1
|
Ashworth E, McCarthy M, Wynne S, Robinson J, McKay S, Lane S, Richardson G, Boardman N, Henderson K, Crosbie V, Humphrey N, York S, Michail M, Hart D, Clacy D, Jalota M, Saini P. Study protocol for the Multimodal Approach to Preventing Suicide in Schools (MAPSS) project: A regionally based feasibility trial of an integrated response to suicide risk among UK secondary school pupils. PLoS One 2024; 19:e0302873. [PMID: 39058694 PMCID: PMC11280149 DOI: 10.1371/journal.pone.0302873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/30/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Suicide is the leading cause of death of children and young people under 35 in the UK, and suicide rates are rising in this age group. Schools are considered an appropriate and logical setting for youth suicide prevention activities, with universal, selective, and indicated approaches all demonstrating efficacy. Given that international best practice recommends suicide prevention programmes combine these approaches, and that to date this has not been done in school settings in the UK, this study aims to evaluate the feasibility of delivering a suicide prevention programme incorporating universal, selective, and indicated components in UK schools. METHODS This study is a feasibility cluster-randomised controlled trial (RCT) of an adapted version of the Multimodal Approach to Preventing Suicide in Schools (MAPSS) programme. The programme, initially developed in Australia, involves delivering universal psychoeducation to all pupils, screening them for suicide risk, and delivering Internet-based Cognitive Behavioural Therapy (Reframe IT-UK) to those students identified as being at high-risk for suicide. The programme will be trialled in six secondary schools in Northwest England and will target Year 10 students (14- and 15-year-olds). The primary aims are to assess: 1) the acceptability and safety of delivering MAPSS in a school setting in the UK; 2) the social validity of the MAPSS programme; and 3) the feasibility of delivering a large-scale, appropriately powered, cluster-RCT and economic evaluation of this intervention in the future. Secondary aims are to assess changes over time in mental health and wellbeing outcomes. DISCUSSION This study is the first to evaluate a suicide prevention programme comprising universal, selective, and indicated components in UK schools. If the programme is found to be feasible, it could be more widely tested in schools and may ultimately lead to reduced rates of suicide and suicidal behaviour in young people.
Collapse
Affiliation(s)
- Emma Ashworth
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Molly McCarthy
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sio Wynne
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jo Robinson
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Samuel McKay
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Steven Lane
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Gerry Richardson
- Centre for Health Economics, University of York, York, United Kingdom
| | - Neil Boardman
- Champs Public Health Collaborative, Cheshire and Merseyside, United Kingdom
| | | | - Vivienne Crosbie
- Child and Adolescent Mental Health Services, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, United Kingdom
| | - Sian York
- Calderstones School, Liverpool, United Kingdom
| | - Maria Michail
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Damian Hart
- Merseyside Youth Association, Liverpool, United Kingdom
| | | | | | - Pooja Saini
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| |
Collapse
|
2
|
Lu J, Gao W, Wang Z, Yang N, Pang WIP, In Lok GK, Rao W. Psychosocial interventions for suicidal and self-injurious-related behaviors among adolescents: a systematic review and meta-analysis of Chinese practices. Front Public Health 2023; 11:1281696. [PMID: 38164448 PMCID: PMC10757980 DOI: 10.3389/fpubh.2023.1281696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024] Open
Abstract
Background Suicidal and self-injurious-related behaviors (SSIRBs) are a serious public health challenge in China. However, a comprehensive systematic review of psychosocial interventions for SSIRBs among Chinese adolescents has not been performed. To fill this gap, this systematic review and meta-analysis aimed to examine psychosocial interventions for SSIRBs among Chinese adolescents. Methods Eight international (PubMed, EMBASE, Cochrane Library, ScienceDirect, Clinical Trial, CINAHL, PsycINFO, and Web of Science) and four Chinese (Wanfang, SinoMed, CEPS, and CNKI) databases were searched from inception to 31 January 2023. Data extraction and quality assessment were independently conducted by two groups of researchers. Qualitative synthesis and meta-analysis were both used. Results The initial search yielded 16,872 titles. Of the 649 full texts reviewed, 19 intervention articles focusing on SSIRBs met the inclusion criteria. Thirteen out of the 19 included studies involved cognitive-behavioral therapy (CBT). Seven non-suicidal self-injury (NSSI) studies assessing self-injurious behaviors were included (six short-term studies and three long-term studies). Compared with long-term interventions [-1.30 (95% CI: -1.84, -0.76)], short-term psychosocial interventions had a higher standardized mean difference (SMD) value [1.86 (95% CI: -2.72, -0.99)]. Meta-regression showed an inverse relationship between the treatment response and sample size (slope = 0.068, Z = 2.914, p = 0.004) and proportion of females (slope = 1.096, Z = 5.848, p < 0.001). Subgroup analyses showed that compared with the "less than 1 month" group [-0.494 (-0.783, -0.205)], in the "immediate postintervention" group, the pooled estimate was significantly lower [-2.800 (-4.050, -1.550), p < 0.001]. Conclusion Our review systematically summarized the key characteristics and effectiveness of existing psychosocial interventions for SSIRBs among Chinese adolescents. Short-term psychosocial interventions for NSSI were significantly effective in reducing self-injurious behavior scores, especially in the immediate postintervention period. More favorable treatment responses could be observed in both male and small samples.
Collapse
Affiliation(s)
- Junjie Lu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Wanting Gao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Zexin Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Nan Yang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Weng Ian Phoenix Pang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Grace Ka In Lok
- Macao Polytechnic University, Peking University Health Science Center-Macao Polytechnic University Nursing Academy, Macao, Macao SAR, China
| | - Wenwang Rao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| |
Collapse
|
3
|
Branjerdporn G, Erlich F, Ponraj K, McCosker LK, Woerwag-Mehta S. What Is Helpful and What Is Challenging for the Caregivers of Young People Receiving Interventions to Prevent Suicide? Caregivers' Perspectives-A Rapid Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1801. [PMID: 38002892 PMCID: PMC10670828 DOI: 10.3390/children10111801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
(1) Background: Suicide is a leading cause of death among young people. Preventing suicide in young people is a priority. Caregivers play a vital role in ensuring interventions for young people experiencing suicide ideation and/or attempts are implemented, and that they are maintained over time. Despite this, little is known about what caregivers find helpful and challenging in relation to suicide prevention interventions. This rapid scoping review is the first to address this gap. (2) Methods: Searches were completed on six electronic databases using keywords relating to 'suicide prevention, 'young people', and 'caregivers'. Ten studies-using both qualitative and quantitative methods, and involving >1400 carers from the United States and Europe-were selected for inclusion. (3) Results: The review shows that caregivers value interventions that are delivered by non-judgmental clinicians, that are suitable to the particular needs of their child, that are available when needed, and that support their confidence and communication. Caregivers experience difficulties with interventions that require their attendance at specific times, and that fail to recognize and/or address their own mental health needs. (4) Conclusions: The findings can be used to inform and improve the intervention design, with the aim of improving outcomes for caregivers and young people.
Collapse
Affiliation(s)
- Grace Branjerdporn
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Ferrell Erlich
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Karthikeyan Ponraj
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Laura K. McCosker
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- School of Medicine and Dentistry, Griffith University, Nathan, QLD 4111, Australia
| | - Sabine Woerwag-Mehta
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| |
Collapse
|
4
|
Marchetti I, Alloy LB, Koster EH. Breaking the vise of hopelessness: Targeting its components, antecedents, and context. Int J Cogn Ther 2023; 16:285-319. [PMID: 39131585 PMCID: PMC11314313 DOI: 10.1007/s41811-023-00165-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 08/13/2024]
Abstract
Hopelessness is a painful cognitive state that is related to depression and suicide. Despite its importance, only unsystematic efforts have been made to specifically target hopelessness in interventions, and no comprehensive review is currently available to guide future clinical studies. In this narrative review, we first analyze the phenomenon of hopelessness, by highlighting its components (e.g., dismal expectations, blocked goal-directed processing, and helplessness), antecedents (e.g., inferential styles), and contextual factors (e.g., loneliness and reduced social support). Then, we review the currently available interventions and manipulations that target these mechanisms, either directly or indirectly, and we highlight both their strengths and lacunae. Finally, we propose possible avenues to improve our clinical toolbox for breaking the vise of hopelessness.
Collapse
Affiliation(s)
- Igor Marchetti
- University of Trieste, Department of Life Sciences, Via Edoardo Weiss 21, 34128, Trieste, Italy
| | - Lauren B. Alloy
- Temple University, Department of Psychology and Neuroscience, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA 19122, USA
| | - Ernst H.W. Koster
- Ghent University, Department of Experimental-Clinical and Health Psychology, Henri Dunantlaan 2, Ghent, B-9000, Belgium
| |
Collapse
|
5
|
Meyerhoff J, Kruzan KP, Kim KYA, Van Orden K, Mohr DC. Exploring the Safety of a General Digital Mental Health Intervention to Effect Symptom Reduction among Individuals with and without Suicidal Ideation: A Secondary Analysis. Arch Suicide Res 2023; 27:966-983. [PMID: 35822235 PMCID: PMC9834433 DOI: 10.1080/13811118.2022.2096520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Trials of digital mental health interventions (DMHIs) often exclude individuals with suicide-related thoughts and behaviors precluding an understanding of whether DMHIs for affective disorders are safe for, and perform similarly within, this high-risk group. We explore the safety and performance of a DMHI for depression in participants with and without suicidal ideation (SI) at baseline. Three hundred and one participants were included in this secondary data analysis from a trial of an 8-week DMHI comprising 14 smartphone apps. We found that SI decreased across the study among participants with baseline SI and that baseline SI status did not attenuate depression treatment effects. Through a case study of the IntelliCare platform, we find that DMHIs for general affective disorders can be safe.
Collapse
Affiliation(s)
- Jonah Meyerhoff
- Feinberg School of Medicine, Northwestern University, Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), 750 North Lake Shore Drive, 10 Floor, Chicago, IL 60611
| | - Kaylee P. Kruzan
- Feinberg School of Medicine, Northwestern University, Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), 750 North Lake Shore Drive, 10 Floor, Chicago, IL 60611
| | - Kwang-Youn A. Kim
- Feinberg School of Medicine, Northwestern University, Department of Preventive Medicine, 750 North Lake Shore Drive, 10 Floor, Chicago, IL 60611
| | - Kimberly Van Orden
- University of Rochester Medical Center, Department of Psychiatry, 300 Crittenden Blvd. Rochester, NY 14642
| | - David C. Mohr
- Feinberg School of Medicine, Northwestern University, Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), 750 North Lake Shore Drive, 10 Floor, Chicago, IL 60611
| |
Collapse
|
6
|
Tepe ÇŞ, Eker F. Content analysis of suicide prevention web pages from perspective of preventive psychiatric approaches. CURRENT PSYCHOLOGY 2023:1-8. [PMID: 37359652 PMCID: PMC10008009 DOI: 10.1007/s12144-023-04496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/13/2023]
Abstract
Suicide is a serious public health problem; however, suicides are preventable with evidence-based and often low-cost interventions. This study analyzes the online content of suicide prevention and helps websites in the context of preventive psychiatry. The universe and sample of the research consisted of 147 web pages whose links can be found on the most widely used international social media platforms and websites dedicated to suicide prevention. To conduct the content analysis, the crisis hotline guide prepared by the World Health Organization for suicide prevention and the guide prepared for media professionals were used in the data collection form created by the researchers. The majority of the websites were of European origin and were prepared by mental health and suicide prevention associations for suicide prevention and crisis intervention. Telephone helplines were the most common means of communicating with consultants via the web page. On the basis of the research findings, suggestions were generated regarding the scope, content, and sustainability of web pages for crisis intervention and suicide prevention prepared at the national and international levels.
