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Kasal A, Táborská R, Juríková L, Grabenhofer-Eggerth A, Pichler M, Gruber B, Tomášková H, Niederkrotenthaler T. Facilitators and barriers to implementation of suicide prevention interventions: Scoping review. Glob Ment Health (Camb) 2023; 10:e15. [PMID: 37854412 PMCID: PMC10579684 DOI: 10.1017/gmh.2023.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/12/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023] Open
Abstract
We know that suicide is preventable, yet hundreds of thousands of people still die due to suicide every year. Many interventions were proven to be effective, and dozens of others showed promising results. However, translating these interventions into new settings brings several challenges. One of the crucial obstacles to success is not anticipating possible barriers to implementation nor enhancing possible benefits of factors facilitating the implementation. While we witnessed great support for suicide prevention activities globally in the past years, implementation barriers and facilitating factors are yet to be comprehensively mapped to help implementation activities worldwide. This scoping review maps current knowledge on facilitators and barriers to the implementation of suicide prevention interventions while using the Consolidated Framework for Implementation Research (CFIR) for classification. We included 64 studies. Barriers and facilitators were most commonly identified in the outer setting CFIR domain, namely in the sub-domain of patient needs and resources, which refers to the way in which these needs and resources are reflected by the reviewed interventions. The second most saturated CFIR domain for facilitators was intervention characteristics, where relative advantage, adaptability and cost of intervention sub-domains were equally represented. These sub-domains refer mostly to how the intervention is perceived by key stakeholders, to what extent it can be tailored to the implementation context and how much it costs. While intervention characteristics domain was the second most common also for barriers, the complexity sub-domain referring to high perceived difficulty of implementation was the most frequently represented. With reference to the results, we recommend adapting interventions to the needs of the target groups. Furthermore, carefully selecting the intervention to suit the target context concerning their adaptability, costs and complexity is vital for a successful implementation. Further implications for practice and research are discussed.
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Affiliation(s)
- Alexandr Kasal
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Social Sciences, Charles University, Prague, Czech Republic
| | - Roksana Táborská
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
| | - Laura Juríková
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | | | - Michaela Pichler
- Department of Psychosocial Health, Gesundheit Österreich GmbH, Wien, Austria
| | - Beate Gruber
- Department of Psychosocial Health, Gesundheit Österreich GmbH, Wien, Austria
| | - Hana Tomášková
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
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2
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Wand AP, Browne R, Jessop T, Peisah C. A systematic review of evidence-based aftercare for older adults following self-harm. Aust N Z J Psychiatry 2022; 56:1398-1420. [PMID: 35021912 DOI: 10.1177/00048674211067165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Self-harm is closely associated with suicide in older adults and may provide opportunity to intervene to prevent suicide. This study aimed to systematically review recent evidence for three components of aftercare for older adults: (1) referral pathways, (2) assessment tools and safety planning approaches and (3) engagement and intervention strategies. METHODS Databases PubMed, Medline, PsychINFO, Embase and CINAHL were searched from January 2010 to 10 July 2021 by two reviewers. Empirical studies reporting aftercare interventions for older adults (aged 60+) following self-harm (including with suicidal intent) were included. Full text of articles with abstracts meeting inclusion criteria were obtained and independently reviewed by three authors to determine final studies for review. Two reviewers extracted data and assessed level of evidence (Oxford) and quality ratings (Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative and Attree and Milton checklist for qualitative studies), working independently. RESULTS Twenty studies were reviewed (15 quantitative; 5 qualitative). Levels of evidence were low (3, 4), and quality ratings of quantitative studies variable, although qualitative studies rated highly. Most studies of referral pathways were observational and demonstrated marked variation with no clear guidelines or imperatives for community psychiatric follow-up. Of four screening tools evaluated, three were suicide-specific and one screened for depression. An evidence-informed approach to safety planning was described using cases. Strategies for aftercare engagement and intervention included two multifaceted approaches, psychotherapy and qualitative insights from older people who self-harmed, carers and clinicians. The qualitative studies identified targets for improved aftercare engagement, focused on individual context, experiences and needs. CONCLUSION Dedicated older-adult aftercare interventions with a multifaceted, assertive follow-up approach accompanied by systemic change show promise but require further evaluation. Research is needed to explore the utility of needs assessment compared to screening and evaluate efficacy of safety planning and psychotherapeutic approaches.
