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Jeong H, Yim HW, Lee SY, Park M, Ko W. The effectiveness of a suicide prevention program in primary care clinics supported by community public health resources: A difference-in-differences analysis. Psychiatry Res 2024; 334:115803. [PMID: 38412714 DOI: 10.1016/j.psychres.2024.115803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 02/29/2024]
Abstract
The importance of appropriate and intensive follow-up management for individuals identified with suicide risk through screening is highlighted. The Link between Primary Care Clinic and Public Health Resources Intervention(LinkPC-PH), a suicide prevention program in primary care clinics supported by community public health resources, was implemented at the district level in 2017. The purpose of the present study is to evaluate the effectiveness of the LinkPC-PH intervention by comparing suicide rates before(2014-2016) and after(2017-2019) implementation of the intervention using a difference-in-differences design. The LinkPC-PH comprises several dimensions of intervention including screening, risk assessment of suicidality, and referral in primary care clinics and crisis contact within 24 hours, case management, and safety planning led by public health professionals. After adjustment for district-level confounders, an intervention-implemented district had 2.87 fewer suicide deaths per 100,000 people in a population sample at post-intervention than would have been expected from the same trend in suicide rates as non-implemented intervention districts. In other words, the suicide rate in the intervention area decreased by 25% following the intervention. These results empirically substantiate suicide prevention programs in primary care clinics by community public health resources for reduced suicide rates to support effective community-based suicide prevention interventions.
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Affiliation(s)
- Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Rep. of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Rep. of Korea.
| | - Seung-Yup Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Rep of Korea
| | - Misun Park
- Department of Biostatistics, Clinical Research Coordinating Center, The Catholic University of Korea, Seoul, Rep of Korea
| | - Woolim Ko
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Rep. of Korea
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Newell S, Rynerson A, Gade P, Bahraini NH, Denneson LM, Dobscha SK. What Now?: Experiences of VHA patients following disclosure of suicidal ideation in primary care and mental health settings. Gen Hosp Psychiatry 2024; 87:7-12. [PMID: 38266442 PMCID: PMC10939769 DOI: 10.1016/j.genhosppsych.2024.01.004] [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] [Received: 08/18/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE While screening and treatment options for patients who disclose suicidal ideation in clinical settings have grown in recent decades, little is known about patient experiences following disclosure. We characterize patient perspectives of responses following disclosure of suicidal ideation in Veteran Health Administration (VHA) primary care and mental health settings. METHOD Qualitative thematic analysis using a conventional/directed hybrid approach. RESULTS A national sample comprised of sixty participants who recently screened for suicidal ideation in primary care (n = 28) and mental health (n = 32) settings completed interviews. Many patients described therapeutic experiences following disclosure, including caring staff, timely follow-up care, and offers of multiple treatment options. Other patients, however, reported deficits in staff empathy, long waits for follow-up care, or inadequate treatment options. CONCLUSIONS While many VA clinical settings provided empathic and helpful responses, these experiences were not universal. Our findings reinforce the importance of a patient-centered approach to screening and response to disclosure, including collaboration with patients in treatment planning. Improved follow-up care coordination processes are needed. Following disclosure, contact with the staff who received the disclosure also helps patients feel cared about, and provides opportunity to troubleshoot barriers a patient may experience in accessing care.
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Affiliation(s)
- Summer Newell
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States.
| | - Annabelle Rynerson
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
| | - Praful Gade
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
| | - Nazanin H Bahraini
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center, Aurora, CO, United States of America; Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz School of Medicine, Aurora, CO, United States of America; Department of Psychiatry University of Colorado, Anschutz School of Medicine, Aurora, CO, United States of America
| | - Lauren M Denneson
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States; Department of Psychiatry, Oregon Health & Sciences University, Portland, OR, United States
| | - Steven K Dobscha
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States; Department of Psychiatry, Oregon Health & Sciences University, Portland, OR, United States
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Richards H, Rajaram G, Lamblin M, Knott J, Connolly O, Hetrick S, Robinson J. Staff perceptions of barriers to self-harm care in the emergency department: A cross-sectional survey study. Australas Emerg Care 2024; 27:15-20. [PMID: 37516604 DOI: 10.1016/j.auec.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Emergency departments (EDs) are often the first point of contact for people with self-harm; however, they do not always receive optimal care. The study objective was to examine the perspectives of ED staff who respond to self-harm presentations, perceived barriers to providing optimal, guideline-concordant care, and staff's familiarity with existing guidelines. METHODS An online cross-sectional survey comprising purpose-designed questions concerning self-harm in the ED was completed by 131 staff (83.2% nurses) from two hospitals in Victoria, Australia. Survey results were analysed using Stata version 16 and frequencies and percentages were calculated. RESULTS Respondents reported knowledge of how to appropriately manage a person presenting with self-harm. However, lack of space (62.3%) and time (78.7%) to conduct the appropriate assessments, lack of self-harm training (71.8%), and limited awareness of or access to guidelines and recommendations for self-harm management within the ED (63.6%), were identified as primary barriers to their ability to appropriately manage these presenters. CONCLUSIONS Improvements to the ED environment and processes, as well as the provision of regular self-harm specific education and training for all ED staff are needed. Implementation of best-practice standards should prioritise guideline-concordant care, with a particular focus on the education needs of nursing staff.
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Affiliation(s)
- Hannah Richards
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Department of Medical Education, The University of Melbourne, VIC, Australia.
| | - Gowri Rajaram
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Department of Medical Education, The University of Melbourne, VIC, Australia
| | - Michelle Lamblin
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Department of Medical Education, The University of Melbourne, VIC, Australia
| | - Jonathan Knott
- Royal Melbourne Hospital, VIC, Australia; Department of Critical Care, The University of Melbourne, VIC, Australia; Department of Medical Education, The University of Melbourne, VIC, Australia
| | | | - Sarah Hetrick
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Department of Medical Education, The University of Melbourne, VIC, Australia; University of Auckland, Auckland, New Zealand
| | - Jo Robinson
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Department of Medical Education, The University of Melbourne, VIC, Australia
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Viard MC, Grandgenèvre P, Bubrovszky M, Coisne E, Plancke L, Notredame CE, Wathelet M. [Impact of the suicidal crisis intervention training program on the confidence and skills of hospital professionals in the Hauts-de-France region]. L'ENCEPHALE 2023; 49:504-509. [PMID: 35985851 DOI: 10.1016/j.encep.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Suicide is a major public health issue given its huge human and economic consequences. Symptoms prior to suicide are often not specific. Nevertheless, the majority of suicidal people express suicidal thoughts, and nearly one in two meet a health professional in the period preceding the act. Being able to recognize the warnings and intervene during the suicidal crisis, defined as a mental crisis where the major risk is suicide, is to seize the opportunity to postpone the suicidal plan and to gain time to implement in place lasting strategies to combat suffering. Thus, the training for suicidal crisis intervention is a major axis of the suicide prevention strategy. Recently, crisis intervention training programs have been updated with knowledge accumulated since the early 2000's. In France, one of the countries most concerned by suicide, the Hauts-de-France region is one of the most impacted. In this context, the Regional Health Agency of Hauts-de-France included in its Regional Health Program of 2018-2023 the training of healthcare workers who work with high suicidal risk patients. The suicidal crisis intervention training program (SCIT) has been introduced to hospital staffs in Hauts-de-France. The purpose of this study was to evaluate this program. METHODS Eight training sessions with 15 to 21 participants were carried out from 2019 November to 2021 January in the Hauts-de-France region. Participants were volunteer healthcare professionals in direct contact with suicidal crisis patients. The training included three modules. The first one concerned the suicidal crisis intervention training: definition of the suicidal crisis, typology of the crisis, vulnerability development, crisis evaluation and crisis intervention practice. The second concerned the evaluation with the RED scale (Risk-Emergency-Danger) and the adequate patient orientation to a psychiatric unit. The third was dedicated to the Gatekeeper training with the constitution of a Gatekeeper network to enhance the capacity to detect suicidal risk and to orient the concerned person towards an adequate evaluation or care organization. We evaluated the first two levels of the Kirkpatrick's model: level 1) the participant's satisfaction (rated out of 10), and level 2) the degree of confidence in their professional abilities (rated out of 10) and their skills in responding to a person in a suicidal crisis (using the SIRI-2-VF - French version of the Suicide Intervention Response Inventory-2). The participants were interviewed before (T0), just after (T1) and at one month of training (T2). RESULTS Among the 141 health professionals who followed the training, 139 answered the questionnaire at least one time (13 psychologists, 22 doctors, 97 nurses and 7 head nurses). The participation rates were 99.3 % at T0, 96.4 % at T1 and 46.0 % at T2. Most of the participants were nurses (69.8 %), and 33.1 % of the respondents declared they had already followed a suicidal crisis training. The satisfaction with the training was evaluated at 8.6 (± 1.3) out of 10. There was no significant difference among the professions, neither between those having already received or not a previous training. The self-perceived capacity to manage a suicidal crisis was rate 6.8 (± 1.8) out of 10 at T0. There was a significant increase just after the training (8.1±1.2 vs 6,8±1,8, p<0,001) which persisted at 1 month (8.1±1.1 vs 6.8±1.8, P<0.001). The score at the SIRI-2-VF was 15.0 (± 4.2) out of 30 at T0. There was a significant increase just after the training (17.5±3.5 vs 15.0±4.2, P<0.001), which persisted at 1 month (17.0±4.0 vs 15.0±4.2, P<0.001). DISCUSSION This is the first evaluation of the suicidal crisis intervention training program. This program increased and homogenized the competency of the participants to manage suicidal ideation and behaviors. Those who followed a previous training maintained higher scores than the others, which shows the importance of repeated training to maintain a satisfying level of knowledge over the long term. One of the strengths of this training is the use of roleplay which enhances the learning and abilities to interact with people at suicidal risk. It seems important to integrate a suicidal crisis intervention training in the cursus of health students to avoid suicide and the dramatic consequences for the entourage and the health professionals who are confronted with it. CONCLUSION The SCIT program showed encouraging results in terms of confidence and capacity of the healthcare professionals to intervene in suicidal crisis.