Collapse
Affiliation(s)
- Çiğdem Şen Tepe
- Faculty of Health Sciences, Department of Psychiatric Nursing, Sakarya University, Sakarya, Turkey
| | - Fatma Eker
- Faculty of Health Sciences, Department of Nursing, Cyprus International University, Nicosia, North Cyprus
| |
Collapse
|
7
|
Walsh EH, Herring MP, McMahon J. A Systematic Review of School-Based Suicide Prevention Interventions for Adolescents, and Intervention and Contextual Factors in Prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:365-381. [PMID: 36301381 DOI: 10.1007/s11121-022-01449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/26/2022]
Abstract
Suicide is the fourth leading cause of death among adolescents, globally. Though post-primary, school-based suicide prevention (PSSP) has the potential to be a key strategy for preventing adolescent suicidal thoughts and behaviours (STBs), there are persisting challenges to translating PSSP research to practice. Intervention and contextual factors relevant to PSSP are likely key to both PSSP effectiveness and implementation. As such, this systematic review aimed to summarise the effectiveness of PSSP for adolescent STBs and highlight important intervention and contextual factors with respect to PSSP. PsycINFO, Medline, Education Source, ERIC, Web of Science, and the Cochrane Central Register of Controlled Trials were searched to identify randomised and non-randomised studies evaluating the effectiveness of interventions located in post-primary, school-based settings targeting adolescent STBs. PSSP effectiveness and intervention and contextual factors were synthesised narratively. Twenty-eight studies were retained, containing nearly 47,000 participants. Twelve out of twenty-nine trials comparing intervention and independent control comparators reported statistically significant reductions in STBs postintervention, and 5/7 trials comparing preintervention and postintervention scores demonstrated significant reductions in STBs over time. Reporting and analysis of intervention and contextual factors were lacking across studies, but PSSP effectiveness and intervention acceptability varied across type of school. Although school personnel commonly delivered PSSP interventions, their input and perspectives on PSSP interventions were lacking. Notably, adolescents had little involvement in designing, inputting on, delivering and sharing their perspectives on PSSP interventions. Twenty out of twenty-eight studies were rated as moderate/high risk of bias, with non-randomised trials demonstrating greater risks of bias and trial effectiveness, in comparison to cluster randomised trials. Future research should prioritise complete reporting and analysis of intervention and contextual factors with respect to PSSP, involving key stakeholders (including adolescents and school personnel) in PSSP, and investigating key stakeholders' perspectives on PSSP. Given the inverse associations between both study quality and study design with PSSP effectiveness, particular consideration to study quality and design in PSSP research is needed. Future practice should consider PSSP interventions with universal components and PSSP which supports and involves key stakeholders in engaging with PSSP.
Collapse
Affiliation(s)
- Eibhlin H Walsh
- School, Child & Youth (SCY) Mental Health and Wellbeing Research Lab, Department of Psychology, University of Limerick, Limerick, Ireland.
- National Institute of Studies in Education, University of Limerick, Limerick, Ireland.
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Matthew P Herring
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
| | - Jennifer McMahon
- School, Child & Youth (SCY) Mental Health and Wellbeing Research Lab, Department of Psychology, University of Limerick, Limerick, Ireland
- National Institute of Studies in Education, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| |
Collapse
|
8
|
Dallinger VC, Krishnamoorthy G, Burton LJ, du Plessis C, Pillai-Sasidharan A, Ayres A. Internet-based interventions to support recovery in youth: A systematic review. Digit Health 2022; 8:20552076221129094. [PMID: 36211796 PMCID: PMC9537499 DOI: 10.1177/20552076221129094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 09/11/2022] [Indexed: 11/30/2022] Open
Abstract
Personal recovery represents a paradigm shift in how individuals are seen to benefit from mental health interventions, from a narrow view of symptom reduction to a holistic, multi-dimensional view of well-being, functional gains and rehabilitation. Although there is a large body of evidence supporting the use of recovery-oriented care in adults, research on personal recovery amongst youth with mental health concerns is an emerging area of research. Efforts to promote youth mental health have also focussed on the use of digital applications and platforms as a means of overcoming barriers related to factors including stigma and lack of available services. This systematic review aims to review the literature on existing internet-based, youth mental health interventions with regard to (a) identifying elements of the programs that align with the personal recovery and (b) outcome measures utilised in assessing personal recovery. Eleven papers were identified that met the inclusion criteria. Five of the programs reviewed from these eleven papers showed efficacy for recovery processes. The results offer preliminary support and guidance for the use of internet-based mental health interventions in the promotion of personal recovery amongst youth. Future research and practice are suggested to further develop understanding in this area.
Collapse
Affiliation(s)
- Vicki C Dallinger
- University of Southern Queensland
(USQ), Toowoomba, QLD 4350, Australia,Vicki C Dallinger, Department of Psychology
and Counselling, University of Southern Queensland, West Street Toowoomba QLD
4350, Australia.
| | | | - Lorelle J Burton
- University of Southern Queensland
(USQ), Toowoomba, QLD 4350, Australia
| | - Carol du Plessis
- University of Southern Queensland
(USQ), Ipswich, QLD 4350, Australia
| | - Arun Pillai-Sasidharan
- Jacaranda Place Queensland Adolescent Extended Treatment Centre,
Chermside, QLD 4032, Australia
| | - Alice Ayres
- Jacaranda Place Queensland Adolescent Extended Treatment Centre,
Chermside, QLD 4032, Australia
| |
Collapse
|
9
|
Guillén V, Fonseca-Baeza S, Fernández-Felipe I, Botella C, Baños R, García-Palacios A, Marco J. Effectiveness of family connections intervention for family members of persons with personality disorders in two different formats: Online vs face-to-face. Internet Interv 2022; 28:100532. [PMID: 35646607 PMCID: PMC9136357 DOI: 10.1016/j.invent.2022.100532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD). AIM The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified. METHOD This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention. RESULTS There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (μ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134); depression, anxiety, and stress (η 2 = 0.087); family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219); and quality of life (η 2 = 0.006), respectively). CONCLUSIONS This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.
Collapse
Affiliation(s)
- V. Guillén
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain,Corresponding author at: Dep. of Personality, Evaluation and Psychological Treatments, University of Valencia, Av. Blasco Ibañez 21, 46010, Spain.
| | | | - I. Fernández-Felipe
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - C. Botella
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - R. Baños
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - A. García-Palacios
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - J.H. Marco
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| |
Collapse
|
10
|
Núñez D, Gaete J, Meza D, Andaur J, Robinson J. Testing the Effectiveness of a Blended Intervention to Reduce Suicidal Ideation among School Adolescents in Chile: A Protocol for a Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073947. [PMID: 35409630 PMCID: PMC8997451 DOI: 10.3390/ijerph19073947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022]
Abstract
Suicidal ideation is prevalent in adolescents and is a marker for subsequent psychiatric vulnerability and symptom severity. Literature shows that blended care (integrating online and offline components in a treatment process) could improve the effectiveness and adherence of interventions targeting suicidal ideation in adolescents, but the evidence is inconclusive. Thus, we will test the effectiveness of a blended intervention to reduce suicidal ideation (primary outcome) in school settings using a single-blind two-armed cluster randomized controlled trial (cRCT). The internet-based component corresponds to the Reframe-IT, a program encompassing eight online sessions based on cognitive-behavioral therapy (CBT) principles. The face-to-face intervention will be delivered through four CBT sessions. Additionally, we will assess the effect of the intervention on the following secondary outcomes: suicidal attempts, depressive symptoms, hopelessness, emotional regulation, and problem-solving skills. Primary and secondary outcomes will be assessed at post-intervention, 3-month, 6-month, and 12-month follow-up. Finally, we will explore the mediation role of cognitive, emotional, and behavioral correlates of suicide on the effect of the intervention. Results will inform whether the intervention can reduce suicide among school adolescents and be implemented on a large scale in Chile.
Collapse
Affiliation(s)
- Daniel Núñez
- Faculty of Psychology, Universidad de Talca, Talca 3460000, Chile; (D.M.); (J.A.)
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8320000, Chile
- Associative Research Program, Center of Cognitive Sciences, Faculty of Psychology, Universidad de Talca, Talca 3460000, Chile
- Correspondence: (D.N.); (J.G.); Tel.: +56-9-2201775 (D.N.); +56-2-2618-2277 (J.G.)
| | - Jorge Gaete
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8320000, Chile
- Faculty of Education, Universidad de los Andes, Monseñor Álvaro del Portillo, 12455 Santiago, Chile
- Correspondence: (D.N.); (J.G.); Tel.: +56-9-2201775 (D.N.); +56-2-2618-2277 (J.G.)
| | - Daniela Meza
- Faculty of Psychology, Universidad de Talca, Talca 3460000, Chile; (D.M.); (J.A.)
| | - Javiera Andaur
- Faculty of Psychology, Universidad de Talca, Talca 3460000, Chile; (D.M.); (J.A.)
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia;
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
| |
Collapse
|
11
|
Byrne SJ, Bailey E, Lamblin M, McKay S, Pirkis J, Mihalopoulos C, Spittal MJ, Rice S, Hetrick S, Hamilton M, Yuen HP, Lee YY, Boland A, Robinson J. Study protocol for the Multimodal Approach to Preventing Suicide in Schools (MAPSS) project: a regionally based randomised trial of an integrated response to suicide risk among secondary school students. Trials 2022; 23:186. [PMID: 35236397 PMCID: PMC8889397 DOI: 10.1186/s13063-022-06072-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 01/31/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Suicide is the leading cause of death among young Australians, accounting for one-third of all deaths in those under 25. Schools are a logical setting for youth suicide prevention activities, with universal, selective and indicated approaches all demonstrating efficacy. Given that international best practice recommends suicide prevention programmes combine these approaches, and that to date this has not been done in school settings, this study aims to evaluate a suicide prevention programme incorporating universal, selective and indicated components in schools. METHODS This study is a trial of a multimodal suicide prevention programme for young people. The programme involves delivering universal psychoeducation (safeTALK) to all students, screening them for suicide risk, and delivering internet-based Cognitive Behavioural Therapy (Reframe IT) to those students identified as being at high risk for suicide. The programme will be trialled in secondary schools in Melbourne, Australia, and target year 10 students (15 and 16 year-olds). safeTALK and screening will be evaluated using a single group pre-test/post-test case series, and Reframe IT will be evaluated in a Randomised Controlled Trial. The primary outcome is change in suicidal ideation; other outcomes include help-seeking behaviour and intentions, and suicide knowledge and stigma. The programme's cost-effectiveness will also be evaluated. DISCUSSION This study is the first to evaluate a suicide prevention programme comprising universal, selective and indicated components in Australian schools. If the programme is found to be efficacious and cost-effective, it could be more widely disseminated in schools and may ultimately lead to reduced rates of suicide and suicidal behaviour in school students across the region.
Collapse
Affiliation(s)
- Sadhbh J. Byrne
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Eleanor Bailey
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Michelle Lamblin
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Samuel McKay
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Institute for Health Transformation, School for Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Simon Rice
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Sarah Hetrick
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Matthew Hamilton
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Yong Yi Lee
- Deakin Health Economics, Institute for Health Transformation, School for Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Alexandra Boland
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Jo Robinson
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
12
|
Validation of a brief tool to assess and monitor suicidal ideation: The Youth Suicide Ideation Screen (YSIS-3). J Affect Disord 2021; 295:235-242. [PMID: 34481152 DOI: 10.1016/j.jad.2021.08.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/30/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND . Suicidal ideation is common in young people. Assessment and monitoring can help to understand its dynamic nature and inform treatment planning. AIMS . The aims were to evaluate psychometric properties of a brief screening tool - the Youth Suicide Ideation Screen-3 item (YSIS-3) and determine its correlation with the Suicidal Ideation Question-Junior (SIQ-JR) and measures of depressive and anxiety symptoms a. METHOD . Cronbach's alpha (α) was used to evaluate internal consistency of the YSIS-3 in 1107 young people. Convergent validity was evaluated using network analysis based on individual item polychoric correlations. Structural equation modelling was used to understand latent constructs; pearson product moment correlations to validate the integrity of the underlying construct. and two-way mixed Intraclass Correlation Coefficient to examine longitudinal stability and Cohen's d to assess sensitivity to change. RESULTS . The YSIS-3 was found to have internal consistency, convergent validity and criteria validity almost identical to the 15-item SIQ-JR. There was a high correlation (0.91) between the latent factor underpinning YSIS-3 and SIQ-JR. The YSIS-3 was more sensitive to change among those presenting with suicidal ideation at baseline. CONCLUSIONS . The YSIS-3 is a valid measure for the assessment and monitoring of suicidal ideation, and is sensitive to change. This brief measure can contribute to regular monitoring of the presence and nature of suicidal ideation, which when included in comprehensive assessment, will inform the clinical management of those at risk of suicide.
