus providing little insight into the nature of the relationship. More robust evidence is needed in this area, with theory-driven studies focussing on a wider range of poverty dimensions, and employing more sophisticated statistical methods.
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Doran CM, Ling R, Gullestrup J, Swannell S, Milner A. The Impact of a Suicide Prevention Strategy on Reducing the Economic Cost of Suicide in the New South Wales Construction Industry. CRISIS 2015; 37:121-9. [PMID: 26695869 PMCID: PMC4901996 DOI: 10.1027/0227-5910/a000362] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract.Background: Little research has been conducted into the cost and prevention of self-harm in the workplace. Aims: To quantify the economic cost of self-harm and suicide among New South Wales (NSW) construction industry (CI) workers and to examine the potential economic impact of implementing Mates in Construction (MIC). Method: Direct and indirect costs were estimated. Effectiveness was measured using the relative risk ratio (RRR). In Queensland (QLD), relative suicide risks were estimated for 5-year periods before and after the commencement of MIC. For NSW, the difference between the expected (i.e., using NSW pre-MIC [2008–2012] suicide risk) and counterfactual suicide cases (i.e., applying QLD RRR) provided an estimate of potential suicide cases averted in the post-MIC period (2013–2017). Results were adjusted using the average uptake (i.e., 9.4%) of MIC activities in QLD. Economic savings from averted cases were compared with the cost of implementing MIC. Results: The cost of self-harm and suicide in the NSW CI was AU $527 million in 2010. MIC could potentially avert 0.4 suicides, 1.01 full incapacity cases, and 4.92 short absences, generating annual savings of AU $3.66 million. For every AU $1 invested, the economic return is approximately AU $4.6. Conclusion: MIC represents a positive economic investment in workplace safety.
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Affiliation(s)
- Christopher M Doran
- 1 School of Human, Health and Social Sciences, Central Queensland University, Brisbane, QLD, Australia
| | - Rod Ling
- 2 Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia
| | | | - Sarah Swannell
- 4 Mater Hill Psychology Services, Woolloongabba, QLD, Australia
| | - Allison Milner
- 5 McCaughey VicHealth Centre for Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
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Milner A, Witt K, Burnside L, Wilson C, LaMontagne AD. Contact & connect--an intervention to reduce depression stigma and symptoms in construction workers: protocol for a randomised controlled trial. BMC Public Health 2015; 15:1062. [PMID: 26475500 PMCID: PMC4609134 DOI: 10.1186/s12889-015-2394-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/30/2015] [Indexed: 11/10/2022] Open
Abstract
Background Males employed in the construction industry have high rates of suicide. Although reasons underpinning this risk are multifaceted, poor help-seeking and stigma are represent major contributors. Males in the construction industry are also exposed to other risk factors for mental ill health and suicide, including unemployment. Sigma-reducing interventions that are accessible and attractive to recently unemployed males in the construction industry could therefore improve help-seeking, and address depression and suicidal behaviour in this population. Methods/Design Contact&Connect will use a parallel individual randomized design to evaluate the effectiveness of a multimedia-based intervention aimed at reducing stigma. The intervention consists of a package of 12 brief contact interventions (BCIs) delivered over a six month period. BCIs will direct participants to informational programs and microsites. Content will address three major themes: debunking depression myths and stereotypes, normalisation, and empowerment. Target enrolment is 630 (315 in each arm), each to be followed for 12 months. Eligible participants will be males, between 30 and 64 years, unemployed at the time of recruitment, registered with Incolink (a social welfare trustee company for unemployed members of the construction industry), and own a smart phone with enabled internet connectivity. Discussion At present, there are no programs that have been shown to be effective in reducing stigma in the blue-collar male population. Contact&Connect promises to provide a tailored, efficient, and scalable approach to reducing stigma, depressive symptoms and suicidality among unemployed males. Trial registration Australian New Zealand Clinical Trials Register ACTRN12615000792527 (date of registration: 30 July, 2015). Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2394-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allison Milner
- Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Burwood, VIC, Australia. .,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Katrina Witt
- Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Burwood, VIC, Australia
| | | | | | - Anthony D LaMontagne
- Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Burwood, VIC, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Milner AJ, Niven H, LaMontagne AD. Occupational class differences in suicide: evidence of changes over time and during the global financial crisis in Australia. BMC Psychiatry 2015; 15:223. [PMID: 26391772 PMCID: PMC4578370 DOI: 10.1186/s12888-015-0608-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 09/11/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Previous research showed an increase in Australian suicide rates during the Global Financial Crisis (GFC). There has been no research investigating whether suicide rates by occupational class changed during the GFC. The aim of this study was to investigate whether the GFC-associated increase in suicide rates in employed Australians may have masked changes by occupational class. METHODS Negative binomial regression models were used to investigate Rate Ratios (RRs) in suicide by occupational class. Years of the GFC (2007, 2008, 2009) were compared to the baseline years 2001-2006. RESULTS There were widening disparities between a number of the lower class occupations and the highest class occupations during the years 2007, 2008, and 2009 for males, but less evidence of differences for females. CONCLUSIONS Occupational disparities in suicide rates widened over the GFC period. There is a need for programs to be responsive to economic downturns, and to prioritise the occupational groups most affected.
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Affiliation(s)
- Alison J Milner
- Work, Health, & Welbeing Unit, Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Building BC3.213, Burwood, Melbourne, VIC, 3125, Australia.
- McCaughey VicHealth Centre for Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Heather Niven
- Work, Health, & Welbeing Unit, Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Building BC3.213, Burwood, Melbourne, VIC, 3125, Australia.
| | - Anthony D LaMontagne
- Work, Health, & Welbeing Unit, Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Building BC3.213, Burwood, Melbourne, VIC, 3125, Australia.
- McCaughey VicHealth Centre for Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
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A Bayesian Approach to Account for Misclassification and Overdispersion in Count Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:10648-61. [PMID: 26343704 PMCID: PMC4586634 DOI: 10.3390/ijerph120910648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 07/17/2015] [Accepted: 08/25/2015] [Indexed: 12/24/2022]
Abstract
Count data are subject to considerable sources of what is often referred to as non-sampling error. Errors such as misclassification, measurement error and unmeasured confounding can lead to substantially biased estimators. It is strongly recommended that epidemiologists not only acknowledge these sorts of errors in data, but incorporate sensitivity analyses into part of the total data analysis. We extend previous work on Poisson regression models that allow for misclassification by thoroughly discussing the basis for the models and allowing for extra-Poisson variability in the form of random effects. Via simulation we show the improvements in inference that are brought about by accounting for both the misclassification and the overdispersion.
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Malard L, Chastang JF, Niedhammer I. Changes in major depressive and generalized anxiety disorders in the national French working population between 2006 and 2010. J Affect Disord 2015; 178:52-9. [PMID: 25795536 DOI: 10.1016/j.jad.2015.02.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/18/2015] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study aimed at assessing the changes in mental disorders in the French working population between 2006 and 2010, using nationally representative prospective data and a structured diagnostic interview for major depressive episode (MDE) and generalized anxiety disorder (GAD), and also at exploring the differential changes in mental disorders according to age, origin, occupation, public/private sector, self-employed/employee status and work contract. METHODS The data came from the prospective national representative Santé et Itinéraire Professionnel (SIP) survey, including a sample of 5600 French workers interviewed in 2006 and 2010. The Mini International Neuropsychiatric Interview (MINI) was used to measure MDE and GAD. Analyses were performed using weighted generalized estimation equations, and were stratified by gender. RESULTS No changes in MDE and GAD were observed for both genders among the working population. No differential changes were observed, except one: the prevalence of GAD increased among women working in the public sector while there was no change among women in the private sector. LIMITATIONS Two data collections over a 4-year period may not capture the effects of the crisis on mental disorders properly. CONCLUSION No changes in mental disorders between 2006 and 2010 were found but the increase in the prevalence of anxiety among women in the public sector may be of particular interest for prevention policies. High levels of social protection in France might contribute to explain these non-significant results.