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Affiliation(s)
- M-C Viard
- Fédération régionale de recherche en santé mentale et psychiatrie (F2RSMPsy) Hauts-de-France, Saint-André-lez-Lille, France
| | - P Grandgenèvre
- Université de Lille, Inserm, CHU de Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, 59000 Lille, France; Département de psychiatrie, CHU de Lille, 59000 Lille, France
| | - M Bubrovszky
- Fédération régionale de recherche en santé mentale et psychiatrie (F2RSMPsy) Hauts-de-France, Saint-André-lez-Lille, France; Établissement Public de santé mentale de l'agglomération Lilloise (EPSM-AL), Saint-André-lez-Lille, France
| | - E Coisne
- Fédération régionale de recherche en santé mentale et psychiatrie (F2RSMPsy) Hauts-de-France, Saint-André-lez-Lille, France
| | - L Plancke
- Fédération régionale de recherche en santé mentale et psychiatrie (F2RSMPsy) Hauts-de-France, Saint-André-lez-Lille, France
| | - C-E Notredame
- Université de Lille, Inserm, CHU de Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, 59000 Lille, France; Département de psychiatrie, CHU de Lille, 59000 Lille, France
| | - M Wathelet
- Fédération régionale de recherche en santé mentale et psychiatrie (F2RSMPsy) Hauts-de-France, Saint-André-lez-Lille, France; Université de Lille, Inserm, CHU de Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, 59000 Lille, France; Département de psychiatrie, CHU de Lille, 59000 Lille, France; Centre National de Ressources et Résilience (CN2R), 59000 Lille, France.
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Silla A. Identifying measures with the highest potential to reduce suicides on Finnish railways. APPLIED ERGONOMICS 2022; 102:103748. [PMID: 35349938 DOI: 10.1016/j.apergo.2022.103748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
The purpose of this study was to work systematically through all known measures for preventing railway suicides and to consider their suitability for the Finnish railway environment. The research method included a selection and grouping of measures, definition of assessment criteria, a literature review and compilation of assessment forms, and a workshop for experts in the field. We assessed 21 measures based on 12 specified criteria. Specifically, the aim of these criteria was to support the identification and structuring of the available information on each measure to be in easily exploitable format for railway stakeholders. The measures were listed in order of priority in three categories based on final assessments from the workshop. The measures categorised as top priority with the highest potential to reduce suicides on Finnish railways included training of railway personnel to identify suicidal people (also called Gatekeeper training), camera surveillance, detection systems (radar, movement sensors, etc.), collaboration between organisations, learning from international experience, cooperation between railway organisations, police and fire and rescue services, and training of mental health providers. This prioritisation, together with the information included in the assessment forms and expert's views related to each measure, support the Finnish railway stakeholders in selecting measures and defining implementation strategies to prevent railway suicides on Finnish railways. The insights of Finnish experts on the effectiveness and potential implementation of these different measures are valuable information also for railway stakeholders in other countries when selecting appropriate measures to prevent railway suicides. The results of this study support the safe and effective functioning of the railway system by adding knowledge that will help effectively prevent railway suicides and loss of life, delays to train traffic, and work-related stress and trauma to railway staff, rescue personnel and eyewitnesses.
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Affiliation(s)
- Anne Silla
- VTT Technical Research Centre of Finland Ltd, P.O. Box 1000, 02044, VTT, Finland.
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Schmied EA, Glassman LH, Carinio SR, Dell'Acqua RG, Bryan CJ, Thomsen CJ. Suicide-Specific Training Experiences and Needs Among Military Mental Health Providers. Arch Suicide Res 2022:1-15. [PMID: 35510759 DOI: 10.1080/13811118.2022.2067510] [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: 11/02/2022]
Abstract
BACKGROUND Military suicide rates have risen over the past two decades, with a notable spike in recent years. To address this issue, military mental health providers must be equipped with the skills required to provide timely and effective care; yet little is known about the suicide-specific training experiences or needs of these professionals. METHODS Thirty-five mental health care providers who treat active duty personnel at military treatment facilities participated in this mixed-methods study. All participants completed a survey assessing training and clinical experiences, comfort and proficiency in working with patients at risk for suicide, and perceived barriers to obtaining suicide-specific training. A sub-set of participants (n = 8) completed a telephone interview to further describe previous experiences and perceived challenges to obtaining training. RESULTS The majority of participants (79.4%) had 6+ years of clinical experience, had a patient who had attempted suicide (85.3%), and completed at least one suicide-related training since finishing their education (82.4%). Survey results showed the leading barrier to enrolling in suicide-specific trainings was perceived lack of training opportunities (40.7% reported it was a barrier "quite often" or more), followed by lack of time (25%). Interview results revealed lack of time, location and logistical issues, and low perceived need for additional training among providers could impede enrollment. CONCLUSIONS Study results identified several modifiable barriers to receiving suicide-specific continuing education among military mental health providers. Future efforts should develop accessible training programs that can be easily integrated into routine clinical operations to mount the best defense against suicide. HIGHLIGHTSMilitary mental health providers report significant experience and relatively high degrees of comfort and proficiency working with patients at high risk for suicide.Most providers reported receiving training in suicide assessment and screening; few reported prior training in management of suicidality.Study results identified several modifiable barriers to receiving suicide-prevention continuing education among military mental health care providers; future efforts should seek to develop accessible training programs that can be easily integrated into routine clinical operations to mount the best defense against suicide.
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Perot R, Bergot C, Silliau D, Gourevitch R, Pham-Scottez A. Formation des infirmiers à l’évaluation du risque suicidaire : revue de la littérature et perspectives pour la pratique avancée infirmière. Rech Soins Infirm 2022; 147:17-26. [DOI: 10.3917/rsi.147.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Exploring Adolescent Experiences with Disclosing Self-Injurious Thoughts and Behaviors Across Settings. Res Child Adolesc Psychopathol 2021; 50:669-681. [PMID: 34705197 PMCID: PMC9043038 DOI: 10.1007/s10802-021-00878-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Disclosure of self-injurious thoughts and behaviors (SITBs) is critical to current treatment and prevention programs. Limited research has examined patterns of and barriers to SITB disclosure in adolescents. This work is critical given the limits of confidentiality in this population. Over 1,000 adolescents aged 13-17 with a history of mental health treatment and SITBs were recruited online. Participants reported their history with disclosing SITBs across a range of relationships, honesty in and barriers to disclosure to health care providers, and their experiences with breaches of confidentiality to parents/guardians. We examined relationships among these experiences and a range of outcomes, including perceived likelihood of future disclosure. Participants reported most frequent disclosure of all SITBs to friends, and more frequent disclosure of nonsuicidal self-injury compared to suicide ideation or attempts. Adolescents were most likely to disclose SITBs when directly asked by health care providers, though many participants reported continued SITB concealment. The most commonly endorsed barrier to disclosure was fear that the provider would tell a parent/guardian. Experiences with confidentiality breaches involving a non-collaborative breach were negatively associated with future disclosure, mental health symptoms, and adolescent-parent relationships. SITB disclosure is a cornerstone to their treatment and prevention. Better understanding of to whom and when, barriers, and the impact of disclosure experiences is critical. Our research suggests that most adolescents do not want their parents to know about their SITBs, and that fear of parent involvement prevents disclosure. Results have several implications for SITB assessment across physical and mental healthcare settings.
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Kilty C, Goodwin J, Hartigan I, Meehan E, Murphy M, Dillon C, Heffernan S, Hegarty J, Greaney S, O'Brien M, Chambers D, Twomey U, Horgan A. Healthcare staff's views on responding to suicide and self-harm: Part I. Perspect Psychiatr Care 2021; 57:1693-1699. [PMID: 33616214 DOI: 10.1111/ppc.12737] [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: 10/06/2020] [Revised: 12/23/2020] [Accepted: 01/16/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To explore healthcare staff's knowledge and awareness of, and responses to, suicide and self-harm. DESIGN AND METHODS A qualitative design was adopted, and data were collected using a "World Café" approach (n = 143 participants), in addition to written submissions (n = 10). Data were analyzed using reflexive thematic analysis. FINDINGS There was variation relating to awareness of and responses to suicide and self-harm. Participants highlighted the need for further staff education and training, and a review of standardized assessment tools and referral processes. PRACTICE IMPLICATIONS Tailored training and education resources are required for healthcare staff. Clear protocols for assessing, treating, and referring people deemed at risk of suicide and self-harm are needed.
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Affiliation(s)
- Caroline Kilty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | - John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland.,ENGAGE (Interdisciplinary Clinical Mental Health Research Network), University College Cork, Cork, Republic of Ireland
| | - Irene Hartigan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | - Elaine Meehan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | - Margaret Murphy
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | - Christina Dillon
- School of Public Health, University College Cork, Cork, Republic of Ireland
| | - Sinead Heffernan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | - Sonya Greaney
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland.,HSE South, HSE Mental Health Services, Cork, Republic of Ireland
| | - Maidy O'Brien
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | | | - Una Twomey
- Service Improvement, HSE, Cork, Republic of Ireland
| | - Aine Horgan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland.,ENGAGE (Interdisciplinary Clinical Mental Health Research Network), University College Cork, Cork, Republic of Ireland
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Piot MA, Dechartres A, Attoe C, Romeo M, Jollant F, Billon G, Cross S, Lemogne C, Layat Burn C, Michelet D, Guerrier G, Tesniere A, Rethans JJ, Falissard B. Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta-analysis. J Adv Nurs 2021; 78:332-347. [PMID: 34378236 DOI: 10.1111/jan.14986] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/24/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022]
Abstract
AIMS Mental disorders constitute one of the main causes of disease and disability worldwide. While nurses are often at the frontline of mental health care, they have limited access to dedicated psychiatric training opportunities. Simulation training may foster the development of the appropriate competencies required when supporting people with mental disorders. To evaluate the effectiveness of simulation training in psychiatry for nursing students, nurses and nurse practitioners. DESIGN Systematic review and meta-analysis. DATA SOURCES Eight electronic databases, trial registries, key journals and reference lists of selected studies were searched from inception to August 20, 2020 without language restriction. REVIEW METHODS We included randomized and non-randomized controlled studies and single group pre/post studies. Cochrane Risk of Bias tool 2.0 was used for randomized controlled study appraisal, and the Medical Education Research Study Quality instrument was completed for all other studies. Meta-analysis was restricted to randomized controlled studies. The other studies were synthesized narratively. The main outcomes were based on Kirkpatrick levels. RESULTS A total of 118 studies (6738 participants) were found. Interventions included simulated patients (n = 55), role-plays (n = 40), virtual reality (n = 12), manikins (n = 9) and voice simulations (n = 9). Meta-analyses based on 11 randomized controlled studies found a significant large effect size on skills at immediate post-test for simulation compared with active control; and a small and medium effect size on learners' attitudes for simulation compared with inactive control, at immediate post-test and at three-month follow-up respectively. Three quarters of non-randomized controlled studies and pre/post-tests assessing attitudes and skills showed significant differences, and three quarters of participants in randomized controlled studies and pre/post-tests showed significant differences in behaviours. Among the few studies assessing people with mental health outcomes, almost all reported significant differences. CONCLUSION These findings support the effectiveness of simulation training in psychiatric nursing throughout professional development grades, despite heterogeneity in methods and simulation interventions.