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Affiliation(s)
- Anne Pf Wand
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Older Peoples Mental Health Service, Jara Ward, Concord Centre for Mental Health, Sydney Local Health District, Concord, Australia
| | - Roisin Browne
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,ForeFront Motor Neuron Disease & Frontotemporal Dementia Clinic, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
| | - Tiffany Jessop
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
| | - Carmelle Peisah
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
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3
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Wayland S, Coker S, Maple M. The human approach to supportive interventions: The lived experience of people who care for others who suicide attempt. Int J Ment Health Nurs 2021; 30:667-682. [PMID: 33355984 DOI: 10.1111/inm.12829] [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] [Received: 08/05/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 01/29/2023]
Abstract
There is currently limited information about the impact and experiences of a suicide attempt on the well-being of a person providing care before, during, or after the attempt. Scant evidence available suggests that providing care has a profound impact on the support person or carers' own physical and psychological health; they may experience adverse health, financial, and functional outcomes, collectively described as 'caregiver burden'. This project sought to understand insights into the experience of providing care for someone who has previously attempted suicide. The larger study was designed in three phases consisting of an online survey, semi-structured interviews, and a follow-up survey. This paper reports the qualitative findings of the interviews which were thematically analysed. Two symbiotic themes emerged: the lived experience of caring and the impact of engagement and support from the healthcare system. The authors concluded that that the carer position is a multidimensional role involving informal agreements and situational or time-based support. Further, awareness of this shifting relationship needs to be embedded in the provision of care by health professionals following a suicide attempt. Recommendations for enhanced health system response are proposed.
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Affiliation(s)
- Sarah Wayland
- School of Social Work, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Sarah Coker
- SANE Australia, South Melbourne, Vic., Australia
| | - Myfanwy Maple
- School of Social Work, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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4
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Pons-Baños J, Ballester-Ferrando D, Riesco-Miranda L, Escoté-Llobet S, Jiménez-Nuño J, Fuentes-Pumarola C, Serra-Millàs M. Sociodemographic and Clinical Characteristics Associated with Suicidal Behaviour and Relationship with a Nurse-Led Suicide Prevention Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238765. [PMID: 33255772 PMCID: PMC7728328 DOI: 10.3390/ijerph17238765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
Suicidal behaviour is a major public health problem that needs to be tackled by all health agents including mental health nurses. Aims: The purpose of this study was to analyse the relationship between demographic and clinical characteristics and different kinds of suicidal behaviour with a nurse-led suicide prevention programme. Methods: The design was a cross-sectional study, performed in the region of Osona (Catalonia) in the five-year period 2013–2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt or completed suicide. Results: The sample included 753 patients (of whom 53 completed suicide) who experienced 931 suicidal behaviour episodes. Men represented only 38.4% of the sample but 81.1% of completed suicides. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. Two thirds (66.4%) of the individuals (0.8% (n = 4) of whom completed suicide) were participants in a nurse-led suicidal behaviour case management programme. Conclusion: The main risk factors were being a woman for suicidal behaviour and being a man and being older for completed suicide. Mental disorders, widowhood and retirement were also associated with completed suicide. The completed suicide rate was lower among participants in the nurse-led programme.
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Affiliation(s)
- Judit Pons-Baños
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
- Interinstitutional Research Group, Department of Mental Health and Social Innovation, 08500 Vic, Spain
| | - David Ballester-Ferrando
- Health and Healthcare Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain;
- Correspondence: ; Tel.: +34-972-418771
| | - Lola Riesco-Miranda
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
| | - Santiago Escoté-Llobet
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Interinstitutional Research Group, Department of Mental Health and Social Innovation, 08500 Vic, Spain
| | - Jordi Jiménez-Nuño
- Vic Forensic Medicine Department, Institute of Legal Medicine and Forensic Sciences of Catalonia, 08500 Vic, Spain;
| | | | - Montserrat Serra-Millàs
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
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5
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Tölli S, Kontio R, Partanen P, Häggman-Laitila A. Patient safety and staff competence in managing challenging behavior based on feedback from former psychiatric patients. Perspect Psychiatr Care 2020; 56:785-796. [PMID: 32096221 DOI: 10.1111/ppc.12493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/28/2020] [Accepted: 02/12/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to describe the perceptions and lived experiences of former psychiatric patients of their own and/or co-patients' behavior that nursing staff has regarded as challenging and that has resulted in behavior management. DESIGN AND METHODS An explorative-descriptive qualitative design with video vignettes, semistructured interviews, and abductive content analysis. FINDINGS Many reasons for different kinds of patient behavior that were considered challenging by staff were identified. Delivering care based on patients' needs was identified as core staff competence. PRACTICE IMPLICATIONS Findings can be utilized when pursuing restraint reduction in psychiatric care by enhancing staff competence.