Collapse
|
13
|
Wasserman D, Carli V, Iosue M, Javed A, Herrman H. Suicide prevention in childhood and adolescence: a narrative review of current knowledge on risk and protective factors and effectiveness of interventions. Asia Pac Psychiatry 2021; 13:e12452. [PMID: 33646646 DOI: 10.1111/appy.12452] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/28/2021] [Accepted: 02/15/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Suicide is a global mental health problem for people of all ages. While rates of suicide in children and adolescents are reported as lower than those in older populations worldwide, they represent the third leading cause of death in 15-19-year-olds. The rates are higher among boys than girls worldwide, though the death rates for girls exceed those for boys in Bangladesh, China, India, and Nepal. There has been a general decrease in adolescent suicide rates over recent decades. However, increases are reported in South East Asia as well as South America over the same time period. METHODS A narrative review method has been used to summarize current knowledge about risk and protective factors for suicide among children and adolescents and to discuss evidence-based strategy for suicide prevention in this age group. RESULTS Identified suicide risk and protective factors for children and adolescents largely overlap with those for adults. Nevertheless, developmental characteristics may strengthen the impact of some factors, such as decision-making style, coping strategies, family and peer relationships, and victimization. The implementation of evidence-based suicide preventive strategies is needed. Restricting access to lethal means, school-based awareness and skill training programs, and interventions delivered in clinical and community settings have been proven effective. The effectiveness of gatekeeper training and screening programs in reducing suicidal ideation and behavior is unproven but widely examined in selected settings. DISCUSSION Since most studies have been conducted in western countries, future research should assess the effectiveness of these promising strategies in different cultural contexts. The use of more rigorous study designs, the use of both short- and long-term follow-up evaluations, the larger inclusion of individuals belonging to vulnerable groups, the evaluation of online intervention, and the analysis of programs' cost-effectiveness are also required.
Collapse
Affiliation(s)
- Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Miriam Iosue
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Afzal Javed
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Helen Herrman
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
14
|
Finlayson BT, Jones E, Pickens JC. Solution Focused Brief Therapy Telemental Health Suicide Intervention. CONTEMPORARY FAMILY THERAPY 2021; 45:49-60. [PMID: 34393359 PMCID: PMC8353437 DOI: 10.1007/s10591-021-09599-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 12/01/2022]
Abstract
One of the innumerable impacts of the coronavirus has been the change in how individuals provide services. For mental health providers, the pandemic required a sudden shift from in person to online service delivery. As therapists learn and embrace a new modality for providing therapy, crisis situations may present with some anxiety. With the pandemic increasing crisis situations for so many individuals, and teletherapy as a mode of service delivery being unlikely to go away after the pandemic, therapists require support in navigating crises situations online, in a medium that feels like the therapist has less control with their clients due to being in different physical locations. The authors believe that regardless of the primary model(s) therapists utilize in session, solution-focused brief therapy is an integrative model that uniquely captures client's resources and reasons for living and when clients are in crisis. The purpose of this paper is to present recommendations for applying solution-focused language in teletherapy practice, to provide ethical, evidenced based care for clients in crisis. A clinical vignette is used to illustrate the application of solution focused brief therapy for working with clients in crisis. Future directions and limitations are discussed.
Collapse
Affiliation(s)
- Benjamin T. Finlayson
- Department of Community, Family, & Addiction Sciences, Texas Tech University, Lubbock, TX USA
| | - Ethan Jones
- Department of Community, Family, & Addiction Sciences, Texas Tech University, Lubbock, TX USA
| | - Jaclyn Cravens Pickens
- Department of Community, Family, & Addiction Sciences, Texas Tech University, Lubbock, TX USA
| |
Collapse
|
15
|
Londoño T, Klodnick VV, Emerson KR, Stevens L, Cohen DA. Creative Technology-Based Strategies for Engaging Young People with Serious Mental Health Conditions in Longitudinal Mental Health Services Research. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2021; 40:313-324. [PMID: 34155420 PMCID: PMC8210497 DOI: 10.1007/s10560-021-00778-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 05/24/2023]
Abstract
A better understanding of the transition from child to adult community mental health services is important given the high rates of service drop-out. Conducting longitudinal research is challenging during a major service provider change. Developmentally-typical transition-to-adulthood instability can deter study engagement. This study examines the efficacy of creative technology-based strategies to recruit and engage adolescents and young adults (AYA) with serious mental health diagnoses in a qualitative study during their transition from child to adult services. Participants were recruited from one agency to complete three in-depth qualitative interviews and monthly surveys exploring mental health service experiences over 12-months. Participants received a smartphone and data plan for 6-months at initial interview, $50 at 6-month interview and $55 at 12-month interview. Four research assistants used a shared Google Voice account to text monthly online surveys and to communicate with participants. 19 participants enrolled; 74% remained enrolled across the 12-months. Smartphones and data plans were not effective in recruiting nor sustaining study engagement for most participants. Participants preferred a mix of texting and phone calls to prompt study engagement; 60% of online surveys were completed. Unanticipated participant-researcher communication outside of research scope suggests that the formation of strong relationships and additional support during this transitional time is critical for sustained study engagement. Study findings have practical implications for social work longitudinal research design and effective study implementation. Future social work research is warranted on innovative strategies to boost study and service engagement among AYA with serious co-occurring mental health and developmental instability.
Collapse
Affiliation(s)
- Tatiana Londoño
- Steve Hicks School of Social Work, The University of Texas, 1924 San Jacinto Blvd. D3500, Austin, TX 78712 USA
| | | | - Kaleigh R. Emerson
- Steve Hicks School of Social Work, The University of Texas, 1924 San Jacinto Blvd. D3500, Austin, TX 78712 USA
| | - Laura Stevens
- Steve Hicks School of Social Work, The University of Texas, 1924 San Jacinto Blvd. D3500, Austin, TX 78712 USA
| | - Deborah A. Cohen
- Steve Hicks School of Social Work, The University of Texas, 1924 San Jacinto Blvd. D3500, Austin, TX 78712 USA
| |
Collapse
|
16
|
Yu T, Hu D, Teng F, Mao J, Xu K, Han Y, Liu Y, Wu M. Effectiveness of internet-based cognitive behavioral therapy for suicide: a systematic review and meta-analysis of RCTs. PSYCHOL HEALTH MED 2021; 27:2186-2203. [PMID: 34074167 DOI: 10.1080/13548506.2021.1930073] [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: 10/21/2022]
Abstract
Suicidal individuals rarely seek help and receive professional psychological intervention on their initiative. Internet-based cognitive behavioral therapy(iCBT) can increase availability and reduce stigma compared to face-to-face interventions for suicide.However, conclusions about the effectiveness of iCBT on suicide are controversial. The review aimed to determine the effectiveness of iCBT on reducing suicidal ideation (primary outcomes) and other outcomes related to suicide like suicide attempts(secondary outcomes). PubMed, the Cochrane Library, EMBASEwere searched up to March 2020 for RCTs of iCBT which aimed to reduce suicide.The potential bias was assessed by the Cochrane risk of bias tool. Data analyses wereperformed by RevMan5.3.Four studies meeting the eligibility criteria were included which reported data on a total of 1225 participants. We found iCBT was associated with reducing an individual's suicidal ideation, and first indications suggest that the treatment effect might be even more pronounced in the short term and in adults.Additionally, there was insufficient evidence to prove its effectiveness in reducing suicide attempts and suicide death.Overall, iCBT can overcome the disadvantages of traditional interventions and show promise on suicidal ideation. While ensuring safety and ethics, further studies are warranted, focusing on suicide specific behavior like suicide attempts.
Collapse
Affiliation(s)
- Ting Yu
- School of Nursing, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Deying Hu
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fen Teng
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Mao
- School of Nursing, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Xu
- School of Public Health, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Han
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yilan Liu
- Department of Nursing, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Minge Wu
- School of Nursing, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
17
|
Rassy J, Bardon C, Dargis L, Côté LP, Corthésy-Blondin L, Mörch CM, Labelle R. Information and Communication Technology Use in Suicide Prevention: Scoping Review. J Med Internet Res 2021; 23:e25288. [PMID: 33820754 PMCID: PMC8132980 DOI: 10.2196/25288] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/10/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The use of information and communication technology (ICT) in suicide prevention has progressed rapidly over the past decade. ICT plays a major role in suicide prevention, but research on best and promising practices has been slow. OBJECTIVE This paper aims to explore the existing literature on ICT use in suicide prevention to answer the following question: what are the best and most promising ICT practices for suicide prevention? METHODS A scoping search was conducted using the following databases: PubMed, PsycINFO, Sociological Abstracts, and IEEE Xplore. These databases were searched for articles published between January 1, 2013, and December 31, 2018. The five stages of the scoping review process were as follows: identifying research questions; targeting relevant studies; selecting studies; charting data; and collating, summarizing, and reporting the results. The World Health Organization suicide prevention model was used according to the continuum of universal, selective, and indicated prevention. RESULTS Of the 3848 studies identified, 115 (2.99%) were selected. Of these, 10 regarded the use of ICT in universal suicide prevention, 53 referred to the use of ICT in selective suicide prevention, and 52 dealt with the use of ICT in indicated suicide prevention. CONCLUSIONS The use of ICT plays a major role in suicide prevention, and many promising programs were identified through this scoping review. However, large-scale evaluation studies are needed to further examine the effectiveness of these programs and strategies. In addition, safety and ethics protocols for ICT-based interventions are recommended.
Collapse
Affiliation(s)
- Jessica Rassy
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- School of Nursing, Université de Sherbrooke, Longueuil, QC, Canada
- Quebec Network on Nursing Intervention Research, Montréal, QC, Canada
| | - Cécile Bardon
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Luc Dargis
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
| | - Louis-Philippe Côté
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Laurent Corthésy-Blondin
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Carl-Maria Mörch
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Algora Lab, Université de Montréal, Montréal, QC, Canada
- Mila, Quebec Artificial Intelligence Institute, Montréal, QC, Canada
| | - Réal Labelle
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| |
Collapse
|
18
|
Suicide Behavior Among Vocational High School Students: The Role of School-Related Factors. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
19
|
Forte A, Sarli G, Polidori L, Lester D, Pompili M. The Role of New Technologies to Prevent Suicide in Adolescence: A Systematic Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:109. [PMID: 33530342 PMCID: PMC7912652 DOI: 10.3390/medicina57020109] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 11/17/2022]
Abstract
Background and objectives: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging. We aimed to provide an overview of the present literature on the use of new technologies in adolescent suicide prevention. Materials and methods: An electronic search was run using the following keywords: Technology OR Technologies OR APP OR Application OR mobile application) AND (Adolescent OR youth OR puberty) AND (Suicid* OR Self-harm OR self-destruction). Inclusion criteria were: English language, published in a peer-reviewed journal, suicide prevention with the use of new technologies among adolescents. Results: Our search strategy yielded a total of 12 studies on the use of telemedicine, 7 on mobile applications, and 3 on language detection. We also found heterogeneity regarding the study design: 3 are randomized controlled trials (RCT), 13 are open-label single group trials, 2 are randomized studies, and 1 is a cross-sectional study. Telemedicine was the most adopted tool, especially web-based approaches. Mobile applications mostly focused on screening of depressive symptoms and suicidal ideation, and for clinical monitoring through the use of text messages. Although telepsychiatry and mobile applications can provide a fast and safe tool, supporting and preceding a face-to-face clinical assessment, only a few studies demonstrated efficacy in preventing suicide among adolescents through the use of these interventions. Some studies suggested algorithms able to recognize people at risk of suicide from the exploration of the language on social media posts. Conclusions: New technologies were found to be well accepted and tolerated supports for suicide prevention in adolescents. However, to date, few data support the use of such interventions in clinical practice and preventive strategies. Further studies are needed to test their efficacy in suicide prevention among adolescents and young adults.