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Affiliation(s)
- Marie-Aude Piot
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie de l'AP-HP (Cephepi), F75013, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Marie Romeo
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Fabrice Jollant
- Université de Paris, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Department of Psychiatry, Moods Team, INSERM UMR-1178, CESP, Paris, France.,Nîmes academic hospital (CHU), Nîmes, France.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Grégoire Billon
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Sean Cross
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland.,Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Daphné Michelet
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Gilles Guerrier
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Antoine Tesniere
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Jan-Joost Rethans
- Skillslab, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bruno Falissard
- Public Health Department, School of Medicine, University Paris Saclay, INSERM 1018, CESP, Villejuif, Ile-de-France, France
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Monahan MF, Karver MS. Are they ready yet?: A theory-driven evaluation of suicide risk assessment trainings in psychology graduate programs. J Clin Psychol 2021; 77:1614-1628. [PMID: 34004040 DOI: 10.1002/jclp.23171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/22/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The present study sought to understand the state of suicide risk assessment trainings in clinical psychology graduate programs. METHODS We surveyed 167 clinical psychology doctoral students' behavioral competency in responding to suicidal clients and their attitudes, perceived behavioral control, subjective norms, and intentions related to suicide risk assessment. Hypotheses were tested using path analysis. RESULTS Ninety six percent of participants reported receiving some type of suicide risk assessment training at their program. Results provided partial support for significant relationships between attitudes, perceived behavioral control, subjective norms, and intentions. Unexpectedly, amount of training in suicide risk assessments was not related to theory of planned behavior variables including behavioral competency. CONCLUSION These findings have implications regarding the effectiveness of current suicide risk assessment training practices and ways to improve trainings to help increase the number of clinical psychologists competent in suicide risk assessment and management.
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Affiliation(s)
- Maureen F Monahan
- New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Marc S Karver
- Department of Psychology, University of South Florida, Tampa, Florida, USA
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Procter N, Posselt M, Ferguson M, McIntyre H, Kenny MA, Curtis R, Loughhead M, Clement N, Mau V. An Evaluation of Suicide Prevention Education for People Working With Refugees and Asylum Seekers. CRISIS 2021; 43:205-213. [PMID: 33944607 PMCID: PMC9102884 DOI: 10.1027/0227-5910/a000777] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract.Background: There are concerning rates of suicidality among asylum seekers and refugees in Australia, and tailored suicide prevention initiatives are needed. Aims: We aimed to evaluate the impact of a tailored suicide prevention education program for people working with asylum seekers and refugees. Method: Attendees of the education program completed self-report questionnaires at pretraining, posttraining, and 4–6 months follow-up. Results: Over 400 workers, volunteers, and students across Australia took part in the education program. A series of linear mixed-effects models revealed significant improvements in outcome measures from pretraining (n = 247) to posttraining (n = 231). Improvements were maintained at follow-up (n = 75). Limitations: Limitations of this research were the lack of a control group and a low follow-up response rate. Conclusion: Findings suggest that a 2 days tailored suicide prevention education program contributes to significant improvements in workers’ attitudes toward suicide prevention, and their confidence and competence in assessing and responding to suicidal distress.
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Affiliation(s)
- Nicholas Procter
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Miriam Posselt
- Survivors of Torture and Trauma Assistance and Rehabilitation Service, Adelaide, SA, Australia
| | - Monika Ferguson
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Heather McIntyre
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | | | - Rachel Curtis
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Mark Loughhead
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Noel Clement
- Migration, Emergencies and Movement Relations, Melbourne, VIC, Australia
| | - Vicki Mau
- Migration Support Programs, Carlton, VIC, Australia
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Hager NM, Cramer RJ, Kaniuka AR, Vandecar-Burdin T, Badger N, Holley AM, Foss J, Glenn CR, Judd S, South G, Judah MR. An Evaluation of the Core Competency Suicide Prevention Training Program for University Health Service Providers. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2021. [DOI: 10.1080/87568225.2021.1911726] [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]
Affiliation(s)
- Nathan M. Hager
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Robert J. Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Andrea R. Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | | | - Nancy Badger
- Office of Counseling Services, Old Dominion University, Norfolk, Virginia, USA
| | - Angela M. Holley
- Office of Counseling Services, Old Dominion University, Norfolk, Virginia, USA
| | - Jennifer Foss
- Student Health Center, Old Dominion University, Norfolk, Virginia, USA
| | - Catherine R. Glenn
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Sarah Judd
- Office of Counseling Services, Old Dominion University, Norfolk, Virginia, USA
| | - Gabrielle South
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Matt R. Judah
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
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Wand APF, Draper B, Brodaty H, Hunt GE, Peisah C. Evaluation of an Educational Intervention for Clinicians on Self-Harm in Older Adults. Arch Suicide Res 2021; 25:156-176. [PMID: 31941427 DOI: 10.1080/13811118.2019.1706678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Clinicians may lack knowledge and confidence regarding self-harm in older adults and hold attitudes that interfere with delivering effective care. A 1-hour educational intervention for hospital-based clinicians and general practitioners (GPs) was developed, delivered, and evaluated. Of 119 multidisciplinary clinicians working in aged care and mental health at two hospitals, 100 completed pre/post-evaluation questions. There were significant improvements in knowledge, confidence in managing, and attitudes regarding self-harm in late life, and the education was rated as likely to change clinical practice. No GP education sessions could be conducted. A brief educational intervention had immediate positive impacts for hospital-based clinicians albeit with high baseline knowledge. The sustainability of these effects and effectiveness of the intervention for GPs warrant examination.
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Saini VK, Gehlawat P, Gupta T. Evaluation of knowledge and competency among nurses after a brief suicide prevention educational program: A pilot study. J Family Med Prim Care 2020; 9:6018-6022. [PMID: 33681036 PMCID: PMC7928102 DOI: 10.4103/jfmpc.jfmpc_984_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/31/2020] [Accepted: 09/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background Suicide is major public health issue worldwide. The educational interventions in enhancing the knowledge, modifying the attitudes, and raising the competence levels of healthcare professionals to prevent suicides have shown positive results. However, these education programs are under-evaluated, especially in India. Aim The aim was to evaluate the effect on suicide prevention and management-related knowledge among nursing staff, attitudes, and competence for suicidal patients and their family members. Methods A brief suicide educational intervention training program was prepared for the study participants. The outcomes of this study were evaluated through a single group pre-test-post-test questionnaire. Result The mean age of the participants was 28.74 ± 5.73 years. Participants reported significant improvement in their attitude and knowledge about suicide after attending the training program. Conclusion Empowering primary health care staff including nurses to identify, assess, manage, and refer the suicidal person should be considered as an important step in suicide prevention.
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Affiliation(s)
- Vijay K Saini
- Department of Psychiatry, All India Institute of Medical Sciences- Jodhpur, Rajasthan, India
| | - Pratibha Gehlawat
- Department of Psychiatry, All India Institute of Medical Sciences- Jodhpur, Rajasthan, India
| | - Tanu Gupta
- Department of Psychiatry, All India Institute of Medical Sciences- Jodhpur, Rajasthan, India
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Engaging primary care professionals in suicide prevention: A qualitative study. PLoS One 2020; 15:e0242540. [PMID: 33253178 PMCID: PMC7704003 DOI: 10.1371/journal.pone.0242540] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 11/04/2020] [Indexed: 01/06/2023] Open
Abstract
In health systems with strongly developed primary care, such as in the Netherlands, effectively engaging primary care professionals (PCPs) in suicide prevention is a key strategy. As part of the national Suicide Prevention Action Network (SUPRANET), a program was offered to PCPs in six regions in the Netherlands in 2017–2018 to more effectively engage them in suicide prevention. This implementation study aimed to evaluate to what extent SUPRANET was helpful in supporting PCPs to apply suicide prevention practices. From March to May 2018, 21 semi-structured interviews have been carried out with PCPs and other non-clinical professionals from SUPRANET regions in the Netherlands. Verbatim transcripts were analysed using the grounded theory approach. Data was structured using the Consolidated Framework for Implementation Research, which enabled identifying facilitating and challenging factors for PCPs to carry out suicide prevention practices. An important challenge included difficulties in assessing suicide risk (intervention characteristics) due to PCPs’ self-perceived incompetence, burdensomeness of suicide and limited time and heavy workload of PCPs. Another important limitation was collaboration with mental health care (outer setting), whereas mental health nurses (inner setting) and SUPRANET (implementation process) were facilitating factors for applying suicide prevention practices. With regard to SUPRANET, especially the training was positively evaluated by PCPs. PCPs expressed a strong need for improving collaboration with specialized mental health care, which was not provided by SUPRANET. Educating PCPs on suicide prevention seems beneficial, but is not sufficient to improve care for suicidal patients. Effective suicide prevention also requires improved liaison between mental health services and primary care, and should therefore be the focus of future suicide prevention strategies aimed at primary care.