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Affiliation(s)
- Sirpa Tölli
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Oulu University of Applied Sciences, Health and Social Care, Oulu, Finland
| | - Raija Kontio
- Hyvinkää Hospital, Hyvinkää, Finland.,Helsinki University Hospital, Finland.,Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Pirjo Partanen
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Arja Häggman-Laitila
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Social and Health Care, Helsinki, Finland
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6
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Jackson KP, Welch A, Hopkinson S. Back from the Brink: The Experience of Hospital after a Suicide Attempt, and What Happens When You Go Home. Issues Ment Health Nurs 2020; 41:560-567. [PMID: 32357110 DOI: 10.1080/01612840.2019.1710010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Key proponents of suicide prevention around the world have been calling for research to focus on people who have survived a suicide attempt in the belief that people with this experience are an important but neglected source of information, with a great deal to contribute to the field of suicidology. This paper concerns the period in the immediate aftermath of a suicide attempt: the experiences of being hospitalised; discharged; returning home to the same struggle with suicidality and mental illness; difficulties with other people; and the side effects of medication. The methodology underpinning the study was descriptive phenomenology in the tradition of Edmund Husserl. The researcher conducted taped, face-to-face interviews of 1-2 hours with eight, adult volunteers and asked them to share their experience of re-engaging with life after a suicide attempt. What is of particular interest in this research are new findings on the way patients can help each other find a pathway to self-acceptance and the beginning of hope; and on the experience of returning home following a suicide attempt. These findings have the potential to inform mental health professionals, and improve existing mental health and suicide prevention practice by providing insight into the personal experiences of service users at this critical time in their life.
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Affiliation(s)
| | - Anthony Welch
- School of Nursing, Midwifery & Social Science, Central Queensland University, Rockhampton, Australia.,LEAP Centre (Learning, Equity, Access and Participation), Central Queensland University, Rockhampton, Australia
| | - Shane Hopkinson
- School of Nursing, Midwifery & Social Science, Central Queensland University, Rockhampton, Australia
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The perspectives of adults with suicidal ideation and behaviour regarding their interactions with nurses in mental health and emergency services: A systematic review. Int J Nurs Stud 2020; 110:103692. [PMID: 32682109 DOI: 10.1016/j.ijnurstu.2020.103692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/04/2020] [Accepted: 06/14/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND In contemporary healthcare, both community and inpatient mental health and emergency services are important help-seeking avenues for persons with suicidal ideation and behaviour. Regarding nursing practice in these services, there is a strong focus on assessing and managing suicide risk. Within this clinical context, the perspectives of persons with suicidal ideation and behaviour are often overlooked. OBJECTIVE To synthesise the literature examining the perceptions and experiences of persons with suicidal ideation and behaviour regarding their interactions with nurses. DESIGN Review of qualitative and quantitative studies within a data-based convergent synthesis design. DATA SOURCES A systematic search of electronic databases (until January 2020) in PubMed, Web of Science, Embase, and PsycARTICLES. Additional articles were identified through hand searching reference lists. REVIEW METHODS The methodological quality was assessed using the Critical Appraisal Skills Programme for qualitative studies and the QualSyst tool for quantitative studies. Thematic analysis was used to identify the key themes and subthemes. RESULTS In total, 26 studies were selected for analysis. Most studies were qualitative and focused on inpatient mental health services. The studies reflected a spectrum of positive and negative perceptions and experiences of persons with suicidal ideation and behaviour regarding their interactions with nurses. Three key themes were identified: being cared for and acknowledged as a unique individual, giving voice to myself in an atmosphere of connectedness, and encountering a nurturing space to address my suicidality. CONCLUSIONS This systematic review provides insights that can be used to encourage nurses to contribute to suicide prevention and treatment as part of an approach in which they care for, connect, and collaborate with persons experiencing suicidal ideation and behaviour as unique individuals.