Collapse
Affiliation(s)
- Alberto Forte
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Roma, 00185 Roma, Italy; (G.S.); (L.P.)
- Department of Psychiatry and Substance Abuse, ASL Roma5, 00015 Rome, Italy
| | - Giuseppe Sarli
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Roma, 00185 Roma, Italy; (G.S.); (L.P.)
| | - Lorenzo Polidori
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Roma, 00185 Roma, Italy; (G.S.); (L.P.)
| | - David Lester
- Psychology Program, Stockton University, Galloway, NJ 08205, USA;
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University, 00185 Rome, Italy;
| |
Collapse
|
20
|
Reis S, Matthews EL, Grenyer BFS. Characteristics of effective online interventions: implications for adolescents with personality disorder during a global pandemic. ACTA ACUST UNITED AC 2020; 23:488. [PMID: 33585296 PMCID: PMC7875074 DOI: 10.4081/ripppo.2020.488] [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: 08/28/2020] [Accepted: 11/27/2020] [Indexed: 11/29/2022]
Abstract
In recent years, the necessity of providing online interventions for adolescents, as an alternative to face-to-face interventions, has become apparent due to several barriers some adolescents face in accessing treatment. This need has become more critical with the coronavirus disease 2019 (COVID-19) global pandemic impacting the delivery of psychotherapy and limiting accessibility of face-to-face therapy. Whilst it has been established that face-to-face psychotherapy for adolescents with personality disorder can be effective in reducing the impact these complex mental illnesses have on functioning, online interventions for adolescents are rare, and to our knowledge there are no empirically validated online interventions for personality disorder. The development of novel online interventions are therefore necessary. To inform the development of online interventions for adolescents with personality disorder or symptoms of emerging personality disorder, a two-phase rapid review was conducted. Phase one consisted of a search and examination of existing online mental health programs for adolescents with symptoms of personality disorder, to understand how to best use online platforms. Phase two consisted of a rapid review of empirical literature examining online interventions for adolescents experiencing symptoms of personality disorder to identify characteristics that promote efficacy. There were no online programs specific to personality disorder in adolescence. However, 32 online mental health programs and 41 published empirical studies were included for analysis. Common intervention characteristics included timeframes of one to two months, regular confidential therapist contact, simple interactive online components and modules, and the inclusion of homework or workbook activities to practice new skills. There is an urgent need for online interventions targeting personality dysfunction in adolescence. Several characteristics of effective online interventions for adolescents were identified. These characteristics can help inform the development and implementation of novel online treatments to prevent and reduce the burden and impact of personality disorder, or symptoms of emerging personality disorder, in adolescents. This has implications for the COVID-19 pandemic when access to effective online interventions has become more urgent.
Collapse
Affiliation(s)
| | | | - Brin F S Grenyer
- School of Psychology.,Illawarra Health and Medical Research Institute, University of Wollongong, Australia
| |
Collapse
|
21
|
Aruah DE, Emeka OM, Eze VO, Okonkwo UU, Agbo GC. Perspectives of college students on the causes and prevention of suicide in Nigerian universities. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1842592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Diane Ezeh Aruah
- Department of Mass Communication, University of Nigeria, Nsukka, Nigeria
| | | | - Virginia Obioma Eze
- The Use of English Unit, School of General Studies, University of Nigeria, Nsukka, Nigeria
| | | | - George Chibuike Agbo
- Department of Computer and Robotics Education, University of Nigeria, Nsukka, Nigeria
| |
Collapse
|
22
|
Fulginiti A, Rhoades H, Mamey MR, Klemmer C, Srivastava A, Weskamp G, Goldbach JT. Sexual Minority Stress, Mental Health Symptoms, and Suicidality among LGBTQ Youth Accessing Crisis Services. J Youth Adolesc 2020; 50:893-905. [PMID: 33206318 DOI: 10.1007/s10964-020-01354-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/02/2020] [Indexed: 12/18/2022]
Abstract
Sexual and gender minority youth are at elevated risk for suicide. Studies have separately established the relation between minority stress and mental health symptoms, as well as minority stress and suicidality. However, no known research has simultaneously examined different mental health mechanisms whereby minority stress may be associated with different suicidal experiences (e.g., suicidal ideation, suicide attempts). The present study used data from a national sample of 572 sexual and gender minority youth aged 12 to 24 (mean age = 17.59; SD = 3.13) recruited from an LGBTQ youth-focused suicide crisis prevention provider. Nearly one-third of the sample (30.2%) identified as transgender, genderqueer, or questioning. Nearly one quarter of the sample (24.3%) identified as gay, 17.1% as pansexual, 16.8% as bisexual, and 15.2% as lesbian. Structural equation modeling was used for mediation analyses to explain suicidal ideation and suicide attempts. Serial mediation models were determined to be the best fit for both suicide-related outcomes. Minority stress was associated with depressive and PTSD symptoms, which were linked with suicidal ideation and attempt through hopelessness. The findings supported the hypotheses that minority stress would be associated with suicidality not just directly, but also indirectly through multiple mental health symptom pathways.
Collapse
Affiliation(s)
- Anthony Fulginiti
- Graduate School of Social Work, University of Denver, 2148S. High St., Denver, CO, 80208, USA.
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Cary Klemmer
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Ankur Srivastava
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Garrett Weskamp
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Jeremy T Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| |
Collapse
|
23
|
Bergin AD, Vallejos EP, Davies EB, Daley D, Ford T, Harold G, Hetrick S, Kidner M, Long Y, Merry S, Morriss R, Sayal K, Sonuga-Barke E, Robinson J, Torous J, Hollis C. Preventive digital mental health interventions for children and young people: a review of the design and reporting of research. NPJ Digit Med 2020; 3:133. [PMID: 33083568 PMCID: PMC7562906 DOI: 10.1038/s41746-020-00339-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/18/2020] [Indexed: 02/02/2023] Open
Abstract
Digital health interventions (DHIs) have frequently been highlighted as one way to respond to increasing levels of mental health problems in children and young people. Whilst many are developed to address existing mental health problems, there is also potential for DHIs to address prevention and early intervention. However, there are currently limitations in the design and reporting of the development, evaluation and implementation of preventive DHIs that can limit their adoption into real-world practice. This scoping review aimed to examine existing evidence-based DHI interventions and review how well the research literature described factors that researchers need to include in their study designs and reports to support real-world implementation. A search was conducted for relevant publications published from 2013 onwards. Twenty-one different interventions were identified from 30 publications, which took a universal (n = 12), selective (n = 3) and indicative (n = 15) approach to preventing poor mental health. Most interventions targeted adolescents, with only two studies including children aged ≤10 years. There was limited reporting of user co-design involvement in intervention development. Barriers and facilitators to implementation varied across the delivery settings, and only a minority reported financial costs involved in delivering the intervention. This review found that while there are continued attempts to design and evaluate DHIs for children and young people, there are several points of concern. More research is needed with younger children and those from poorer and underserved backgrounds. Co-design processes with children and young people should be recognised and reported as a necessary component within DHI research as they are an important factor in the design and development of interventions, and underpin successful adoption and implementation. Reporting the type and level of human support provided as part of the intervention is also important in enabling the sustained use and implementation of DHIs.
Collapse
Affiliation(s)
- Aislinn D. Bergin
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Mental Health and Technology Theme, University of Nottingham, Nottingham, UK
| | - Elvira Perez Vallejos
- NIHR Nottingham Biomedical Research Centre, Mental Health and Technology Theme, University of Nottingham, Nottingham, UK
| | - E. Bethan Davies
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Mental Health and Technology Theme, University of Nottingham, Nottingham, UK
| | - David Daley
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Gordon Harold
- Faculty of Education, University of Cambridge, Cambridge, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Sarah Hetrick
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- Orygen, University of Melbourne, Parkville, Australia
| | - Megan Kidner
- The Children and Young People’s Mental Health Research Collaboration, University of Exeter, Exeter, UK
| | - Yunfei Long
- Horizon Digital Economy Research Institute, University of Nottingham, Nottingham, UK
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK
| | - Sally Merry
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Richard Morriss
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Mental Health and Technology Theme, University of Nottingham, Nottingham, UK
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- NIHR Applied Research Centre East Midlands, Nottingham, UK
| | - Kapil Sayal
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Applied Research Centre East Midlands, Nottingham, UK
| | - Edmund Sonuga-Barke
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
| | - Jo Robinson
- Orygen, University of Melbourne, Parkville, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
| | - Chris Hollis
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Mental Health and Technology Theme, University of Nottingham, Nottingham, UK
- NIHR Applied Research Centre East Midlands, Nottingham, UK
| |
Collapse
|
24
|
Biernesser C, Sewall CJ, Brent D, Bear T, Mair C, Trauth J. Social Media Use and Deliberate Self-Harm Among Youth: A Systematized Narrative Review. CHILDREN AND YOUTH SERVICES REVIEW 2020; 116:105054. [PMID: 32773916 PMCID: PMC7413131 DOI: 10.1016/j.childyouth.2020.105054] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Suicide is now the 2nd leading cause of death among adolescents and young adults. Social media's influence on youth suicidal risk or attenuation of risk is a novel and rapidly expanding topic of research that requires attention from a broad range of mental health services professionals. We aimed to provide an updated review of social media-related risk and protective factors to youth deliberate-self harm (DSH) to guide mental health services professionals in offering care and support to youth vulnerable to suicide. METHODS Studies on which primary research was conducted that evaluated young people's use of social media platforms related to DSH were systematically searched via Scopus and identified through expert recommendation and the Association for Computing Machinery's digital library of conference materials. The search focused on the timeframe June 2014 to September 2019, to offer an update since the time the most recent systematic reviews on this topic concluded their literatures searches. Quality was reviewed using the Mixed Methods Appraisal Tool (MMAT). RESULTS A total of 38 articles were eligible, and 24 articles rated as high quality were included in a narrative review. Of the included articles, 19 explored DSH risk and 8 explored DSH protection. Most articles reported on cross-sectional quantitative or qualitative studies. Opportunities for both risks and benefits were explored, and potential influences of social media use were considered for subgroups of youth who may be especially vulnerable to suicide. CONCLUSIONS In the relatively short period of review, the association between social media use and youth DSH was tested in population-based studies, offering preliminary evidence for suicide prevention and treatment efforts. Further research is needed to understand the contribution of social media use to youth DSH, particularly among youth most vulnerable to suicidal risk.
Collapse
Affiliation(s)
- Candice Biernesser
- Department of Psychiatry, School of Medicine, University of
Pittsburgh, 3811 O’Hara St., Pittsburgh, PA 15213
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
| | - Craig J.R. Sewall
- School of Social Work, University of Pittsburgh, 2117
Cathedral of Learning, 4200 Fifth Ave., Pittsburgh, PA 15260
| | - David Brent
- Department of Psychiatry, School of Medicine, University of
Pittsburgh, 3811 O’Hara St., Pittsburgh, PA 15213
| | - Todd Bear
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
| | - Christina Mair
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
| | - Jeanette Trauth
- Department of Behavioral and Community Health Sciences,
Graduate School of Public Health, University of Pittsburgh, 130 De Soto St.