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Dillon CB, Saab MM, Meehan E, Goodwin MJ, Murphy M, Heffernan MS, Greaney MS, Kilty C, Hartigan I, Chambers D, Twomey U, Horgan A. Staff awareness of suicide and self-harm risk in healthcare settings: A mixed-methods systematic review. J Affect Disord 2020; 276:898-906. [PMID: 32739708 DOI: 10.1016/j.jad.2020.07.113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicide risk screening in healthcare settings plays a significant role in suicide prevention. Healthcare staff who are poorly informed about self-harm and suicide risk are less likely to identify and subsequently screen at-risk individuals. This mixed-method systematic review aimed to appraise and synthesise evidence from studies that explored and promoted healthcare staff's knowledge and awareness of suicide and self-harm risk in healthcare settings. METHODS Electronic databases (CINAHL, MEDLINE, APA PsycInfo, APA PsycARTICLES, Psychology and behavioural Science Collection, ERIC, and SocINDEX), the Cochrane Library, and various grey literature databases were searched for relevant studies. The level of evidence and methodological quality of the included studies were assessed. RESULTS Eighteen empirical studies were included. Levels of knowledge about suicide and self-harm risk varied significantly across the reviewed studies. Face-to-face group training and educational programmes, digital or online educational programmes, and an educational poster campaign were amongst the strategies used to promote awareness of suicide and self-harm risk, with the majority marginally succeeding in doing so. LIMITATIONS The reviewed studies were heterogeneous in terms of design, interventions, and outcome measures which made it difficult to make comparisons. The overall level of scientific evidence was classified as being relatively low. The lack of blinding and lack of a control group were amongst the limitations for experimental studies. CONCLUSIONS Long-term, routine face-to-face group training programmes should be established to educate healthcare staff about suicide risk across all professions and in specific patient groups.
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Affiliation(s)
- Christina B Dillon
- Environmental Research Institute/School of Public Health, University College Cork, Ireland.
| | - Mohamad M Saab
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Elaine Meehan
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Mr John Goodwin
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Margaret Murphy
- School of Nursing and Midwifery, University College Cork, Ireland
| | | | | | - Caroline Kilty
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Irene Hartigan
- School of Nursing and Midwifery, University College Cork, Ireland
| | | | - Una Twomey
- Health Service Executive Southern Area, Ireland
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Ireland.
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Taking Youth Suicide Prevention to the Schools: Pilot Evaluation of School-Based Clinician Outcomes and Perspectives of a Multi-Modal Program Including Post-Training Online Consultations for Management of Ongoing Suicide Risk. PSYCHIATRY INTERNATIONAL 2020. [DOI: 10.3390/psychiatryint1010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
School-based youth-specific suicide prevention and early intervention initiatives are presently underdeveloped. The current study conducted a pilot evaluation of a multi-modal suicide prevention training program for school-based social workers, ‘Management of Youth Suicidality Training for Schools’ (MYSTS). The program comprised a two-day workshop and six fortnightly post-workshop webinar online consultations. Participants were 36 social workers (years’ experience M = 11.23, SD = 8.29) employed by the Department of Education in Tasmania, Australia. Outcomes were self-rated confidence, competence, and knowledge of self-harm in young people, and attitudes toward suicide prevention and suicide-related behaviors. Exploratory quantitative results indicated significant improvements with large effect sizes for participants’ self-reported competence (d = 1.33), and confidence (d = 1.29) to identify and respond therapeutically to youth suicidality following the workshop. Confidence remained significantly higher than baseline following the online consultations (d = 0.90). Qualitative analysis of online supervision consultations indicated key themes of accessibility, communication and information sharing, and clinical management. Participants endorsed the MYSTS package as well-presented, with relevant topics, and effective learning activities. This study highlights the need for continued supervisory or implementation support to practitioners following suicide prevention training initiatives and suggests web-based teleconference technology as a feasible strategy for this. Further evaluation of the MYSTS package, including a suitable comparison or control condition, is indicated.
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Piot MA, Dechartres A, Attoe C, Jollant F, Lemogne C, Layat Burn C, Rethans JJ, Michelet D, Cross S, Billon G, Guerrier G, Tesniere A, Falissard B. Simulation in psychiatry for medical doctors: A systematic review and meta-analysis. MEDICAL EDUCATION 2020; 54:696-708. [PMID: 32242966 DOI: 10.1111/medu.14166] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 05/06/2023]
Abstract
CONTEXT Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. METHODS For this systematic review and meta-analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group pre- and post-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random-effects models. RESULTS From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n = 69), simulated patients (n = 72), virtual reality (n = 22), manikin (n = 5) and voice simulation (n = 2). Meta-analysis found significant differences at immediate post-tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD] = 0.52, 95% confidence interval [CI] 0.31-0.73 [I2 = 0.0%] and SMD = 0.28, 95% CI 0.04-0.53 [I2 = 52.0%], respectively), skills (SMD = 1.37, 95% CI 0.56-2.18 [I2 = 93.0%] and SMD = 1.49, 95% CI 0.39-2.58 [I2 = 93.0%], respectively), knowledge (SMD = 1.22, 95% CI 0.57-1.88 [I2 = 0.0%] and SMD = 0.72, 95% CI 0.14-1.30 [I2 = 80.0%], respectively), and behaviours (SMD = 1.07, 95% CI 0.49-1.65 [I2 = 68.0%] and SMD = 0.45, 95% CI 0.11-0.79 [I2 = 41.0%], respectively). Significant differences in terms of patient benefit and doctors' behaviours and skills were found at the 3-month follow-up. CONCLUSIONS Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.
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Affiliation(s)
- Marie-Aude Piot
- Epidemiological and Public Health Research Centre, Villejuif, France
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, Institute Mutualiste Montsouris, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Agnès Dechartres
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fabrice Jollant
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital Center, Paris, France
- Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Cédric Lemogne
- University of Paris, Faculty of Health, Medicine School, Paris, France
- University of Paris, INSERM, Institute of Psychiatry and Neurosciences of Paris (IPNP), Paris, France
- AP-HP.Centre-University of Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland
- Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Jan-Joost Rethans
- Institute for Education and Skills Lab, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Daphne Michelet
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Sean Cross
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gregoire Billon
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gilles Guerrier
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Anaesthesiology, Cochin Hospital, AP-HP, Paris, France
| | - Antoine Tesniere
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Bruno Falissard
- Epidemiological and Public Health Research Centre, Villejuif, France
- Department of Public health, School of Medecine, University Paris Saclay, Villejuif, France
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European Psychiatric Association (EPA) guidance on prevention of mental disorders. Eur Psychiatry 2020; 27:68-80. [DOI: 10.1016/j.eurpsy.2011.10.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 10/11/2011] [Accepted: 10/19/2011] [Indexed: 12/18/2022] Open
Abstract
AbstractThere is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions. Since a large proportion of lifetime mental illness starts before adulthood, such interventions are particularly important during childhood and adolescence. Prevention is important for the sustainable reduction of the burden of mental disorder since once it has arisen, treatment can only reduce a relatively small proportion of such burden. The challenge for clinicians is to incorporate such interventions into non-clinical and clinical practice as well as engaging with a range of other service providers including public health. Similar strategies can be employed in both the European and global contexts. Promotion of mental well-being can prevent mental disorder but is also important in the recovery from mental disorder. This guidance should be read in conjunction with the EPA Guidance on Mental Health Promotion. This guidance draws on preparatory work for the development of England policy on prevention of mental disorder which used a wide range of sources.
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Skruibis P, Astrauskas K, Mazulyte-Rasytine E. Changes in prospective helpline volunteers' suicide intervention skills throughout the initial training. DEATH STUDIES 2019; 45:578-582. [PMID: 31578941 DOI: 10.1080/07481187.2019.1671538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The objective of this study was to evaluate the changes in prospective helpline volunteers' suicide intervention skills throughout the training in Lithuania. In total, 90 participants of the Youth Line volunteer initial training course completed the Suicide Intervention Response Inventory (SIRI-2) before any training, before and after the suicide intervention module, and after all training. There was a steady and significant increase in the trainees' suicide intervention competencies during the training. Younger and less skilled trainees benefited more from the training. These results indicate that helpline volunteers can be trained in suicide intervention skills in a relatively short time.
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Affiliation(s)
- Paulius Skruibis
- Suicide Research Centre, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | - Egle Mazulyte-Rasytine
- Suicide Research Centre, Institute of Psychology, Vilnius University, Vilnius, Lithuania
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Navin K, Kuppili PP, Menon V, Kattimani S. Suicide Prevention Strategies for General Hospital and Psychiatric Inpatients: A Narrative Review. Indian J Psychol Med 2019; 41:403-412. [PMID: 31548762 PMCID: PMC6753714 DOI: 10.4103/ijpsym.ijpsym_169_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/18/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In-patient (IP) suicides contribute a small but significant proportion of overall suicides. Despite this, suicide prevention strategies focusing on the general hospital IP population remain relatively underresearched. This paper is intended to provide an overview of various proposed suicide prevention approaches in the general hospital, including psychiatric IP, settings, and their evidence base. METHODOLOGY Electronic searches of MEDLINE through PubMed, ScienceDirect, and Google Scholar databases were performed to identify potentially relevant articles from inception till January 2019. The generated abstracts were systematically screened for their eligibility to be included in the review. Included articles were grouped under five broad themes: environmental modification, staff education, pharmacotherapy, psychotherapy, and brain stimulation. Data extraction was done using a structured proforma. RESULTS Environmental modifications and educating the health care professionals appear to be the most promising strategies to reduce suicide-related mortality among IPs. Among pharmacological methods, ketamine has shown initial promise in reducing suicidal ideations. Follow-up data are lacking for most of the described methods. Limited but positive evidence exists for cognitive therapies focusing on the immediate postadmission period and brain stimulation techniques, and it warrants further replication. CONCLUSION There is a striking paucity of original research on IP suicide prevention. Given the ethical and methodological issues in carrying out studies with IP suicide as the primary outcome, there is a need to focus on intermediate suicide outcome measures, such as knowledge, attitude, and skills among staff handlers of suicidal patients.