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8
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Lee K, Lee D, Hong HJ. Text mining analysis of teachers' reports on student suicide in South Korea. Eur Child Adolesc Psychiatry 2020; 29:453-465. [PMID: 31222535 DOI: 10.1007/s00787-019-01361-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 06/11/2019] [Indexed: 11/28/2022]
Abstract
A teacher as a suicide prevention gatekeeper has an important role in identifying suicide risks and warning signs in students. After a student's suicide, teachers in Korea have to write a student suicide case report based on their direct and indirect observations. In particular, the section 'characteristic of student suicide' of this report contains valuable information about the suicide; however, it is unstructured, and thus cannot be analyzed using conventional statistical methods. We aimed to identify the characteristics of observed Korean students, who have committed suicide, using text mining techniques as well as to improve our understanding of suicidal behaviors in the school contexts. Therefore, a series of text mining techniques: topic analysis, word correlation, and word frequency analysis, in three problem categories: health, school, and family problems, were used to analyze the characteristics of student suicides. Topic analysis showed that only 30% of the student suicide case reports identified problematic student characteristics related to suicide. Correlations between words showed that words in one problem category were often correlated with words in other problem categories. Frequency word analysis showed that the three problem categories varied across gender and school levels. These results provide interesting insights into the characteristics of suicides among Korean students and important implications for suicide intervention in the education field.
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Affiliation(s)
- KangWoo Lee
- Suicide and School Mental Health Institute, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang, 14068, South Korea
| | - Dayoung Lee
- Department of Psychiatry, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang, 14068, South Korea
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang, 14068, South Korea.
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The Attempt Was My Own! Suicide Attempt Survivors Respond to an Australian Community-Based Suicide Exposure Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224549. [PMID: 31752077 PMCID: PMC6888602 DOI: 10.3390/ijerph16224549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022]
Abstract
Those who attempt suicide have often been overlooked in the suicide prevention literature. Where stories of lived experience have been included, it is often from the perspectives of healthcare professionals who treat the physical and/or psychological impacts following an attempt, rather than firsthand accounts. Yet, the most intimate insights of suicide are lost by not including the voices of those with lived experience of suicide attempt. Through an online, community-based, non-representative survey exploring the impact of exposure to suicide, a sub-sample of 88 participants responded who reported their exposure to suicide as being their own attempt. The survey covered demographic information, questions assessing exposure to suicide attempts and death, current global psychological distress via the Kessler Psychological Distress (K10) Scale, and short qualitative responses provided by 46 participants. The qualitative data was thematically analysed resulting in three themes; the way in which individuals experienced being suicidal; who they were able, or not, to disclose these intentions to—before and after their suicide attempt; and, how these people experienced the formal and informal health care supports available to them to assist with their suicidal crisis. This paper presents important findings from a sample of participants who are highly distressed, and have previously attempted to take their own lives. This adds depth to our understanding of lived experience of suicide attempt, issues associated with seeking appropriate support after suicide attempt, and also demonstrates a willingness of participants to share their stories, even in a study that did not explicitly target those with lived experience of suicide attempt. The need for consistent and compassionate mental health care after a suicide attempt is identified as a vital component of living well after a suicide attempt.