6 Floor, Pittsburgh, PA 15261
| |
Collapse
|
25
|
Bailey E, Mühlmann C, Rice S, Nedeljkovic M, Alvarez-Jimenez M, Sander L, Calear AL, Batterham PJ, Robinson J. Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey. BMC Med Ethics 2020; 21:37. [PMID: 32404098 PMCID: PMC7222514 DOI: 10.1186/s12910-020-00479-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 04/30/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention. METHOD This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data. RESULTS The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees. CONCLUSION There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them (i.e., those who prefer anonymity). Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area.
Collapse
Affiliation(s)
- Eleanor Bailey
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia.
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.
- Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, VIC, 3122, Australia.
| | - Charlotte Mühlmann
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 4. Sal, 2900, Hellerup, Denmark
- University of Copenhagen, Nørregade 10, 1165, København, Denmark
| | - Simon Rice
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Maja Nedeljkovic
- Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, VIC, 3122, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Lasse Sander
- Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Engelbergerstr. 41, D-79085, Freiburg, Germany
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, 2061, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, 2061, Australia
| | - Jo Robinson
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| |
Collapse
|
26
|
Becker M, Correll CU. Suicidality in Childhood and Adolescence. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 117:261-267. [PMID: 32449889 DOI: 10.3238/arztebl.2020.0261] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/01/2019] [Accepted: 01/28/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The suicide of minors in Germany is rare in absolute numbers: there were only 212 suicides among persons aged 10 to 20 in Germany in 2017. Nonetheless, in school surveys, 36.4-39.4% of those surveyed reported suicidal ideation, and 6.5-9% reported suicide attempts. Suicide among children and adolescents is thus a clinically and societally relevant problem. METHODS This review is based on pertinent articles retrieved by a selective literature search in the PubMed and PsycInfo databases (April 2019) employing the search terms "suicidality," "suicidal*," and "suicide," and on further information from several textbooks (1991-2017). RESULTS In children and adolescents with a mental illness, the risk of suicide is higher by a factor of 3 to 12. Mobbing experiences increase the suicide risk as well (odds ratio [OR] = 2.21, p <0.05). Non-suicidal self-injurious behavior (NSSB) is also a risk factor for both suicidal ideation (OR = 2.95) and suicide attempts (hazard ratio [HR] = 2.00). Intoxication with medications is the most common method of attempted suicide (67.7%). Most suicides are preceded by early warning signs. Psychiatric hospitalization is indicated for children and adolescents who are in acute danger of doing harm to themselves. Specific types of treatment, family-centered methods in particular, have been found to lessen the frequency of suicidal ideation and suicide attempts. The administration of antidepressant drugs to children and adolescents is controversial, as there is evidence of increased suicidality (but not mortality) for single medications. Antidepressant drugs should not, however, be withheld for this reason, if indicated. The prerequisite in all cases is close observation. CONCLUSION To prevent suicide and improve outcomes, risk factors for suicide must be considered, and the indications for primary and secondary preventive and therapeutic measures must be established. Online therapeutic modalities may become more widely used in the near future, particularly among young patients, who are well versed in the use of the Internet.
Collapse
Affiliation(s)
- Merle Becker
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité University Medical Center, Berlin; The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA;Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine,Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for PsychiatricNeuroscience, Manhasset, NY, USA
| | | |
Collapse
|
27
|
Cognitive behavioral therapy for suicide prevention in youth admitted to hospital following an episode of self-harm: A pilot randomized controlled trial. J Affect Disord 2020; 266:686-694. [PMID: 32056945 DOI: 10.1016/j.jad.2020.01.178] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/29/2019] [Accepted: 01/28/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Self-harm (SH) is among the strongest risk factors for eventual suicide death yet there are limited data on which interventions are most effective for treating SH in youth. METHODS This single-blind, pilot randomized controlled trial examined brief cognitive behavioral therapy (BCBT) for suicide prevention vs. minimally-directive supportive psychotherapy in youth (aged 16-26) hospitalized following SH. Both therapies included 10 acute sessions over 15 weeks with three booster sessions occurring at three month intervals thereafter. The primary feasibility outcome was ≥70% retention at study endpoint. Efficacy measures, including repeat SH, were secondary outcomes. RESULTS Twenty-four subjects were enrolled (12 per group) with one BCBT subject and two controls dropping out prior to the first therapy session. Five (45%) of the remaining BCBT subjects and seven (70%) control subjects completed all 10 acute therapy sessions. All subjects who completed five sessions went on to complete 10. There were significantly fewer instances of repeat SH in BCBT subjects (7 of 62 weeks of acute follow-up; 11%) compared to control subjects (24 of 79 weeks; 30%)(OR 0.34, 95%CI:0.13-0.92). Three subjects, all in the control condition, made a total of five suicide attempts during the study. LIMITATIONS This study had a modest sample size and retention rate. CONCLUSIONS This study failed to achieve its primary feasibility retention goal for BCBT. However, it did demonstrate that initial adherence to follow-up predicted study completion. Despite small numbers, it also found a significant reduction in repeat SH in the BCBT group, a finding which requires replication.
Collapse
|
28
|
Arshad U, Farhat‐ul‐Ain, Gauntlett J, Husain N, Chaudhry N, Taylor PJ. A Systematic Review of the Evidence Supporting Mobile- and Internet-Based Psychological Interventions For Self-Harm. Suicide Life Threat Behav 2020; 50:151-179. [PMID: 31448847 PMCID: PMC7027458 DOI: 10.1111/sltb.12583] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Internet- and mobile phone-based psychological interventions have the potential to overcome many of the barriers associated with accessing traditional face-to-face therapy. Self-injurious thoughts and behaviors (STB) are prevalent global health problems that may benefit from Internet- and mobile-based interventions. We provide a systematic review and meta-analysis of studies evaluating mobile- and Internet-based interventions for STB, including nonsuicidal self-injury (NSSI). METHODS Online databases (PsycINFO, Web of Science, Medline) were searched up to March 2019 for single-arm and controlled trials of Internet- or mobile-based interventions for STB. The potential for bias was assessed using the Cochrane risk of bias tool. RESULTS Twenty-two eligible trials were identified. The research was limited by a lack of controlled designs and small samples. Evidence supports the acceptability of interventions. There is preliminary evidence that these interventions are associated with a decline in STB. A meta-analysis suggested a positive treatment effect on suicidal ideation when compared to treatment as usual, but not when trials with active controls were also considered. CONCLUSIONS Overall, Internet- and mobile-based interventions show promise and further controlled trials are warranted, focusing on behavioral outcomes (NSSI, suicidal behavior). This review was preregistered with PROSPERO (CRD42017074065).
Collapse
Affiliation(s)
- Usman Arshad
- Pakistan Institute of Living & LearningKarachiPakistan
| | - Farhat‐ul‐Ain
- Pakistan Institute of Living & LearningKarachiPakistan
| | - Jessica Gauntlett
- Division of Psychology & Mental HealthManchester Academic Health Sciences CentreSchool of Health SciencesUniversity of ManchesterManchesterUK
| | - Nusrat Husain
- Division of Psychology & Mental HealthManchester Academic Health Sciences CentreSchool of Health SciencesUniversity of ManchesterManchesterUK
| | | | - Peter James Taylor
- Division of Psychology & Mental HealthManchester Academic Health Sciences CentreSchool of Health SciencesUniversity of ManchesterManchesterUK
| |
Collapse
|
29
|
Te Maro B, Cuthbert S, Sofo M, Tasker K, Bowden L, Donkin L, Hetrick SE. Understanding the Experience and Needs of School Counsellors When Working with Young People Who Engage in Self-Harm. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4844. [PMID: 31810234 PMCID: PMC6926739 DOI: 10.3390/ijerph16234844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/09/2019] [Accepted: 11/15/2019] [Indexed: 11/17/2022]
Abstract
Self-harm rates are increasing globally and demand for supporting, treating and managing young people who engage in self-harm often falls to schools. Yet the approach taken by schools varies. This study aimed to explore the experience of school staff managing self-harm, and to obtain their views on the use of guidelines in their work. Twenty-six pastoral care staff from New Zealand were interviewed. Interviews were analyzed and coded using thematic analysis. Three themes emerged: The burden of the role; discrepancies in expectations, training, and experience; and the need for guidelines to support their work. This research, therefore, demonstrated a need for guidelines to support school staff to provide support around decision making and response to self-harm in the school environment.
Collapse
Affiliation(s)
- Ben Te Maro
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; (B.T.M.); (L.B.); (L.D.)
| | - Sasha Cuthbert
- Department of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; (S.C.); (K.T.)
| | - Mia Sofo
- Department of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; (S.C.); (K.T.)
| | - Kahn Tasker
- Department of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; (S.C.); (K.T.)
| | - Linda Bowden
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; (B.T.M.); (L.B.); (L.D.)
| | - Liesje Donkin
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; (B.T.M.); (L.B.); (L.D.)
| | - Sarah E. Hetrick
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; (B.T.M.); (L.B.); (L.D.)
- Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Melbourne, Victoria 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne 3010, Australia
| |
Collapse
|
30
|
Dodemaide P, Joubert L, Merolli M, Hill N. Exploring the Therapeutic and Nontherapeutic Affordances of Social Media Use by Young Adults with Lived Experience of Self-Harm or Suicidal Ideation: A Scoping Review. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2019; 22:622-633. [DOI: 10.1089/cyber.2018.0678] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Paul Dodemaide
- Department of Social Work, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Lynette Joubert
- Department of Social Work, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Mark Merolli
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
- Health and Biomedical Informatics Centre, University of Melbourne, Parkville, Australia
| | - Nicole Hill
- Department of Social Work, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
31
|
Liu X, Liu X, Sun J, Yu NX, Sun B, Li Q, Zhu T. Proactive Suicide Prevention Online (PSPO): Machine Identification and Crisis Management for Chinese Social Media Users With Suicidal Thoughts and Behaviors. J Med Internet Res 2019; 21:e11705. [PMID: 31344675 PMCID: PMC6682269 DOI: 10.2196/11705] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/02/2018] [Accepted: 03/30/2019] [Indexed: 12/29/2022] Open
Abstract
Background Suicide is a great public health challenge. Two hundred million people attempt suicide in China annually. Existing suicide prevention programs require the help-seeking initiative of suicidal individuals, but many of them have a low motivation to seek the required help. We propose that a proactive and targeted suicide prevention strategy can prompt more people with suicidal thoughts and behaviors to seek help. Objective The goal of the research was to test the feasibility and acceptability of Proactive Suicide Prevention Online (PSPO), a new approach based on social media that combines proactive identification of suicide-prone individuals with specialized crisis management. Methods We first located a microblog group online. Their comments on a suicide note were analyzed by experts to provide a training set for the machine learning models for suicide identification. The best-performing model was used to automatically identify posts that suggested suicidal thoughts and behaviors. Next, a microblog direct message containing crisis management information, including measures that covered suicide-related issues, depression, help-seeking behavior and an acceptability test, was sent to users who had been identified by the model to be at risk of suicide. For those who replied to the message, trained counselors provided tailored crisis management. The Simplified Chinese Linguistic Inquiry and Word Count was also used to analyze the users’ psycholinguistic texts in 1-month time slots prior to and postconsultation. Results A total of 27,007 comments made in April 2017 were analyzed. Among these, 2786 (10.32%) were classified as indicative of suicidal thoughts and behaviors. The performance of the detection model was good, with high precision (.86), recall (.78), F-measure (.86), and accuracy (.88). Between July 3, 2017, and July 3, 2018, we sent out a total of 24,727 direct messages to 12,486 social media users, and 5542 (44.39%) responded. Over one-third of the users who were contacted completed the questionnaires included in the direct message. Of the valid responses, 89.73% (1259/1403) reported suicidal ideation, but more than half (725/1403, 51.67%) reported that they had not sought help. The 9-Item Patient Health Questionnaire (PHQ-9) mean score was 17.40 (SD 5.98). More than two-thirds of the participants (968/1403, 69.00%) thought the PSPO approach was acceptable. Moreover, 2321 users replied to the direct message. In a comparison of the frequency of word usage in their microblog posts 1-month before and after the consultation, we found that the frequency of death-oriented words significantly declined while the frequency of future-oriented words significantly increased. Conclusions The PSPO model is suitable for identifying populations that are at risk of suicide. When followed up with proactive crisis management, it may be a useful supplement to existing prevention programs because it has the potential to increase the accessibility of antisuicide information to people with suicidal thoughts and behaviors but a low motivation to seek help.