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Affiliation(s)
- Karthick Navin
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Pooja Patnaik Kuppili
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Gask L, Coupe N, Green G. An evaluation of the implementation of cascade training for suicide prevention during the 'Choose Life' initiative in Scotland - utilizing Normalization Process Theory. BMC Health Serv Res 2019; 19:588. [PMID: 31429739 PMCID: PMC6701107 DOI: 10.1186/s12913-019-4398-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 08/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 'Cascade training' or 'train-the-trainers' has been widely utilised in the dissemination of information and expertise in health and social care, but with little examination of the work required for optimal delivery. National suicide prevention strategies commonly include such training initiatives. METHODS A qualitative study to characterise the work, according to the concepts of Normalization Process Theory, required to disseminate STORM, a model of suicide prevention training across Scotland, and then implement it within organisations. This utilised a cascade style 'train-the trainers' intervention delivered as part of the Choose Life suicide prevention strategy in Scotland during 2008-11. Semi-structured interviews were carried out with 19 training facilitators, 30 of their group participants within organisations and 11 local managers within health boards in Scotland. RESULTS Crucial to the process of a cascade training approach to implementing suicide prevention within an organisation was the multi-layered activity of constructing coherence of the intervention at every level in order to prevent dilution of the training. This necessitated collaborative work within and between groups of actors- managers, facilitators and participants. Where facilitators were effectively engaged in their role, confident in their ability to train, supported by supervision and possessed the leadership skills to engage both with participants and their local context to deliver training, there was evidence of both successful delivery and embedding within the organisation. However, there was little systematic evidence of institutional level appraisal- crucial to truly implementing a novel intervention within the system - despite efforts at local managerial engagement. CONCLUSIONS Successful cascade or train-the-trainer implementation of an intervention requires extensive collaborative work to take place between and within groups of actors at all levels of an organization from those working at policy level to the 'coalface'. A priori application of Normalization Process Theory, to specify aims and goals for the necessary work to be carried out between different groups of actors, would assist in embedding a novel working practice at all levels. Future national training strategies for suicide prevention should address what is required to establish a flourishing culture of high-quality skills acquisition and development within healthcare organisations.
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Affiliation(s)
- Linda Gask
- Centre for Primary Care, University of Manchester, Manchester, UK
| | - Nia Coupe
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
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Audouard-Marzin Y, Kopp-Bigault C, Scouarnec P, Walter M. General practitioners training about suicide prevention and risk: A systematic review of literature. Presse Med 2019; 48:767-779. [DOI: 10.1016/j.lpm.2019.05.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/25/2018] [Accepted: 05/28/2019] [Indexed: 11/15/2022] Open
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Ferguson M, Dollman J, Jones M, Cronin K, James L, Martinez L, Procter N. Suicide Prevention Training – Improving the Attitudes and Confidence of Rural Australian Health and Human Service Professionals. CRISIS 2019; 40:15-26. [DOI: 10.1027/0227-5910/a000524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Suicide rates are higher in rural and remote areas of Australia compared with major cities. Aim: To evaluate the impact of a brief, community-based suicide prevention educational intervention on the attitudes and confidence of rural South Australian health and human service professionals. Method: Participants attended a 1-day suicide prevention education program, and completed a survey at four time points: baseline (T1), immediately pretraining (T2), immediately posttraining (T3), and 4-month follow-up (T4). Main outcome measures were self-reported attitudes and confidence when working with people vulnerable to suicide. Results: A total of 248 people attended the training, with 213 participants completing the survey at T1, 236 at T2, 215 at T3, and 172 at T4. There were significant improvements in 11 of the 14 attitude items between T2 and T3 (immediate change), and between T1 and T4 (maintained change). Further, there were significant improvements in all four confidence items between T2 and T3, and T1 and T4. Limitations: Despite the repeated-measures design, findings are limited by the lack of a control group. Conclusion: Findings extend the international evidence by indicating the value of brief suicide prevention education for improving health and human service professionals' attitudes and confidence in rural Australia.
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Affiliation(s)
- Monika Ferguson
- School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
| | - James Dollman
- University Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - Martin Jones
- University Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - Kathryn Cronin
- Country Health South Australia Local Health Network, Port Lincoln, SA, Australia
| | - Lynne James
- School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
| | - Lee Martinez
- University Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - Nicholas Procter
- School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
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Osafo J, Akotia CS, Boakye KE, Dickson E. Between moral infraction and existential crisis: Exploring physicians and nurses' attitudes to suicide and the suicidal patient in Ghana. Int J Nurs Stud 2018; 85:118-125. [DOI: 10.1016/j.ijnurstu.2018.05.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 11/24/2022]
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Blanco-Vieira T, Ramos FADC, Lauridsen-Ribeiro E, Ribeiro MVV, Meireles EA, Nóbrega BA, Motta Palma SM, Ratto MDF, Caetano SC, Ribeiro WS, Rosário MCD. A Guide for Planning and Implementing Successful Mental Health Educational Programs. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2018; 38:126-136. [PMID: 29851717 DOI: 10.1097/ceh.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. METHODS The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. RESULTS We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. IMPLICATIONS FOR PRACTICE These results will be helpful for planning and improving the quality of future educational programs in mental health.
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Affiliation(s)
- Thiago Blanco-Vieira
- Dr. Blanco-Vieira: Child Psychiatrist, Post Graduation Student, Department of Psychiatry, UNIFESP, and Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), Federal University of São Paulo (UNIFESP), São Paulo, Brazil. Dr. Ramos: Child Psychiatrist, Coordinator of Rio de Janeiro Mental Health School (ESAM), Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Lauridsen-Ribeiro: Pediatrician, Child Psychiatrist, Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Vieira Ribeiro: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Meireles: Psychologist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), UNIFESP, São Paulo, Brazil. Dr. Nóbrega: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Palma: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Ratto: Psychologist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Caetano: Associate Professor, Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), and Professor of the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Ribeiro: Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom. Dr. Rosário: Associate Professor, Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), and Coordinator of the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil
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Nakagami Y, Kubo H, Katsuki R, Sakai T, Sugihara G, Naito C, Oda H, Hayakawa K, Suzuki Y, Fujisawa D, Hashimoto N, Kobara K, Cho T, Kuga H, Takao K, Kawahara Y, Matsumura Y, Murai T, Akashi K, Kanba S, Otsuka K, Kato TA. Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial. J Affect Disord 2018; 225:569-576. [PMID: 28886497 DOI: 10.1016/j.jad.2017.08.074] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/26/2017] [Accepted: 08/27/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. METHODS We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. RESULTS This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. LIMITATIONS Design was a single-arm study with relatively small sample size and short-term follow up. CONCLUSIONS The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates.
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Affiliation(s)
- Yukako Nakagami
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Hiroaki Kubo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Ryoko Katsuki
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tomomichi Sakai
- Aso Iizuka Hispital, Iizuka, 3-83 Yoshio, machi, Iizuka, Fukuoka 820-0018, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Chisako Naito
- Integrated Clinical Education Center, Patient Safety Unit, Kyoto University Hospital, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Hiroyuki Oda
- Aso Iizuka Hispital, Iizuka, 3-83 Yoshio, machi, Iizuka, Fukuoka 820-0018, Japan
| | - Kohei Hayakawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo 060-8638, Japan
| | - Keiji Kobara
- Shimane Prefectural Counseling Center for Physical and Mental Health, 1741-3 Higashi-Tsuda-Cho, Matsue, Shimane 690-0011, Japan
| | - Tetsuji Cho
- Mie Prefectural Mental Medical Center, 1-12-1 Shiroyama, Tsu, Mie 514-0818, Japan
| | - Hironori Kuga
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, 160 Mitsu, Yoshinogari-cho, Kanzaki-gun, Saga 842-0192, Japan
| | - Kiyoshi Takao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, 160 Mitsu, Yoshinogari-cho, Kanzaki-gun, Saga 842-0192, Japan
| | - Yoko Kawahara
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yumi Matsumura
- Patient Safety Unit, Kyoto University Hospital, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Koichi Akashi
- Clinical Education Center, Kyushu University Hospital, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
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Kopp-Bigault C, Audouard-Marzin Y, Scouarnec P, Beauchamp G, Séguin M, Walter M. [French translation and validation of a short version of the Suicide Intervention Response Inventory-2 (SIRI-2-VF)]. Encephale 2017; 44:435-445. [PMID: 29096910 DOI: 10.1016/j.encep.2017.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Training health professionals about suicidal crisis is one major line of suicide prevention worldwide. France has one of the highest suicide rates in Europe, and although crisis intervention training has been set up since 2001, there presently is no training assessment tool in the French language for health professionals trained in suicide prevention. In the four levels of Kirpatrick's education pyramid, training that takes place in France today solely assesses level one status, that is to say relative to the level of satisfaction of participants (self-report). This study proposes a validated short French version of the Suicide Intervention Response Inventory-2 (SIRI-2) of Neimeyer & Mc Innes. The SIRI-2 questionnaire assesses the ability of first line intervention in dealing with suicidal individuals. METHODS The translation methodology was inspired from Vallerand's model of cross-cultural back translation. This method is regularly used for translating from the English language to a French version. In order to translate the English version, we used an extensive 7-step methodology implicating several bilingual translators, expert reviewers (psychologists and psychiatrists) and a scientific committee. Participants were 107 students from different French universities and study programs: psychology, medicine and nursing (17 were men; average age was 26.6). Fifteen of these participants answered the SIRI-2-VF on two occasions (separated by a 15-day interval) in order to estimate the temporal stability of the instrument. The scores of the students were compared to six French experts in suicide prevention and with the original expert group who worked on the development of SIRI-2 (n=7). We used Student t Test for construct validity, Cronbach's Alpha for internal consistency and Pearson's correlation coefficient for temporal stability. RESULTS Following a fidelity comparison of the results of the French experts with those of the American experts, ten items presenting the least good fidelity were suppressed in order to obtain a short version of the SIRI-2 containing 15 questions (SIRI-2-VF). Statistical analyses of the short version (15 questions, SIRI-2-VF) showed good validity (difference between experts and subjects is significant: t=31.5, P<0.001) and reliability (good internal consistency: α=0.850 for positive statements and α=0.830 for negative statements, and a temporal stability: r=0.827, bilateral test, P<0.001). CONCLUSIONS This tool should improve the range of specific instruments in French suicidology adapted for French culture of suicide intervention. It is the first tool in France that reaches level 2a of Kirkpatrick's pyramid to assess clinical skills after training in suicidology.