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10
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Krychiw JK, Ward-Ciesielski EF. Factors related to suicide's unpredictability: a qualitative study of adults with lived experience of suicide attempts. Int J Qual Stud Health Well-being 2019; 14:1650585. [PMID: 31401937 PMCID: PMC6713178 DOI: 10.1080/17482631.2019.1650585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: In recent decades, suicide prevention initiatives have increased substantially, yet the suicide rate has continued to rise, and suicide deaths are still generally perceived as unexpected. This study sought to identify factors that might account for this discrepancy by focusing on the exhibition of suicide warning signs. Methods: Qualitative interviews were conducted with 15 adults [mean age = 36 (SD = 14), 93% female] who had attempted suicide at least once in their lifetime. Results: A disconnect between participants and their environment emerged as a central theme. Many expressed ambivalence about whether they wanted others to intervene before their attempts, resulting in either expression or inhibition of warning signs. Regardless of whether they wanted their attempt to be predictable, most participants expressed disappointment if they perceived a lack of intervention before their attempt. In some cases, this disappointment exacerbated distress and may have contributed to the attempt itself. Participants also expressed difficulty disclosing their suicidal ideation to others. Thus, even if they wanted help, participants were unsure how to effectively attain it. Conclusions: Findings underscore the complexity of predicting and preventing suicide; however, engaging individuals with lived experience in these efforts facilitates greater understanding toward outreach and intervention approaches.
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11
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McGill K, Hackney S, Skehan J. Information needs of people after a suicide attempt: A thematic analysis. PATIENT EDUCATION AND COUNSELING 2019; 102:1119-1124. [PMID: 30679002 DOI: 10.1016/j.pec.2019.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/18/2018] [Accepted: 01/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study aimed to identify the information that people who have attempted suicide and those who support them believed to be helpful to receive after an attempt. METHODS Thirty-seven people with lived experience of suicide attempt(s) (suicide attempt survivors and family members/friends of survivors) were recruited through two national lived experience community groups in Australia. Participants completed a semi-structured telephone interview that included questions about the types of information they believed important to receive after an attempt. RESULTS Using thematic analysis, the key information participants identified was helpful to receive following a suicide attempt was that which could challenge stigma and address negative community attitudes towards suicide. Participants spoke of a need for practical information and information that provided hope. Personal stories of recovery were identified as an important way of communicating this sort of health information. CONCLUSIONS People who have attempted suicide and their family members and friends want information that challenges stigma and supports recovery expectations. PRACTICE IMPLICATIONS Providing people with accurate information about recovery and using personal stories to communicate health information is one way people affected by suicide attempt identify can challenge stigma, and address information needs after a suicide attempt.
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Affiliation(s)
- Katie McGill
- Mental Health-Research, Analysis, Evaluation and Dissemination Unit, Hunter New England Local Health District, P.O. Box 833, Newcastle, NSW, 2300, Australia; School of Medicine & Public Health, University of Newcastle, University Drive, Newcastle, Callaghan, NSW, 2308, Australia; Everymind, Hunter New England Local Health District, P.O. Box 833, Newcastle, NSW, 2300, Australia.
| | - Sue Hackney
- Western New South Wales Primary Health Network, P.O. Box 890, Dubbo, NSW, 2830, Australia
| | - Jaelea Skehan
- School of Medicine & Public Health, University of Newcastle, University Drive, Newcastle, Callaghan, NSW, 2308, Australia; Everymind, Hunter New England Local Health District, P.O. Box 833, Newcastle, NSW, 2300, Australia
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12
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Lee SU, Jeon M, Park JI. A Comparison of Attitudes Toward Suicide Among Individuals With and Without Suicidal Thoughts and Suicide Attempts in South Korea. CRISIS 2019; 40:27-35. [DOI: 10.1027/0227-5910/a000528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract. Background: A suicidal person can go through different stages that include suicidal thoughts and suicide attempts. For a few individuals, these can end up with suicide. However, there have been no studies investigating any differences in attitudes toward suicides among individuals with no suicidal thoughts, those with suicidal thoughts, and those with suicide attempts. Aims: This study was carried out to compare attitudes toward suicide among three different groups: individuals with a history of no suicidal thoughts, those with a history of suicidal thoughts, and those with a history of suicide attempts. Method: To examine Koreans' attitudes toward suicide, we analyzed the data from the 2013 National Suicide Survey involving 1,500 participants aged between 19 and 75 years. Results: Different attitudes toward suicide were found among the three groups. Persons reporting that they had made a suicide attempt in their life showed the most permissive attitudes toward suicide. Limitations: Since this research is based on cross-sectional data, it is difficult to eliminate the possibility of changes in attitude toward suicide completely after having a suicidal thought and suicide attempt. Conclusion: These results can be a useful source for constructing effective messages for suicide prevention campaigns and can ultimately contribute to an improvement in the public's perceptions of suicide in the future.