Collapse
Affiliation(s)
- Xingyun Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xiaoqian Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jiumo Sun
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Bingli Sun
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Qing Li
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
32
|
Glenn CR, Esposito EC, Porter AC, Robinson D. Evidence Base Update of Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2019; 48:357-392. [PMID: 31046461 PMCID: PMC6534465 DOI: 10.1080/15374416.2019.1591281] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The current review provides an evidence base update of psychosocial treatments for self-injurious thoughts and behaviors (SITBs) in youth. A systematic search was conducted of 2 major scientific databases (PsycInfo and PubMed) and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) published prior to June 2018. The search identified 26 RCTs examining interventions for SITBs in youth: 17 were included in the 2015 review and 9 trials were new to this update. The biggest change since the prior review was the evaluation of Dialectical Behavior Therapy for adolescents (DBT-A) as the first Level 1: Well-established intervention for reducing deliberate self-harm (composite of nonsuicidal and suicidal self-injury) and suicide ideation in youth and Level 2: Probably efficacious for reducing nonsuicidal self-injury and suicide attempts. Five other interventions were rated as Level 2: Probably efficacious for reducing SITBs in youth, with the new addition of Integrated Family Therapy. This evidence base update indicates that there are a few promising treatments for reducing SITBs in youth. Efficacious interventions typically include a significant family or parent training component as well as skills training (e.g., emotion regulation skills). Aside from DBT-A, few treatments have been examined in more than one RCT. Given that replication by independent research groups is needed to evaluate an intervention as Well-established, future research should focus on replicating the five promising interventions currently evaluated as Probably efficacious. In addition, an important future direction is to develop brief efficacious interventions that may be scalable to reach large numbers of youth.
Collapse
|
33
|
Reyes-Portillo JA, Lake AM, Kleinman M, Gould MS. The Relation between Descriptive Norms, Suicide Ideation, and Suicide Attempts among Adolescents. Suicide Life Threat Behav 2019; 49:535-546. [PMID: 29470851 PMCID: PMC6105573 DOI: 10.1111/sltb.12446] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 01/10/2018] [Indexed: 11/30/2022]
Abstract
This study examined the relationship between adolescents' beliefs about the prevalence of youth suicide ideation (ideation descriptive norms) and suicide attempts (attempt descriptive norms) with self-reported suicide ideation and attempts. Descriptive norms, suicide ideation, and suicide attempts as well as gender, race/ethnicity, and exposure to family, peer, and others' suicide were assessed in 2,109 students at six suburban New York State high schools. After controlling for demographic variables and exposure to suicide, elevated ideation descriptive norms and attempt descriptive norms were associated with higher rates of suicide ideation and lifetime suicide attempts among adolescents. Adolescents who believed suicide ideation and attempts to be more widespread among peers (i.e., elevated ideation and attempt descriptive norms) were more likely to endorse suicide ideation and attempts. Correcting these descriptive norms may be a worthwhile goal for school-based suicide prevention programs.
Collapse
Affiliation(s)
- Jazmin A. Reyes-Portillo
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute (NYSPI)/Columbia University Medical Center, 1051 Riverside Drive, Box 74, New York, NY 10032
| | - Alison M. Lake
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute (NYSPI)/Columbia University Medical Center, 1051 Riverside Drive, Box 74, New York, NY 10032
| | - Marjorie Kleinman
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute (NYSPI)/Columbia University Medical Center, 1051 Riverside Drive, Box 74, New York, NY 10032
| | - Madelyn S. Gould
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute (NYSPI)/Columbia University Medical Center, 1051 Riverside Drive, Box 74, New York, NY 10032,Department of Epidemiology (School of Public Health), Columbia University, 722 W 168th St, New York, NY 10032
| |
Collapse
|
34
|
Garrido S, Millington C, Cheers D, Boydell K, Schubert E, Meade T, Nguyen QV. What Works and What Doesn't Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People. Front Psychiatry 2019; 10:759. [PMID: 31798468 PMCID: PMC6865844 DOI: 10.3389/fpsyt.2019.00759] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/20/2019] [Indexed: 12/21/2022] Open
Abstract
Background: A major challenge in providing mental health interventions for young people is making such interventions accessible and appealing to those most in need. Online and app-based forms of therapy for mental health are burgeoning. It is therefore crucial to identify features that are most effective and engaging for young users. Objectives: This study reports a systematic review and meta-analysis of digital mental health interventions and their effectiveness in addressing anxiety and depression in young people to determine factors that relate to outcomes, adherence, and engagement with such interventions. Methods: A mixed methods approach was taken, including a meta-analysis of 9 randomized controlled trials that compared use of a digital intervention for depression in young people to a no-intervention control group, and 6 comparing the intervention to an active control condition. A thematic analysis and narrative synthesis of 41 studies was also performed. Results: The pooled effect size of digital mental health interventions on depression in comparison to a no-intervention control was small (Cohen's d = 0.33, 95% CI 0.11 to 0.55), while the pooled effect size of studies comparing an intervention group to an active control showed no significant differences (Cohen's d = 0.14, 95% CI -.04 to 0.31). Pooled effect sizes were higher when supervision was involved (studies with no-intervention controls: Cohen's d = 0.52, 95% CI 0.23 to 0.80; studies with active control: Cohen's d = 0.49, 95% CI -0.11, 1.01). Engagement and adherence rates were low. Qualitative analysis revealed that users liked interventions with a game-like feel and relatable, interactive content. Educational materials were perceived as boring, and users were put off by non-appealing interfaces and technical glitches. Conclusions: Digital interventions work better than no intervention to improve depression in young people when results of different studies are pooled together. However, these interventions may only be of clinical significance when use is highly supervised. Digital interventions do not work better than active alternatives regardless of the level of support. Future interventions need to move beyond the use of digital educational materials, considering other ways to attract and engage young people and to ensure relevance and appeal.
Collapse
Affiliation(s)
- Sandra Garrido
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Milperra, NSW, Australia.,Translational Health Institute, Western Sydney University, Campbelltown, NSW, Australia.,School of Social Sciences & Psychology, Western Sydney University, Milperra, NSW, Australia
| | - Chris Millington
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Milperra, NSW, Australia
| | - Daniel Cheers
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Milperra, NSW, Australia.,NSW Health, Sydney, NSW, Australia
| | | | - Emery Schubert
- School of Arts & Humanities, University of New South Wales, Kensington, NSW, Australia
| | - Tanya Meade
- School of Social Sciences & Psychology, Western Sydney University, Milperra, NSW, Australia
| | - Quang Vinh Nguyen
- School of Computing & Engineering, Western Sydney University, Parramatta, NSW, Australia
| |
Collapse
|
35
|
Tutus D, Plener PL, Niemitz M. [Quality criteria of internet-based cognitive-behavioral interventions for children and adolescents and their parents - A systematic review]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2018; 48:57-75. [PMID: 30526289 DOI: 10.1024/1422-4917/a000640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Quality criteria of internet-based cognitive-behavioral interventions for children and adolescents and their parents - A systematic review Abstract. Introduction: This study provides an overview of existing internet-based evidence-based cognitive behavioral interventions (iCBT) for children/adolescents and their parents. The studies were evaluated based on preliminary defined quality criteria regarding their usability in the healthcare system. Methods: The review was performed according to PRISMA guidelines and evaluated the scientific literature concerning to iCBT. We conducted a comprehensive literature search of PubMed, PsychINFO, PsychARTICLES, PsychNDEX and Science Direct using relevant keywords. Studies were rated according to 10 previously predefined quality measures. Results: A total of 4,479 articles were screened, 62 of which were selected for further analysis. Thereof, 24 international iCBT programs with 50 randomized controlled trials (RCTs) were evaluated and met the quality criteria (M = 7.25, SD = 1.07). Further 13 publications showed preliminary efficacy for another 11 international iCBT programs and met the quality criteria (M = 7.45, SD = .82). There was no significant difference between programs evaluated within and without RCTs t(33) = -.56, p = .58. Conclusions: Our results indicate that multiple international iCBT programs exist. Because in Germany the waiting time for psychotherapeutic or psychiatric treatment is still about five months, iCBT programs have the potential to reduce this gap.
Collapse
Affiliation(s)
- Dunja Tutus
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland
| | - Paul L Plener
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland.,Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Österreich
| | - Mandy Niemitz
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland
| |
Collapse
|
36
|
Robinson J, Bailey E, Witt K, Stefanac N, Milner A, Currier D, Pirkis J, Condron P, Hetrick S. What Works in Youth Suicide Prevention? A Systematic Review and Meta-Analysis. EClinicalMedicine 2018; 4-5:52-91. [PMID: 31193651 PMCID: PMC6537558 DOI: 10.1016/j.eclinm.2018.10.004] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Young people require specific attention when it comes to suicide prevention, however efforts need to be based on robust evidence. METHODS We conducted a systematic review and meta-analysis of all studies examining the impact of interventions that were specifically designed to reduce suicide-related behavior in young people. FINDINGS Ninety-nine studies were identified, of which 52 were conducted in clinical settings, 31 in educational or workplace settings, and 15 in community settings. Around half were randomized controlled trials. Large scale interventions delivered in both clinical and educational settings appear to reduce self-harm and suicidal ideation post-intervention, and to a lesser extent at follow-up. In community settings, multi-faceted, place-based approaches seem to have an impact. Study quality was limited. INTERPRETATION Overall whilst the number and range of studies is encouraging, gaps exist. Few studies were conducted in low-middle income countries or with demographic populations known to be at increased risk. Similarly, there was a lack of studies conducted in primary care, universities and workplaces. However, we identified that specific youth suicide-prevention interventions can reduce self-harm and suicidal ideation; these types of intervention need testing in high-quality studies.
Collapse
Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
| | - Eleanor Bailey
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
| | - Katrina Witt
- Turning Point, Eastern Health Clinical School, Monash University, 110 Church Street, Richmond, VIC 3121, Australia
| | - Nina Stefanac
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
| | - Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie Street, Vic 3010, Australia
| | - Dianne Currier
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie Street, Vic 3010, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie Street, Vic 3010, Australia
| | - Patrick Condron
- University Library, The University of Melbourne, Parkville, Vic 3010, Australia
| | - Sarah Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Vic 3052, Australia
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Support Building Auckland Hospital, 2 Park Rd, Auckland 1142, New Zealand
| |
Collapse
|
37
|
Arora T, Albahri A, Omar OM, Sharara A, Taheri S. The Prospective Association Between Electronic Device Use Before Bedtime and Academic Attainment in Adolescents. J Adolesc Health 2018; 63:451-458. [PMID: 30286900 DOI: 10.1016/j.jadohealth.2018.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/13/2018] [Accepted: 04/15/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine longitudinal associations between five commonly used technology devices prior to bedtime and real-life academic outcomes in adolescents. METHODS A total of 853 adolescents were recruited to a three-year prospective cohort study, with annual assessments. Academic grades/levels for three core subjects (English, Mathematics, and Science) were extracted from school records, and standardized (z-scores) were derived at the end of each academic year. A validated questionnaire was used to determine the frequency of using five types of technology (television viewing, video gaming, mobile telephone use, listening to music, and social networking) before bedtime. RESULTS After adjustment, English attainment was the subject most affected by prebedtime technology use, where three of five technologies assessed were negatively and prospectively associated (social networking [β = -.07 and p = .024], video gaming [β = -.10 and p = .008], and mobile telephone [β = -.07 and p=.017]). Social networking (β = -.07and p = .042), television viewing (β = -.08 and p = .044), and mobile telephones (β = -.07 and p = .031) were associated with significant impairment in English for girls whereas attainment in boys was most impaired by video gaming (β = -.12 and p = .014). CONCLUSIONS The use of electronic devices by adolescents before bedtime may reduce their academic attainment, but apart from video gaming for boys, the negative impact of near bedtime technology use on academic performance is small.