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Affiliation(s)
- C Kopp-Bigault
- University of Strasbourg (EA3071), 67000 Strasbourg, France; Morlaix Hospital, 29600 Brittany, France.
| | - Y Audouard-Marzin
- Collège des hautes études en médecine (CHEM), 29200 Brest, France; CRPV, centre hospitalier universitaire régional de Brest, 29200 Brest, France
| | - P Scouarnec
- Morlaix Hospital, 29600 Brittany, France; Collège des hautes études en médecine (CHEM), 29200 Brest, France; CRPV, centre hospitalier universitaire régional de Brest, 29200 Brest, France
| | - G Beauchamp
- Department of psychoeducation and psychology, université du Québec, Outaouais, Canada
| | - M Séguin
- Department of psychoeducation and psychology, université du Québec, Outaouais, Canada; McGill Group on Suicide Studies, Montréal, Québec, Canada; Québec Network on Suicide Research, Québec, Canada; Centre intégré de santé et service social de l'Outaouais (CISSSO), Outaouais, Canada
| | - M Walter
- Psychiatry Unit, Brest University and Research Hospital, 29200 Brest, France
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Ferguson MS, Reis JA, Rabbetts L, Ashby HJ, Bayes M, McCracken T, Ross C, Procter NG. The Effectiveness of Suicide Prevention Education Programs for Nurses. CRISIS 2017; 39:96-109. [PMID: 28990823 DOI: 10.1027/0227-5910/a000479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Education to improve health professionals' responses to suicide is considered an important suicide prevention strategy. However, the effectiveness of this approach for nurses is unclear. AIM To systematically review the peer-reviewed literature regarding the effectiveness of suicide prevention education programs for nurses. METHOD Nine academic databases (CINAHL, Cochrane Reviews & Trials, Embase, Informit Health Collection, Joanna Briggs Institute, Medline, PsycINFO, Scopus, and Web of Science) were searched in November 2016, utilizing search terms related to suicide, education, and nurses, with no limits placed on publication date or study design. RESULTS The search yielded 5,456 identified articles, 11 of which met the inclusion criteria. Studies were primarily quantitative (RCTs n = 3; quasi-experimental n = 6; qualitative n = 2), and involved nurses (range = 16-561) working in a diversity of settings, particularly hospitals (n = 9). Studies revealed positive changes in nurses' competence, knowledge, and attitudes associated with training over the short term. LIMITATIONS The heterogeneity of education programs and methodological weaknesses of included studies limit the conclusions drawn. CONCLUSION There is a moderate body of evidence to support the effectiveness of suicide prevention education programs for nurses. Future research should examine longer-term changes in clinical practice and strategies for continuing education, with more rigorous study designs.
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Affiliation(s)
- Monika S Ferguson
- 1 School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
| | - Julie A Reis
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Lyn Rabbetts
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Heather-Jean Ashby
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Miriam Bayes
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Tara McCracken
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Christine Ross
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Nicholas G Procter
- 1 School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
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Gask L, Coupe N, McElvenny D, Green G. Pilot study evaluation of suicide prevention gatekeeper training utilising STORM in a British university setting. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2017. [DOI: 10.1080/03069885.2017.1335391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Linda Gask
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Nia Coupe
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Damien McElvenny
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Gill Green
- Storm Skills Training CIC Regent House Business Centre, Stockport, UK
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Santos JC, Simões RMP, Erse MPQDA, Façanha JDN, Marques LAFA. Impact of "+Contigo" training on the knowledge and attitudes of health care professionals about suicide. Rev Lat Am Enfermagem 2016; 22:679-84. [PMID: 25296153 PMCID: PMC4292649 DOI: 10.1590/0104-1169.3503.2467] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 05/08/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to evaluate the results of "+Contigo" training, developed by nurses and directed at 66 health professionals of integrated school health teams in Primary Health Care. METHOD quantitative with data collection through the Suicide Behavior Attitude Questionnaire, administered before and after the training. RESULTS significant increases were observed in suicide prevention knowledge and in changing attitudes of health professionals towards individuals with suicidal behavior. CONCLUSION these results allow us to affirm that nurses hold scientific and pedagogical knowledge that grant them a privileged position in the health teams, to develop training aimed at health professionals involved in suicide prevention.
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Affiliation(s)
| | - Rosa Maria Pereira Simões
- Casa de Saúde Rainha Santa Isabel, Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus, Coimbra, Portugal
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Marzano L, Smith M, Long M, Kisby C, Hawton K. Police and Suicide Prevention. CRISIS 2016; 37:194-204. [DOI: 10.1027/0227-5910/a000381] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Abstract. Background: Police officers are frequently the first responders to individuals in crisis, but generally receive little training for this role. We developed and evaluated training in suicide awareness and prevention for frontline rail police in the UK. Aims: To investigate the impact of training on officers’ suicide prevention attitudes, confidence, and knowledge. Method: Fifty-three participants completed a brief questionnaire before and after undertaking training. In addition, two focus groups were conducted with 10 officers to explore in greater depth their views and experiences of the training program and the perceived impact on practice. Results: Baseline levels of suicide prevention attitudes, confidence, and knowledge were mixed but mostly positive and improved significantly after training. Such improvements were seemingly maintained over time, but there was insufficient power to test this statistically. Feedback on the course was generally excellent, notwithstanding some criticisms and suggestions for improvement. Conclusion: Training in suicide prevention appears to have been well received and to have had a beneficial impact on officers’ attitudes, confidence, and knowledge. Further research is needed to assess its longer-term effects on police attitudes, skills, and interactions with suicidal individuals, and to establish its relative effectiveness in the context of multilevel interventions.
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Affiliation(s)
- Lisa Marzano
- Psychology Department, Middlesex University, London, UK
| | | | | | | | - Keith Hawton
- Centre for Suicide Research, University of Oxford, UK
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McCabe R, Garside R, Backhouse A, Xanthopoulou P. Effective communication in eliciting and responding to suicidal thoughts: a systematic review protocol. Syst Rev 2016; 5:31. [PMID: 26888194 PMCID: PMC4758101 DOI: 10.1186/s13643-016-0211-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/11/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In the UK, over 6500 people die by suicide each year. In England alone, this is one person every 2 h. Professionals assess risk of suicide in face-to-face contacts with people potentially at risk. The National Confidential Inquiry into Suicide found that most people who took their life were classified as 'low risk' in their final contact with mental health services. Training for front-line staff in reducing suicide is a NHS priority. While there is considerable evidence on what to assess when exploring suicidal ideation, there is little evidence on how to ask sensitive questions to effectively identify suicide risk and how to respond in the treatment encounter to reduce patient distress and suicidal ideation. This is critical for identifying risk and putting appropriate care in place. METHODS An electronic search will be conducted using MEDLINE, CINAHL, Cochrane Library, EMBASE and PsycINFO databases. Controlled studies of effectiveness will be identified using a predefined search strategy. The focus will be on suicidal thoughts/feelings rather than self-harm without intent to die. Two authors will independently screen articles using predefined inclusion and exclusion criteria and relevant data will be extracted using the Cochrane Collaboration data extraction form for randomised controlled trials (RCTs). Discrepancies between the two authors will be resolved by consensus or by consulting a third author at all levels of screening. We will assess the quality of evidence as well as risk of bias. A meta-analysis will be conducted if participants, interventions and comparisons are sufficiently similar, and we will perform the meta-analysis using Stata data analysis and statistical software. DISCUSSION The results of this systematic review will be used to guide training and practice for health care professionals. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015025867.
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Affiliation(s)
- Rose McCabe
- College House, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Ruth Garside
- European Centre for Environment and Human Health, Knowledge Spa, Royal Cornwall Hospital, Truro, TR1 3HD, UK.
| | - Amy Backhouse
- College House, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Penny Xanthopoulou
- College House, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
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Tapola V, Wahlström J, Lappalainen R. Effects of training on attitudes of psychiatric personnel towards patients who self-injure. Nurs Open 2016; 3:140-151. [PMID: 27708824 PMCID: PMC5047340 DOI: 10.1002/nop2.45] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 01/22/2016] [Indexed: 11/11/2022] Open
Abstract
Background Improving attitudes of personnel towards self‐injurious patients leads to better working alliance and contributes to better patient outcomes. Previous research into the improvement of these attitudes has recorded the need for specific training in evidence‐based assessment and treatment of self‐injurious patients. Aim The current study describes the attitudes towards self‐injurious patients among psychiatric personnel. The study also evaluates the effect of a structured clinical training program on psychiatric personnel's attitudes towards patients who self‐injure. It further examines whether age, education, frequency of self‐injurious patients contact, and work experience of the personnel are associated with the existing attitudes. Methods Psychiatric personnel (N = 50) attended a four‐day training program, presenting evidence‐based knowledge regarding self‐injury assessment and treatment, using group exercises and reflective learning principles. The personnel completed the Understanding Suicidal Patients Questionnaire (USP) anonymously PreTraining, on 17 January 2014, and PostTraining, on 20 June 2014. The mean differences as well as single USP items before and after the training were tested by unpaired t‐test. Two‐way ANOVA was used to test impact of background variables on the USP scores. Results The training program had statistically significant impact (P < 0·01) on the following individual items of the USP scale: Patients who have tried to commit suicide are usually treated well in my work unit (d = 1·02); A person who has made several suicide attempt is at greater risk of committing suicide (d = 0·64); Because the patients who have tried to commit suicide have emotional problems, they need the best possible treatment (d = 0·57). The results also suggested that the frequency of patient contact had impact on attitudes towards self‐injurious patients.