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Affiliation(s)
- Sang-Uk Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, South Korea
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Mina Jeon
- Department of Psychology and Human Development, UCL Institute of Education, London, UK
| | - Jong-Ik Park
- Department of Psychiatry, Kangwon National University School of Medicine, Chunchon, South Korea
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13
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Vahidi M, Ebrahimi H, Areshtanab HN, Jafarabadi MA, Lees D, Foong A, Cleary M. Therapeutic Relationships and Safety of Care in Iranian Psychiatric Inpatient Units. Issues Ment Health Nurs 2018; 39:967-976. [PMID: 30204047 DOI: 10.1080/01612840.2018.1485795] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Enhancing therapeutic relationships between patients and staff is of central importance to improve the quality and safety of care in psychiatric inpatient units. However, there is limited evidence as to how therapeutic relationships may be enabled in this specific context. This paper presents findings of a study that explored the link between therapeutic relationships and safety in Iranian psychiatric inpatient units. In this exploratory, descriptive study, seven patients at the point of discharge and 19 staff in psychiatric inpatient units in Iran were interviewed regarding their experiences of care. The quality of staff-patient relationship in providing a safe environment was categorized into two groups of "facilitators" and "inhibitors". Facilitators of a safe environment included "supportive relationship with patients" and "improving patient capacity for self-efficacy/self-control". Inhibitors, on the other hand, included "detachment from patients" and "domination over patients", which ultimately limited safety on the ward. Findings indicate interrelated environmental, patient and staff factors mediating the potential for therapeutic relationships and quality and safety of care. Findings suggest the need for more effective preparation and support for staff working within psychiatric inpatient settings. In addition, environments more conducive to collaborative recovery-oriented practice are required to enhance therapeutic relationships and improve quality and safety of care. Both individual staff responsibility and effective leadership are required to realize change.
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Affiliation(s)
- Maryam Vahidi
- a Department of Psychiatric Nursing, Faculty of Nursing & Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hossein Ebrahimi
- a Department of Psychiatric Nursing, Faculty of Nursing & Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hossein Namdar Areshtanab
- a Department of Psychiatric Nursing, Faculty of Nursing & Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mohammad Asghari Jafarabadi
- b Department of Statistics and Epidemiology, Faculty of Health sciences , Tabriz University of Medical Sciences , Tabriz , Iran
| | - David Lees
- c School of Health Sciences , University of Tasmania , Launceston , Tasmania , Australia
| | - Andrew Foong
- d School of Health Sciences , University of Tasmania , Sydney , New South Wales , Australia
| | - Michelle Cleary
- d School of Health Sciences , University of Tasmania , Sydney , New South Wales , Australia
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14
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Abstract
Background: Suffering in a suicidal crisis includes feelings such as despair, loneliness, anxiety, fear, shame, guilt and hopelessness. This study highlights the experiences of patients in the aftermath of suicide attempts. The research question was, what do suicidal patients see as meaningful help in care and treatment situations? Methodology: The methodology is inspired by Gadamer’s hermeneutics, where the parts are understood in light of the whole, and the whole is understood in light of the parts. Qualitative interviews were employed. Participants and research context: A total of 10 persons, 4 women and 6 men 21–52 years old, were informed and asked to participate by specialists in psychology at two emergency psychiatric wards and by one crisis resolution team. Nine of the participants had experienced one or more suicide attempts using drugs and alcohol. Forced hospitalization prevented one of the 10 participants from attempting suicide. Ethical considerations: Before the participants signed an informed consent form, the interviewer met all participants to provide the written information, talking about the interview. A meeting to terminate contact was arranged after the participants had read their own interviews. Findings: Three themes were generated by the methodology we applied: (1) experiencing hope through encounters, (2) experiencing hope through the atmosphere of wisdom and (3) experiencing a ray of hope from taking back responsibility. Discussion: The findings are discussed in the light of Eriksson’s suffering theory and Lindström’s theory about psychiatric care, as well as earlier research and theories about suicidality. Conclusion: The study reinforces possibilities that hope in suicidal patients can be inspired in encounters with healthcare personnel and within caring cultures. Through dialogue and cooperation, patients’ safety and ability to cope with suffering is created and thereby the hope and will to struggle for life.