Collapse
Affiliation(s)
- Teresa Arora
- Zayed University, College of Natural and Health Sciences, Abu Dhabi, United Arab Emirates; Department of Medicine, Weill Cornell Medicine, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, New York City, New York; University of Birmingham, Birmingham, United Kingdom
| | - Afnan Albahri
- Clinical Research Core, Research Division, Weill Cornell Medicine in Qatar, Doha, Qatar
| | - Omar M Omar
- Clinical Research Core, Research Division, Weill Cornell Medicine in Qatar, Doha, Qatar
| | - Ahmad Sharara
- Clinical Research Core, Research Division, Weill Cornell Medicine in Qatar, Doha, Qatar
| | - Shahrad Taheri
- Department of Medicine, Weill Cornell Medicine, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, New York City, New York; University of Birmingham, Birmingham, United Kingdom; Clinical Research Core, Research Division, Weill Cornell Medicine in Qatar, Doha, Qatar.
| |
Collapse
|
38
|
Kelleher E, Moreno M, Wilt MP. Recruitment of Participants and Delivery of Online Mental Health Resources for Depressed Individuals Using Tumblr: Pilot Randomized Control Trial. JMIR Res Protoc 2018; 7:e95. [PMID: 29650507 PMCID: PMC5920159 DOI: 10.2196/resprot.9421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 11/30/2022] Open
Abstract
Background Adolescents and young adults frequently post depression symptom references on social media; previous studies show positive associations between depression posts and self-reported depression symptoms. Depression is common among young people and this population often experiences many barriers to mental health care. Thus, social media may be a new resource to identify, recruit, and intervene with young people at risk for depression. Objective The purpose of this pilot study was to test a social media intervention on Tumblr. We used social media to identify and recruit participants and to deliver the intervention of online depression resources. Methods This randomized pilot intervention identified Tumblr users age 15-23 who posted about depression using the search term “#depress”. Eligible participants were recruited via Tumblr messages; consented participants completed depression surveys and were then randomized to an intervention of online mental health resources delivered via a Tumblr message, while control participants did not receive resources. Postintervention online surveys assessed resource access and usefulness and control groups were asked whether they would have liked to receive resources. Analyses included t tests. Results A total of 25 participants met eligibility criteria. The mean age of the participants was 17.5 (SD 1.9) and 65% were female with average score on the Patient Health Questionnaire-9 of 17.5 (SD 5.9). Among the 11 intervention participants, 36% (4/11) reported accessing intervention resources and 64% (7/11) felt the intervention was acceptable. Among the 14 control participants, only 29% (4/14) of reported that receiving resources online would be acceptable (P=.02). Participants suggested anonymity and ease of use as important characteristics in an online depression resource. Conclusions The intervention was appropriately targeted to young people at risk for depression, and recruitment via Tumblr was feasible. Most participants in the intervention group felt the social media approach was acceptable, and about a third utilized the online resources. Participants who had not experienced the intervention were less likely to find it acceptable. Future studies should explore this approach in larger samples. Social media may be an appropriate platform for online depression interventions for young people.
Collapse
Affiliation(s)
- Erin Kelleher
- Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, WA, United States
| | - Megan Moreno
- Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, WA, United States.,University of Washington, Seattle, WA, United States
| | - Megan Pumper Wilt
- Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, WA, United States
| |
Collapse
|
39
|
Abstract
OBJECTIVES Youth suicide rates are unacceptably high. Schools have long been accepted as an appropriate setting for suicide prevention activities. This review aims to synthesise the evidence for all types of suicide prevention interventions across educational settings. METHODS The review draws on two previous reviews conducted by the authors. In order to be included, studies had to test a specific suicide prevention intervention in an educational setting, have a suicide-related outcome and target young people. RESULTS A totally of 21 studies were included: 17 were conducted in school settings and four in universities. Seven of the school-based studies (41%) and one of the university studies (25%) were randomised controlled trials. Overall, the trials conducted in schools reported positive effects, as did four of the non- randomised controlled trials. Two of the university-based studies reported positive effects. Both universal and indicated interventions showed positive results; no iatrogenic effects were reported. CONCLUSIONS School-based studies can have a positive impact on suicide-related behaviour and, overall, do not appear to cause harm. Study quality is variable, and the number of studies conducted in school settings far exceed those conducted in universities. These gaps need to be addressed by future research.
Collapse
Affiliation(s)
- Jo Robinson
- Senior Research Fellow, Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Alison L Calear
- Associate Professor, Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Eleanor Bailey
- Research Assistant, Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| |
Collapse
|
40
|
Incidence of suicide, hospital-presenting non-fatal self-harm, and community-occurring non-fatal self-harm in adolescents in England (the iceberg model of self-harm): a retrospective study. Lancet Psychiatry 2018; 5:167-174. [PMID: 29246453 DOI: 10.1016/s2215-0366(17)30478-9] [Citation(s) in RCA: 170] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Little is known about the relative incidence of fatal and non-fatal self-harm in young people. We estimated the incidence of suicide, hospital-presenting non-fatal self-harm, and community-occurring non-fatal self-harm in adolescents in England. METHODS We used national mortality statistics (Jan 1, 2011, to Dec 31, 2013), hospital monitoring data for five hospitals derived from the Multicentre Study of Self-Harm in England (Jan 1, 2011, to Dec 31, 2013), and data from a schools survey (2015) to estimate the incidence of fatal and non-fatal self-harm per 100 000 person-years in adolescents aged 12-17 years in England. We described these incidences in terms of an iceberg model of self-harm. FINDINGS During 2011-13, 171 adolescents aged 12-17 years died by suicide in England (119 [70%] male and 133 [78%] aged 15-17 years) and 1320 adolescents presented to the study hospitals following non-fatal self-harm (1028 [78%] female and 977 [74%] aged 15-17 years). In 2015, 322 (6%) of 5506 adolescents surveyed reported self-harm in the past year in the community (250 [78%] female and 164 [51%] aged 15-17 years). In 12-14 year olds, for every boy who died by suicide, 109 attended hospital following self-harm and 3067 reported self-harm in the community, whereas for every girl who died by suicide, 1255 attended hospital for self-harm and 21 995 reported self-harm in the community. In 15-17 year olds, for every male suicide, 120 males presented to hospital with self-harm and 838 self-harmed in the community; whereas for every female suicide, 919 females presented to hospital for self-harm and 6406 self-harmed in the community. Hanging or asphyxiation was the most common method of suicide (125 [73%] of 171), self-poisoning was the main reason for presenting to hospital after self-harm (849 [71%] of 1195), and self-cutting was the main method of self-harm used in the community (286 [89%] of 322). INTERPRETATION Ratios of fatal to non-fatal rates of self-harm differed between males and females and between adolescents aged 12-14 years and 15-17 years, with a particularly large number of females reporting self-harm in the community. Our findings emphasise the need for well resourced community and hospital-based mental health services for adolescents, with greater investment in school-based prevention. FUNDING UK Department of Health.
Collapse
|
41
|
Muñoz-Sánchez JL, Delgado C, Parra-Vidales E, Franco-Martín M. Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study. JMIR Ment Health 2018; 5:e7. [PMID: 29367183 PMCID: PMC5803527 DOI: 10.2196/mental.7784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/05/2017] [Accepted: 10/29/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. OBJECTIVE The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. METHODS Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. RESULTS Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. CONCLUSIONS Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders.
Collapse
Affiliation(s)
| | - Carmen Delgado
- Faculty of Psychology, Universidad Pontificia de Salamanca, Salamanca, Spain
| | | | | |
Collapse
|
42
|
Witt K, Spittal MJ, Carter G, Pirkis J, Hetrick S, Currier D, Robinson J, Milner A. Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. BMC Psychiatry 2017; 17:297. [PMID: 28810841 PMCID: PMC5558658 DOI: 10.1186/s12888-017-1458-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/08/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Online and mobile telephone applications ('apps') have the potential to improve the scalability of effective interventions for suicidal ideation and self-harm. The aim of this review was therefore to investigate the effectiveness of digital interventions for the self-management of suicidal ideation or self-harm. METHODS Seven databases (Applied Science & Technology; CENTRAL; CRESP; Embase; Global Health; PsycARTICLES; PsycINFO; Medline) were searched to 31 March, 2017. Studies that examined the effectiveness of digital interventions for suicidal ideation and/or self-harm, or which reported outcome data for suicidal ideation and/or self-harm, within a randomised controlled trial (RCT), pseudo-RCT, or observational pre-test/post-test design were included in the review. RESULTS Fourteen non-overlapping studies were included, reporting data from a total of 3,356 participants. Overall, digital interventions were associated with reductions for suicidal ideation scores at post-intervention. There was no evidence of a treatment effect for self-harm or attempted suicide. CONCLUSIONS Most studies were biased in relation to at least one aspect of study design, and particularly the domains of participant, clinical personnel, and outcome assessor blinding. Performance and detection bias therefore cannot be ruled out. Digital interventions for suicidal ideation and self-harm may be more effective than waitlist control. It is unclear whether these reductions would be clinically meaningful at present. Further evidence, particularly with regards to the potential mechanisms of action of these interventions, as well as safety, is required before these interventions could recommended.
Collapse
Affiliation(s)
- Katrina Witt
- Population Health, Turning Point, Eastern Health Clinical School, Monash University, 54-62 Gertrude Street, Fitzroy, Victoria, 3065, Australia.
| | - Matthew J. Spittal
- 0000 0001 2179 088Xgrid.1008.9Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria Australia
| | - Gregory Carter
- 0000 0000 8831 109Xgrid.266842.cCentre for Translational Neuroscience and Mental Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - Jane Pirkis
- 0000 0001 2179 088Xgrid.1008.9Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria Australia
| | - Sarah Hetrick
- 0000 0001 2179 088Xgrid.1008.9Orygen, the National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria Australia
| | - Dianne Currier
- 0000 0001 2179 088Xgrid.1008.9Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria Australia
| | - Jo Robinson
- 0000 0001 2179 088Xgrid.1008.9Orygen, the National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria Australia
| | - Allison Milner
- 0000 0001 2179 088Xgrid.1008.9Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria Australia
| |
Collapse
|
43
|
Brown RC. [Psychotherapeutic interventions for suicidal adolescents – a systematic review of the current literature]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 45:499-508. [PMID: 28771078 DOI: 10.1024/1422-4917/a000538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although suicidal thoughts and behaviors are common in adolescents, the German guidelines for suicidality in children and adolescents state a lack of evidence for the effectiveness of specific psychotherapies for those patients. The aim of this systematic review was to summarize and critically discuss newest advances in the evaluation of specific therapeutic approaches for suicidality in youths. Building on other recent systematic reviews, 11 manuscripts published between 2013 and 2017 were included in this review. Included are studies on interventions in emergency departments, psychotherapeutic approaches specifically targeting suicidality despite other psychopathology, interventions for youth with specific disorders or risk-factors, and one study evaluating an online-intervention. First positive effects can be claimed for family interventions in emergency departments (regarding lower hospitalization rates) as well as cognitive-behavioral, dialectical-behavioral, and family-oriented interventions (regarding reducing suicidality). Promising results were also found in a pilot study on an online-intervention. However, further research is necessary, as replication of outcomes has not been attempted or published in most cases and studies including large sample sizes with long-term follow-up evaluation are very rare.