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Affiliation(s)
- Vojna Tapola
- Department of Psychology University of Jyväskylä P.O. 35 FI-40014 Jyväskylä Finland
| | - Jarl Wahlström
- Department of Psychology University of Jyväskylä P.O. 35 FI-40014 Jyväskylä Finland
| | - Raimo Lappalainen
- Department of Psychology University of Jyväskylä P.O. 35 FI-40014 Jyväskylä Finland
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The Impact of Knowledge of Suicide Prevention and Work Experience among Clinical Staff on Attitudes towards Working with Suicidal Patients and Suicide Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:195. [PMID: 26861362 PMCID: PMC4772215 DOI: 10.3390/ijerph13020195] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 01/27/2016] [Accepted: 01/29/2016] [Indexed: 12/19/2022]
Abstract
Suicide-preventive training has shown to influence attitudes. This study aimed at investigating what impact other factors than knowledge might have on attitudes towards work with suicidal patients and suicide prevention. In 2007, 500 health-care staff working in a psychiatric clinic in Stockholm received a questionnaire with items concerning work with suicidal patients to which 358 (71.6%) responded. A set of attitude items were tested using structural equation modelling (LISREL). Three models were found to be satisfactory valid and reliable: Job clarity, Job confidence and Attitudes towards prevention. These were then used in regression analyses as dependent variables with predictors such as experience of work with suicidal patients, perceived sufficient training,age and gender. Perceived sufficient training was consistently the most important predictor for all three attitude concepts (p < 0.01, β = 0.559 for Job clarity; p < 0.01, β = 0.53 for Job confidence; p < 0.01, β = 0.191 for Attitudes towards prevention). Age was another significant predictor for Job clarity (p < 0.05, β = 0.134), as was experience of patient suicide for Job confidence (p < 0.05, β = 0.137). It is concluded that providing suicide preventive education is likely to improve attitudes towards the prevention of suicide, clarity and confidence regarding their role in the care for suicidal patients. These improvements may contribute to the prevention of suicide in health care settings.
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Pullen JM, Gilje F, Tesar E. A descriptive study of baccalaureate nursing students' responses to suicide prevention education. Nurse Educ Pract 2015; 16:104-10. [PMID: 26494302 DOI: 10.1016/j.nepr.2015.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/21/2015] [Accepted: 09/24/2015] [Indexed: 11/27/2022]
Abstract
Internationally, little is known regarding the amount of educational content on suicide in undergraduate nursing curriculum. The literature conducted found few published research studies on implementation of suicide prevention instruction in baccalaureate nursing curriculum, even though various international healthcare and nursing initiatives address suicide prevention. The aim was to describe senior baccalaureate students' responses to an evidence-based suicide prevention gatekeeper training program entitled Question-Persuade-Refer implemented in a required course. This is a multi-method descriptive study. Data were collected utilizing a pre-post-survey questionnaire administered to 150 students in four classes of a psychiatric nursing course over a two-year period. The quantitative data were statistically significant (p < 0.000) indicating an overall positive rating of the training. From the qualitative data, the main theme was 'becoming capable intervening with persons at risk for suicide'. Students responded very positively to the evidence based suicide prevention gatekeeper training program. The instruction addresses various national initiatives and strategies filling a void in nursing curriculum, as well as empowering students to engage in suicide prevention interventions.
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Affiliation(s)
- Julie M Pullen
- Montana State University College of Nursing, 1500 University Drive, Billings, MT 59101, USA.
| | - Fredricka Gilje
- Montana State University College of Nursing, 4088 Laredo Place, Billings, MT 59106, USA.
| | - Emily Tesar
- Montana State University College of Nursing, 1500 University Drive, Billings, MT 59101, USA.
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de Beurs DP, de Groot MH, de Keijser J, Mokkenstorm J, van Duijn E, de Winter RFP, Kerkhof AJFM. The effect of an e-learning supported Train-the-Trainer programme on implementation of suicide guidelines in mental health care. J Affect Disord 2015; 175:446-53. [PMID: 25679199 DOI: 10.1016/j.jad.2015.01.046] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 01/16/2015] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND Randomized studies examining the effect of training of mental health professionals in suicide prevention guidelines are scarce. We assessed whether professionals benefited from an e-learning supported Train-the-Trainer programme aimed at the application of the Dutch multidisciplinary suicide prevention guideline. METHODS 45 psychiatric departments from all over the Netherlands were clustered in pairs and randomized. In the experimental condition, all of the staff of psychiatric departments was trained by peers with an e-learning supported Train-the-Trainer programme. Guideline adherence of individual professionals was measured by means of the response to on-line video fragments. Multilevel analyses were used to establish whether variation between conditions was due to differences between individual professionals or departments. RESULTS Multilevel analysis showed that the intervention resulted in an improvement of individual professionals. At the 3 month follow-up, professionals who received the intervention showed greater guideline adherence, improved self-perceived knowledge and improved confidence as providers of care than professionals who were only exposed to traditional guideline dissemination. Subgroup analyses showed that improved guideline adherence was found among nurses but not among psychiatrists and psychologists. No significant effect of the intervention on team performance was found. LIMITATIONS The ICT environment in departments was often technically inadequate when displaying the video clips clip of the survey. This may have caused considerable drop-out and possibly introduced selection bias, as professionals who were strongly affiliated to the theme of the study might have been more likely to finish the study. CONCLUSIONS Our results support the idea that an e-learning supported Train-the-Trainer programme is an effective strategy for implementing clinical guidelines and improving care for suicidal patients. TRIAL REGISTRATION Netherlands Trial Register (NTR3092 www.trialregister.nl).
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Affiliation(s)
- Derek P de Beurs
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
| | - Marieke H de Groot
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
| | | | - Jan Mokkenstorm
- GGZ Foundation for Mental Health Care GGZ inGeest, The Netherlands.
| | - Erik van Duijn
- GGZ Foundation for Mental Health Care Delfland, The Netherlands.
| | - Remco F P de Winter
- GGZ Foundation for Mental Health Care, Parnassia, The Hague, The Netherlands.
| | - Ad J F M Kerkhof
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
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Clarke S, Taylor G, Lancaster J, Remington B. Acceptance and commitment therapy-based self-management versus psychoeducation training for staff caring for clients with a personality disorder: a randomized controlled trial. J Pers Disord 2015; 29:163-76. [PMID: 24963830 DOI: 10.1521/pedi_2014_28_149] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
People diagnosed with a personality disorder (PD) are often a stigmatized patient group. This can affect the care they receive, their progression, and the well-being of staff caring for them. Interventions targeted at health care professionals that aim to improve attitudes toward these patients and improve staff well-being do exist; however, evidence for their effectiveness is limited. The present study compared a self-management, Acceptance and Commitment Therapy-based training intervention (ACTr) with a Psychoeducation Training (PETr) intervention in their effectiveness in improving attitudes toward PD patients, staff-patient relations, and staff well-being. Both interventions were successful at improving attitudes and measures of staff-patient relations up to 6 months after training; however, staff well-being did not change for either group. The implications for staff training and future research are discussed.
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Wu CY, Lin YY, Yeh MC, Huang LH, Chen SJ, Liao SC, Lee MB. Effectiveness of interactive discussion group in suicide risk assessment among general nurses in Taiwan: a randomized controlled trial. NURSE EDUCATION TODAY 2014; 34:1388-1394. [PMID: 24768204 DOI: 10.1016/j.nedt.2014.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 02/20/2014] [Accepted: 03/25/2014] [Indexed: 06/03/2023]
Abstract
The evidence of suicide prevention training for nurses is scarce. Strategies to enhance general nurses' ability in suicide risk assessment are critical to develop effective training programs in general medical settings. This study was aimed to examine the effectiveness of an interactive discussion group in a suicide prevention training program for general nurses. In this randomized study with two groups of pre-post study design, the sample was recruited from the Medical, Surgical, and Emergency/Intensive Care Sectors of a 2000-bed general hospital via stratified randomization. Among the 111 nurses, 57 participants randomly assigned to the control group received a two-hour baseline suicide gatekeeper lecture, and 54 participants assigning to the experimental group received an additional five-hour group discussion about suicide risk assessment skills. Using a case vignette, the nurses discussed and assessed suicide risk factors specified in a 10-item Chinese SAD PERSONS Scale during a group discussion intervention. The findings revealed that the nurses achieved significant and consistent improvements of risk identification and assessment after the intervention without influencing their mental health status for assessing suicide risks. The result suggested an effective approach of interactive group discussion for facilitating critical thinking and learning suicide risk assessment skills among general nurses.
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Affiliation(s)
- Chia-Yi Wu
- Department of Nursing, College of Medicine, National Taiwan University, Taiwan.
| | - Yi-Yin Lin
- Department of Nursing, College of Medicine, National Taiwan University, Taiwan
| | - Mei Chang Yeh
- Department of Nursing, College of Medicine, National Taiwan University, Taiwan
| | - Lian-Hua Huang
- Department of Nursing, College of Medicine, National Taiwan University, Taiwan; Department of Nursing, National Taiwan University Hospital, Taiwan
| | - Shaw-Ji Chen
- Department of Psychiatry, Mackay Memorial Hospital, Taitung Branch, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taiwan
| | - Ming-Been Lee
- Department of Psychiatry, National Taiwan University Hospital, Taiwan; National Suicide Prevention Centre, Taiwan
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Rothes IA, Henriques MR, Leal JB, Lemos MS. Facing a Patient Who Seeks Help After a Suicide Attempt. CRISIS 2014; 35:110-22. [DOI: 10.1027/0227-5910/a000242] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Although intervention with suicidal patients is one of the hardest tasks in clinical practice, little is known about health professionals’ perceptions about the difficulties of working with suicidal patients. Aims: The aims of this study were to: (1) describe the difficulties of professionals facing a suicidal patient; (2) analyze the differences in difficulties according to the sociodemographic and professional characteristics of the health professionals; and (3) identify the health professionals’ perceived skills and thoughts on the need for training in suicide. Method: A self-report questionnaire developed for this purpose was filled out by 196 health professionals. Exploratory principal components analyses were used. Results: Four factors were found: technical difficulties; emotional difficulties; relational and communicational difficulties; and family-approaching and logistic difficulties. Differences were found between professionals who had or did not have training in suicide, between professional groups, and between the number of patient suicide attempts. Sixty percent of the participants reported a personal need for training and 85% thought it was fundamental to implement training plans targeted at health professionals. Conclusion: Specific training is fundamental. Experiential and active methodologies should be used and technical, relational, and emotional questions must be included in the training syllabus.