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Affiliation(s)
| | - Dagfinn Nåden
- Oslo and Akershus University College of Applied Sciences, Norway
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15
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White J. Qualitative Evidence in Suicide Ideation, Attempts, and Suicide Prevention. HANDBOOKS IN HEALTH, WORK, AND DISABILITY 2016. [DOI: 10.1007/978-1-4939-2920-7_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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16
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Denneson LM, Teo AR, Ganzini L, Helmer DA, Bair MJ, Dobscha SK. Military Veterans' Experiences with Suicidal Ideation: Implications for Intervention and Prevention. Suicide Life Threat Behav 2015; 45:399-414. [PMID: 25367753 DOI: 10.1111/sltb.12136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/15/2014] [Indexed: 11/27/2022]
Abstract
We sought to understand Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans' experiences with suicidal ideation. Semi-structured interviews with 34 OEF/OIF veterans addressed circumstances leading up to disclosure of suicidal ideation during brief clinical assessments. We used an iterative, inductive and deductive thematic analysis approach. Results revealed three pervasive, persistent domains that reinforce the uniqueness of veteran suicidal thoughts: military culture, difficult deployment experiences, and postdeployment adjustment challenges. Within postdeployment, we identified four themes that serve as intervention targets: adjusting to civilian culture, changes to sense of self, feeling overwhelmed by stressors, and lacking life purpose or meaning.
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Affiliation(s)
- Lauren M Denneson
- Portland Center to Improve Veteran Involvement in Care (CIVIC), Portland VA Medical Center, Portland, OR.,Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Alan R Teo
- Portland Center to Improve Veteran Involvement in Care (CIVIC), Portland VA Medical Center, Portland, OR.,Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Linda Ganzini
- Portland Center to Improve Veteran Involvement in Care (CIVIC), Portland VA Medical Center, Portland, OR.,Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Drew A Helmer
- War-Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ.,Department of Medicine, Rutgers University-New Jersey Medical School, Newark, NJ, USA
| | - Matthew J Bair
- Richard L. Roudebush Veteran Affairs Medical Center, Indianapolis, IN, USA
| | - Steven K Dobscha
- Portland Center to Improve Veteran Involvement in Care (CIVIC), Portland VA Medical Center, Portland, OR.,Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
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17
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The Aftermath of a Suicide Cluster in the Age of Online Social Networking: a Qualitative Analysis of Adolescent Grief Reactions. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40688-015-0060-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Kim Y. Understanding the life experiences of older adults in Korea following a suicide attempt. QUALITATIVE HEALTH RESEARCH 2014; 24:1391-1399. [PMID: 25147216 DOI: 10.1177/1049732314547643] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this article is to describe life experiences following suicide attempts from the perspective of older Korean adults. Both field notes and in-depth interviews with 35 elderly Koreans who had attempted suicide were analyzed through qualitative content analysis. With an underlying theme of "life with no way out for those who believe they do not even have any luck in dying," I classified the experiences of participants in the wake of a failed suicide attempt into four categories: (a) facing additional hardships including deteriorating physical health, (b) having more sadness and loneliness than before the suicide attempt, (c) deepening dependency on tranquilizers, and (d) seesawing between despair and faint hope. Based on these research findings, I make four recommendations regarding secondary preventive interventions for elderly suicide attempters.