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Affiliation(s)
- Lucile Malard
- INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, F-75013, Paris, France; Université de Versailles St-Quentin, France
| | - Jean-François Chastang
- INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, F-75013, Paris, France
| | - Isabelle Niedhammer
- INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, F-75013, Paris, France.
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Rachiotis G, Stuckler D, McKee M, Hadjichristodoulou C. What has happened to suicides during the Greek economic crisis? Findings from an ecological study of suicides and their determinants (2003-2012). BMJ Open 2015; 5:e007295. [PMID: 25807950 PMCID: PMC4386238 DOI: 10.1136/bmjopen-2014-007295] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES There is a controversy about the impact of economic crisis on suicide rates in Greece. We analysed recent suicide data to identify who has been most affected and the relationships to economic and labour market indicators. SETTING Greece. PRIMARY AND SECONDARY OUTCOME MEASURES Age-specific and sex-specific suicide rates in Greece for the period 2003-2012 were calculated using data provided by the Hellenic Statistical Authority. We performed a join-point analysis to identify discontinuities in suicide trends between 2003 and 2010, prior to austerity, and in 2011-2012, during the period of austerity. Regression models were used to assess relationships between unemployment, Gross Domestic Product (GDP) and suicide rates for the entire period by age and sex. RESULTS The mean suicide rate overall rose by 35% between 2010 and 2012, from 3.37 to 4.56/100,000 population. The suicide mortality rate for men increased from 5.75 (2003-2010) to 7.43/100,000 (2011-2012; p<0.01). Among women, the suicide rate also rose, albeit less markedly, from 1.17 to 1.55 (p=0.03). When differentiated by age group, suicide mortality increased among both sexes in the age groups 20-59 and >60 years. We found that each additional percentage point of unemployment was associated with a 0.19/100,000 population rise in suicides (95% CI 0.11 to 0.26) among working age men. CONCLUSIONS We found a clear increase in suicides among persons of working age, coinciding with austerity measures. These findings corroborate concerns that increased suicide risk in Greece is a health hazard associated with austerity measures.
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Affiliation(s)
- George Rachiotis
- Department of Hygiene and Epidemiology, Medical Faculty, School of Health Science, University of Thessaly, Larissa, Greece
| | - David Stuckler
- Department of Sociology, University of Oxford, Oxford, UK
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
- European Observatory on Health Systems and Policies, London, UK
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Medical Faculty, School of Health Science, University of Thessaly, Larissa, Greece
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Caiaffa WT, Andrade RG. On the Cost of Big Events: Are Weather-Related Disasters as Bad as Economic Recessions for Health Disparities Related to Drug Use? Subst Use Misuse 2015; 50:894-8. [PMID: 26158750 DOI: 10.3109/10826084.2015.1042289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This commentary reviews two manuscripts about big event empirical data exploring concepts and pathways of drug use and health-related events. Using basic concepts and tools, it proposes a focused framework in order to help comprehension of the multifactorial and multilevel components between macrosocial determinants of health, contextual pathways of drug use and drug-use harm and individual levels in the episode of a big event occurrence. The text also discusses implications of preexisting conditions that may be contributing factors for socially and economically segregated subsets of the population, groups possibly "at risk of risks," meaning unequally exposed to risks that generate exposure to other risks, amplifying preexistent inequities.
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Affiliation(s)
- Waleska Teixeira Caiaffa
- 1Belo Horizonte Observatory for Urban Health (OSUBH), Federal University of Minas Gerais (UFMG) , Belo Horizonte , Brazil
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