Collapse
Affiliation(s)
- Rebecca C Brown
- 1 Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Ulm
| |
Collapse
|
44
|
Hetrick SE, Yuen HP, Bailey E, Cox GR, Templer K, Rice SM, Bendall S, Robinson J. Internet-based cognitive behavioural therapy for young people with suicide-related behaviour (Reframe-IT): a randomised controlled trial. EVIDENCE-BASED MENTAL HEALTH 2017; 20:76-82. [PMID: 28701336 PMCID: PMC10688548 DOI: 10.1136/eb-2017-102719] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 06/16/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Suicide-related behaviours are common in young people and associated with a range of negative outcomes. There are few evidence-based interventions; however, cognitive behavioural therapy (CBT) shows promise. Internet delivery of CBT is popular, with potential to increase reach and accessibility. OBJECTIVE To test the effectiveness of an internet-based CBT program (Reframe-IT) in reducing suicide-related behaviours, depression, anxiety, hopelessness and improving problem solving and cognitive and behavioural skills in school students with suicide-related behaviours. METHODS A parallel randomised controlled trial testing the effectiveness of Reframe-IT plus treatment as usual (TAU) compared with TAU alone in reducing suicidal ideation, suicide attempts, depression, hopelessness, symptoms of anxiety, negative problem orientation and cognitive and behavioural skill acquisition was undertaken. We recruited students experiencing suicidal ideation from 18 schools in Melbourne, Australia, between August 2013 and December 2016. The intervention comprised eight modules of CBT delivered online over 10 weeks with assessments conducted at baseline, 10 weeks and 22 weeks. FINDINGS Only 50 of the planned 169 participants were recruited. There were larger improvements in the Reframe-IT group compared with the TAU group for the primary outcome of suicidal ideation (intervention -61.6, SD 41.6; control -47.1, SD 42.3, from baseline to 22-week follow-up intervention); however, differences were non-significant (p=0.593). There were no increases in distress in the majority of participants (91.1%) after completion of each module. Changes in depression and hopelessness partly mediated the effect of acquisition of CBT skills on suicidal ideation. CONCLUSIONS The trial was underpowered due to difficulties recruiting participants as a result of the complex recruitment procedures that were used to ensure safety of participants. Although there were no significant differences between groups, young people were safely and generally well engaged in Reframe-IT and experienced decreases in suicidal ideation and other symptoms as well as improvements in CBT skills. The study is the first online intervention trial internationally to include young people demonstrating all levels of suicide risk. CLINICAL IMPLICATIONS Integration of internet-delivered interventions for young people with suicide-related behaviour may result in reductions in these behaviours. Further research is needed, but researchers should feel more confident about being able to safely undertake research with young people who experience these behaviours. TRIAL REGISTRATION NUMBER ACTRN12613000864729.
Collapse
Affiliation(s)
- Sarah E Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hok P Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eleanor Bailey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Georgina R Cox
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Templer
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simon M Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen Youth Health, Melbourne, Victoria, Australia
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
45
|
Martínez-Miranda J. Embodied Conversational Agents for the Detection and Prevention of Suicidal Behaviour: Current Applications and Open Challenges. J Med Syst 2017; 41:135. [PMID: 28755270 DOI: 10.1007/s10916-017-0784-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/19/2017] [Indexed: 11/30/2022]
Abstract
Embodied conversational agents (ECAs) are advanced computational interactive interfaces designed with the aim to engage users in the continuous and long-term use of a background application. The advantages and benefits of these agents have been exploited in several e-health systems. One of the medical domains where ECAs are recently applied is to support the detection of symptoms, prevention and treatment of mental health disorders. As ECAs based applications are increasingly used in clinical psychology, and due that one fatal consequence of mental health problems is the commitment of suicide, it is necessary to analyse how current ECAs in this clinical domain support the early detection and prevention of risk situations associated with suicidality. The present work provides and overview of the main features implemented in the ECAs to detect and prevent suicidal behaviours through two scenarios: ECAs acting as virtual counsellors to offer immediate help to individuals in risk; and ECAs acting as virtual patients for learning/training in the identification of suicide behaviours. A literature review was performed to identify relevant studies in this domain during the last decade, describing the main characteristics of the implemented ECAs and how they have been evaluated. A total of six studies were included in the review fulfilling the defined search criteria. Most of the experimental studies indicate promising results, though these types of ECAs are not yet commonly used in routine practice. The identification of some open challenges for the further development of ECAs within this domain is also discussed.
Collapse
Affiliation(s)
- Juan Martínez-Miranda
- CONACYT - Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica, Tepic, Mexico.
| |
Collapse
|
46
|
Niederkrotenthaler T, Haider A, Till B, Mok K, Pirkis J. Comparison of Suicidal People Who Use the Internet for Suicide-Related Reasons and Those Who Do Not. CRISIS 2016; 38:131-135. [PMID: 27733060 DOI: 10.1027/0227-5910/a000432] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies have shown that suicidal individuals who use the Internet for suicide-related purposes are more suicidal than nonsuicide-related users, but evidence from European countries is lacking. AIMS We assessed differences between suicidal individuals who go online for suicide-related purposes and other suicidal individuals in Austria. METHOD Participants were 53 individuals aged between 18 and 24 years who felt suicidal in the past year and completed an anonymous online survey. RESULTS Individuals who went online for suicide-related purposes were more suicidal, and more depressed, compared with individuals who did not use the Internet for suicide-related purposes. There were no large differences with regard to social anxiety and perceived barriers for help-seeking between the two groups. CONCLUSION This study finds that suicidal online users are more depressed and suicidal than nonusers in a sample from Central Europe. Online interventions to combat depression and suicidality need to be strengthened to reach out to this important target population.
Collapse
Affiliation(s)
- Thomas Niederkrotenthaler
- 1 Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Vienna, Austria
| | - Anna Haider
- 1 Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Vienna, Austria
| | - Benedikt Till
- 1 Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Vienna, Austria
| | - Katherine Mok
- 2 The University of Melbourne, Melbourne School of Population and Global Health, Centre for Mental Health, Melbourne, VIC, Australia
| | - Jane Pirkis
- 2 The University of Melbourne, Melbourne School of Population and Global Health, Centre for Mental Health, Melbourne, VIC, Australia
| |
Collapse
|
47
|
Rice S, Robinson J, Bendall S, Hetrick S, Cox G, Bailey E, Gleeson J, Alvarez-Jimenez M. Online and Social Media Suicide Prevention Interventions for Young People: A Focus on Implementation and Moderation. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2016; 25:80-86. [PMID: 27274743 PMCID: PMC4879947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 02/23/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Suicide remains a major global public health issue for young people. The reach and accessibility of online and social media-based interventions herald a unique opportunity for suicide prevention. To date, the large body of research into suicide prevention has been undertaken atheoretically. This paper provides a rationale and theoretical framework (based on the interpersonal theory of suicide), and draws on our experiences of developing and testing online and social media-based interventions. METHOD The implementation of three distinct online and social media-based intervention studies, undertaken with young people at risk of suicide, are discussed. We highlight the ways that these interventions can serve to bolster social connectedness in young people, and outline key aspects of intervention implementation and moderation. RESULTS Insights regarding the implementation of these studies include careful protocol development mindful of risk and ethical issues, establishment of suitably qualified teams to oversee development and delivery of the intervention, and utilisation of key aspects of human support (i.e., moderation) to encourage longer-term intervention engagement. CONCLUSIONS Online and social media-based interventions provide an opportunity to enhance feelings of connectedness in young people, a key component of the interpersonal theory of suicide. Our experience has shown that such interventions can be feasibly and safely conducted with young people at risk of suicide. Further studies, with controlled designs, are required to demonstrate intervention efficacy.
Collapse
Affiliation(s)
- Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental Health; The University of Melbourne, Melbourne, Australia
- Youth Mood Clinic, Orygen Youth Health, Melbourne, Australia
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental Health; The University of Melbourne, Melbourne, Australia
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental Health; The University of Melbourne, Melbourne, Australia
| | - Sarah Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental Health; The University of Melbourne, Melbourne, Australia
| | - Georgina Cox
- Orygen, The National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental Health; The University of Melbourne, Melbourne, Australia
| | - Eleanor Bailey
- Orygen, The National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental Health; The University of Melbourne, Melbourne, Australia
| | - John Gleeson
- School of Psychology, Australian Catholic University, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental Health; The University of Melbourne, Melbourne, Australia
| |
Collapse
|
48
|
Robinson J, Cox G, Bailey E, Hetrick S, Rodrigues M, Fisher S, Herrman H. Social media and suicide prevention: a systematic review. Early Interv Psychiatry 2016; 10:103-21. [PMID: 25702826 DOI: 10.1111/eip.12229] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 01/14/2015] [Indexed: 01/13/2023]
Abstract
AIM Social media platforms are commonly used for the expression of suicidal thoughts and feelings, particularly by young people. Despite this, little is known about the ways in which social media can be used for suicide prevention. The aim of this study was to conduct a systematic review to identify current evidence pertaining to the ways in which social media are currently used as a tool for suicide prevention. METHODS Medline, PsycInfo, Embase, CINHAL and the Cochrane Library were searched for articles published between 1991 and April 2014. English language articles with a focus on suicide-related behaviour and social media were included. No exclusion was placed on study design. RESULTS Thirty studies were included; 4 described the development of social media sites designed for suicide prevention, 6 examined the potential of social media in terms of its ability to reach or identify people at risk of suicide, 15 examined the ways in which people used social media for suicide prevention-related purposes, and 5 examined the experiences of people who had used social media sites for suicide prevention purposes. No intervention studies were identified. CONCLUSION Social media platforms can reach large numbers of otherwise hard-to-engage individuals, may allow others to intervene following an expression of suicidal ideation online, and provide an anonymous, accessible and non-judgmental forum for sharing experiences. Challenges include difficulties controlling user behaviour and accurately assessing risk, issues relating to privacy and confidentiality and the possibility of contagion. Social media appears to hold significant potential for suicide prevention; however, additional research into its safety and efficacy is required.
Collapse
Affiliation(s)
- Jo Robinson
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Georgina Cox
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Eleanor Bailey
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Sarah Hetrick
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Maria Rodrigues
- Community Works Associates Pty Ltd, Docklands, Victoria, Australia
| | - Steve Fisher
- Community Works Associates Pty Ltd, Docklands, Victoria, Australia
| | - Helen Herrman
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
49
|
Ten Recommendations for Effective School-Based, Adolescent, Suicide Prevention Programs. SCHOOL MENTAL HEALTH 2016. [DOI: 10.1007/s12310-016-9189-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
50
|
Abstract
OBJECTIVE To systematically review research on how people use the Internet for suicide-related reasons and its influence on users. This review summarises the main findings and conclusions of existing work, the nature of studies that have been conducted, their strengths and limitations, and directions for future research. METHOD An online search was conducted through PsycINFO, PubMed, Ovid MEDLINE and CINAHL databases for papers published between 1991 and 2014. Papers were included if they examined how the Internet was used for suicide-related reasons, the influence of suicide-related Internet use, and if they presented primary data, including case studies of Internet-related suicide attempts and completions. RESULTS Findings of significant relationships between suicide-related search trends and rates of suicide suggest that search trends may be useful in monitoring suicide risk in a population. Studies that examine online communications between people who are suicidal can further our understanding of individuals' suicidal experiences. While engaging in suicide-related Internet use was associated with higher levels of suicidal ideation, evidence of its influence on suicidal ideation over time was mixed. There is a lack of studies directly recruiting suicidal Internet users. Only case studies examined the influence of suicide-related Internet use on suicidal behaviours, while no studies assessed the influence of pro-suicide or suicide prevention websites. Online professional services can be useful to suicide prevention and intervention efforts, but require more work in order to demonstrate their efficacy. CONCLUSIONS Research has shown that individuals use the Internet to search for suicide-related information and to discuss suicide-related problems with one another. However, the causal link between suicide-related Internet use and suicidal thoughts and behaviours is still unclear. More research is needed, particularly involving direct contact with Internet users, in order to understand the impact of both informal and professionally moderated suicide-related Internet use.
Collapse
Affiliation(s)
- Katherine Mok
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| |
Collapse
|