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Affiliation(s)
- Yujin Kim
- Kyungpook National University, Dae-Gu, South Korea
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19
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Lim M, Kim SW, Nam YY, Moon E, Yu J, Lee S, Chang JS, Jhoo JH, Cha B, Choi JS, Ahn YM, Ha K, Kim J, Jeon HJ, Park JI. Reasons for desiring death: examining causative factors of suicide attempters treated in emergency rooms in Korea. J Affect Disord 2014; 168:349-56. [PMID: 25103630 DOI: 10.1016/j.jad.2014.07.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 07/11/2014] [Accepted: 07/11/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Suicide attempters treated in emergency rooms were studied in order to understand the motives behind this behavior. Disparities between the etiological contributions to suicidal ideation, intention, and action were examined in order to characterize motives in these categories. METHODS Suicide attempters who visited the emergency departments of seven university hospitals were analyzed. Attempts leading to mortality were excluded from the analysis. Participants were assessed using semi-structured questionnaires, the results of which were noted on their medical records. These were analyzed retrospectively. RESULTS Attempter self-report assessment revealed that participants chose external sources of stress (75.4%) and psychiatric symptoms (19.1%) as their main reasons for attempting suicide. However, assessments by interviewers indicated that stressors contributed to suicide attempts to a lesser degree (52.8%) while psychiatric symptoms were more etiologically relevant (36.6%). Compared to those with stressors that was identified as causal in both self-report and clinician assessed evaluation, the participants-regardless of their self-report evaluation-who identified with causal psychiatric symptoms by psychiatrist had more severe and intense suicidal ideation and more determined suicidal intention. LIMITATIONS We collected samples from only university hospitals, resulting in selection bias. In addition, we did not use psychiatric scales to evaluate the participants׳ symptoms. CONCLUSIONS Stress was the greatest motive for attempting suicide, affirmed in both self-report and clinician assessed evaluation. A fair proportion of people were objectively identified as being motivated by psychiatric symptoms, yet were unaware of what they suffered from. Furthermore, suicide severity, intensity, and suicidal intention were stronger in psychiatrically driven cases.
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Affiliation(s)
- Meerae Lim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | | | - Eunsoo Moon
- Department of Psychiatry, Busan National University Hospital Medical Research Institute, Busan, Republic of Korea
| | - Jechun Yu
- Department of Psychiatry, School of Medicine, Eulgi University, Daejeon, Republic of Korea
| | - Soojung Lee
- Korea Suicide Prevention Center, Seoul, Republic of Korea
| | - Jae Seung Chang
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jin-Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Jung-Seok Choi
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; National Seoul Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jayoun Kim
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong-Ik Park
- Korea Suicide Prevention Center, Seoul, Republic of Korea; Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
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20
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Lees D, Procter N, Fassett D. Therapeutic engagement between consumers in suicidal crisis and mental health nurses. Int J Ment Health Nurs 2014; 23:306-15. [PMID: 24575883 DOI: 10.1111/inm.12061] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Registered nurses within public mental health services play crucial roles in helping people recover from suicidal crisis. However, there is a lack of understanding of how care is experienced in this context, and available evidence suggests that nurses and consumers are often dissatisfied with the quality of care. There is thus an imperative to generate understanding of needs and experiences of both groups with a view to informing practice development. This article summarizes qualitative findings from a multimethod study undertaken in Australia, which surveyed and interviewed mental health nurses who had recent experience of caring for consumers in suicidal crisis in a hospital setting, and interviewed consumers who had recovered from a recent suicidal crisis. A framework was developed to guide the study and support ethical imperatives; in particular, the promotion of consumer well-being. The findings highlight that therapeutic interpersonal engagement between nurses and consumers was central to quality care. This was particularly noted, as engagement could help reduce consumer isolation, loss of control, distress, and objectification of the delivery of potentially-objectifying common interventions. Of concern, the results indicate a lack of therapeutic engagement from the perspective of both consumers and nurses. Recommendations to promote fuller therapeutic engagement are presented.
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Affiliation(s)
- David Lees
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
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21
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Lanfredi M, Rossi G, Rossi R, Van Bortel T, Thornicroft G, Quinn N, Zoppei S, Lasalvia A. Depression prevention and mental health promotion interventions: is stigma taken into account? An overview of the Italian initiatives. Epidemiol Psychiatr Sci 2013; 22:363-74. [PMID: 23445538 PMCID: PMC8367333 DOI: 10.1017/s2045796013000085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 01/14/2013] [Accepted: 01/15/2013] [Indexed: 11/07/2022] Open
Affiliation(s)
- M. Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - G. Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - R. Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - T. Van Bortel
- King's College London, Institute of Psychiatry, London, UK
| | - G. Thornicroft
- King's College London, Institute of Psychiatry, London, UK
| | - N. Quinn
- School of Applied Social Sciences, University of Strathclyde, Glasgow, UK
| | - S. Zoppei
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - A. Lasalvia
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
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