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Affiliation(s)
- Inês Areal Rothes
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | | | - Joana Barreiros Leal
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Marina Serra Lemos
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
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Goncalves DA, Fortes S, Campos M, Ballester D, Portugal FB, Tófoli LF, Gask L, Mari J, Bower P. Evaluation of a mental health training intervention for multidisciplinary teams in primary care in Brazil: a pre- and posttest study. Gen Hosp Psychiatry 2013; 35:304-8. [PMID: 23521815 DOI: 10.1016/j.genhosppsych.2013.01.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 12/10/2012] [Accepted: 01/02/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this research was to investigate whether a training intervention to enhance collaboration between mental health and primary care professionals improved the detection and management of mental health problems in primary health care in four large cities in Brazil. The training intervention was a multifaceted program over 96 h focused on development of a shared care model. METHOD A quasiexperimental study design was undertaken with assessment of performance by nurse and general practitioners (GPs) pre- and postintervention. Rates of recognition of mental health disorders (compared with the General Health Questionnaire) were the primary outcome, while self-reports of patient-centered care, psychosocial interventions and referral were the secondary outcomes. RESULTS Six to 8 months postintervention, no changes were observed in terms of rate of recognition across the entire sample. Nurses significantly increased their recognition rates (from 23% to 39%, P=.05), while GPs demonstrated a significant decrease (from 42% to 30%, P=.04). There were significant increases in reports of patient-centered care, but no changes in other secondary outcomes. CONCLUSIONS Training professionals in a shared care model was not associated with consistent improvements in the recognition or management of mental health problems. Although instabilities in the local context may have contributed to the lack of effects, wider changes in the system of care may be required to augment training and encourage reliable changes in behavior, and more specific educating models are necessary.
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Ougrin D, Zundel T, Ng AV, Habel B, Latif S. Teaching therapeutic assessment for self-harm in adolescents: training outcomes. Psychol Psychother 2013; 86:70-85. [PMID: 23386556 DOI: 10.1111/j.2044-8341.2011.02047.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe the teaching programme of Therapeutic Assessment (TA), a brief intervention at the point of initial assessment for adolescents with self-harm; to describe trainees' preferences and choices regarding their use of specific aspects of TA. DESIGN This is a comparative study investigating the differences in the TA skills before and after training. This design was chosen to establish whether or not TA training is efficacious. METHODS Twenty-four clinicians volunteered to participate in five half-day TA training sessions. Their scores on the Therapeutic Assessment Quality Assurance Tool (TAQAT, primary outcome measure) were compared before and after training. Satisfaction with training and therapeutic strategy choices as well as ability to perform TA in an RCT were investigated. RESULTS Clinicians who participated in TA training had significantly increased scores on TAQAT after training. The clinicians who achieved the required quality of TA post assessments were likely to be able to carry out TA in an RCT with high fidelity. In addition, prior to training, significant differences in the quality of assessments as measured by TAQAT were identified depending on the experience of the clinician. This discrepancy was no longer present post training. Therapeutic strategy based on solution-focused brief therapy (SFBT) was the option of choice post training. CONCLUSIONS TA training is feasible and associated with improved quality of self-harm assessment. PRACTITIONER POINTS TA is a brief intervention associated with improved treatment engagement. TA training is feasible and is associated with improved quality of self-harm assessment. SFBT-based exit is the most commonly used strategy in TA.
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Affiliation(s)
- Dennis Ougrin
- Institute of Psychiatry, Child and Adolescent Psychiatry, King's College London, UK
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Mendoza IYQ, Peniche ADCG, Püschel VADA. Conhecimento sobre hipotermia dos profissionais de Enfermagem do Centro Cirúrgico. Rev Esc Enferm USP 2012; 46 Spec No:123-9. [DOI: 10.1590/s0080-62342012000700018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/18/2012] [Indexed: 11/22/2022] Open
Abstract
Objetivou-se identificar a diferença no conhecimento sobre hipotermia do auxiliar de enfermagem após a intervenção educativa. A base conceitual de educação fundamenta-se na perspectiva da aprendizagem significativa, aliada à construção de mapa conceitual e à realização de estudo de caso. Os dados foram coletados por meio de um questionário validado por especialistas. A média do conhecimento após a intervenção educativa teve aumento de 3,49 pontos. Não se verificou diferença significativa do conhecimento quando foi relacionado às variáveis sociais e de formação estudadas. Conclui-se que a intervenção educativa foi satisfatória na medida em que as informações sobre hipotermia foram ancoradas e modificadas na estrutura cognitiva dos auxiliares de enfermagem.
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Jacobson JM, Osteen P, Jones A, Berman A. Evaluation of the recognizing and responding to suicide risk training. Suicide Life Threat Behav 2012; 42:471-85. [PMID: 22924960 DOI: 10.1111/j.1943-278x.2012.00105.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Changes in attitudes, confidence, and practice behaviors were assessed among 452 clinicians who completed the training, Recognizing and Responding to Suicide Risk, and who work with clients at risk for suicide. Data were collected at three time points. Scores on measures of attitudes toward suicide prevention and confidence to work with clients at risk for suicide improved over time. Clinical practice behaviors improved for assessing and formulating suicide risk, developing suicide prevention treatment plans, and responding to vignettes. Results suggest training can improve clinicians' attitudes toward suicide, confidence to work with clients at risk for suicide, and, most importantly, clinical practice skills.
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Mendoza IYQ, Peniche ADCG. Intervenção educativa sobre hipotermia: uma estratégia de ensino para aprendizagem em centro cirúrgico. Rev Esc Enferm USP 2012; 46:851-7. [DOI: 10.1590/s0080-62342012000400010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 12/07/2011] [Indexed: 11/21/2022] Open
Abstract
Este trabalho trata-se de um estudo quase experimental aplicado em uma intervenção educativa de curta duração aos auxiliares de enfermagem do Centro Cirúrgico, cujos objetivos foram conhecer as características sociais e de formação dos auxiliares de enfermagem; identificar a diferença no conhecimento sobre hipotermia no auxiliar de enfermagem após a intervenção educativa e relacionar as ações de enfermagem às variáveis estudadas. A intervenção educativa foi efetiva, uma vez que a diferença na média das ações de enfermagem foi de 5,35 após a intervenção educativa. Entretanto, não se verificou diferença significativa das ações de enfermagem quando relacionadas às variáveis estudadas. Recomenda-se realizar estudos sobre educação nos profissionais de Enfermagem, baseado na aprendizagem significativa nas diferentes unidades.
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Saunders KEA, Hawton K, Fortune S, Farrell S. Attitudes and knowledge of clinical staff regarding people who self-harm: a systematic review. J Affect Disord 2012; 139:205-16. [PMID: 21925740 DOI: 10.1016/j.jad.2011.08.024] [Citation(s) in RCA: 228] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 08/22/2011] [Accepted: 08/22/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND The attitudes held by clinical staff towards people who harm themselves, together with their knowledge about self-harm, are likely to influence their clinical practice and hence the experiences and outcomes of patients. Our aim was to systematically review the nature of staff attitudes towards people who engage in self-harm, including the factors that influence them, and the impact of training on attitudes, knowledge and behaviour of staff. METHODS AND FINDINGS A comprehensive search for relevant studies was performed on six electronic databases. Two independent reviewers screened titles, abstracts and full reports of studies, extracted data and gave each paper a quality rating. Qualitative and quantitative studies published in English were included. A total of 74 studies were included. Attitudes of general hospital staff, especially doctors, were largely negative, particularly towards individuals who repeatedly self-harm. Self-harm patients were viewed more negatively than other patients, except those abusing alcohol or drugs. Psychiatric staff in community and hospital settings displayed more positive attitudes than general hospital staff. Negative attitudes were more common among doctors than nursing staff although this was only true of general hospital staff. Active training led to consistent improvements in attitude and knowledge in all groups. CONCLUSIONS Attitudes of general hospital staff towards self-harm patients are often negative, mirroring the experience of service users. Interventions can have a positive impact and improve the quality of patient care. LIMITATIONS Included only English language publications.
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Affiliation(s)
- Kate E A Saunders
- Centre for Suicide Research, University Department of Psychiatry, Oxford, Warneford Hospital Oxford OX3 7JX, United Kingdom.
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Pisani AR, Cross WF, Watts A, Conner K. Evaluation of the Commitment to Living (CTL) curriculum: a 3-hour training for mental health professionals to address suicide risk. CRISIS 2012; 33:30-8. [PMID: 21940243 DOI: 10.1027/0227-5910/a000099] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Finding effective and efficient options for training mental health professionals to assess and manage suicide risk is a high priority. AIMS To test whether an innovative, brief workshop can improve provider knowledge, confidence, and written risk assessment in a multidisciplinary sample of ambulatory and acute services professionals and trainees. METHODS We conducted a pre/post evaluation of a 3 h workshop designed to improve clinical competence in suicide risk assessment by using visual concept mapping, medical records documentation, and site-specific crisis response options. Participants (N = 338 diverse mental health professionals) completed pre- and postworkshop questionnaires measuring their knowledge and confidence. Before and after the workshop, participants completed documentation for a clinical vignette. Trained coders rated the quality of risk assessment formulation before and after training. RESULTS Participants' knowledge, confidence, and objectively-rated documentation skills improved significantly (p < .001), with large effect sizes. Participants' expectation of their ability to transfer workshop content to their clinical practice was high (mean = 4.10 on 1-5 scale). CONCLUSIONS Commitment to Living is a promising, innovative, and efficient curriculum for educating practicing clinicians to assess and respond to suicide risk. Well-designed, brief, suicide risk management programs can improve clinicians' knowledge, confidence, and skill.
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Development of a short version of the Suicide Intervention Response Inventory. ACTA ACUST UNITED AC 2012; 83:330-6. [DOI: 10.4992/jjpsy.83.330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pisani AR, Cross WF, Gould MS. The assessment and management of suicide risk: state of workshop education. Suicide Life Threat Behav 2011; 41:255-76. [PMID: 21477093 PMCID: PMC3529392 DOI: 10.1111/j.1943-278x.2011.00026.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A systematic search of popular and scholarly databases identified workshops that addressed general clinical competence in the assessment or management of suicide risk, targeted mental health professionals, and had at least one peer-reviewed publication. We surveyed workshop developers and examined empirical articles associated with each workshop. The state of workshop education is characterized by presenting the learning objectives, educational formats, instructor factors, and evaluation studies. Workshops are efficacious for transferring knowledge and shifting attitudes; however, their role in improving clinical care and outcomes of suicidal patients has yet to be determined.
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Affiliation(s)
| | - Wendi F. Cross
- Psychiatry (Psychology) and Pediatrics, University of Rochester
| | - Madelyn S. Gould
- Psychiatry and Epidemiology, Columbia University/New York State Psychiatric Institute
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