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Cai C, Yin C, Tong Y, Qu D, Ding Y, Ren D, Chen P, Yin Y, An J, Chen R. Development of the Life Gatekeeper suicide prevention training programme in China: a Delphi study. Gen Psychiatr 2023; 36:e101133. [PMID: 37859750 PMCID: PMC10582848 DOI: 10.1136/gpsych-2023-101133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/30/2023] [Indexed: 10/21/2023] Open
Abstract
Background Youth suicide has been a pressing public mental health concern in China, yet there is a lack of gatekeeper intervention programmes developed locally to prevent suicide among Chinese adolescents. Aims The current Delphi study was the first step in the systematic development of the Life Gatekeeper programme, the first gatekeeper programme to be developed locally in China that aims to equip teachers and parents with the knowledge, skills and ability to identify and intervene with students at high risk of suicide. Methods The Delphi method was used to elicit a consensus of experts who were invited to evaluate the importance of training content, the feasibility of the training delivery method, the possibility of achieving the training goals and, finally, the appropriateness of the training materials. Two Delphi rounds were conducted among local experts with diversified professional backgrounds in suicide research and practice. Statements were accepted for inclusion in the adjusted training programme if they were endorsed by at least 80% of the panel. Results Consensus was achieved on 201 out of 207 statements for inclusion into the adapted guidelines for the gatekeeper programme, with 151 from the original questionnaire and 50 generated from comments of the panel members. These endorsed statements were synthesised to develop the content of the Life Gatekeeper training programme. Conclusions This Delphi study provided an evidence base for developing the first gatekeeper training programme systematically and locally in China. We hope that the current study can pave the way for more evidence-based suicide prevention programmes in China. Further study is warranted to evaluate the effectiveness of the Life Gatekeeper training programme.
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Affiliation(s)
- Chengxi Cai
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Chen Yin
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yongsheng Tong
- Beijing Huilongguan Hospital, Beijing, China
- HuiLongGuan Clinical Medical School, Peking University, Beijing, China
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yunzhi Ding
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Daixi Ren
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Peiyu Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yi Yin
- Beijing Huilongguan Hospital, Beijing, China
- HuiLongGuan Clinical Medical School, Peking University, Beijing, China
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Jing An
- Beijing Huilongguan Hospital, Beijing, China
- HuiLongGuan Clinical Medical School, Peking University, Beijing, China
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Lee MS, Kim J, Hong HJ, Bhang SY. Can We Notice the Suicidal Warning Signs of Adolescents With Different Psychometric Profiles Before Their Death?: Analysis of Teachers' Reports. J Korean Med Sci 2023; 38:e194. [PMID: 37365728 DOI: 10.3346/jkms.2023.38.e194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/07/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND This study aimed to analyze the suicidal warning signs of Korean students with different psychometric profiles based on teacher reports. METHODS This was a retrospective cohort study based on Korean school teachers' responses to the Student Suicide Report Form. In total, 546 consecutive cases of student suicide were reported from 2017 to 2020. After missing data were excluded, 528 cases were included. The report consisted of demographic factors, the Korean version of the Strengths and Difficulties Questionnaire (SDQ) for teacher reporting, and warning signs of suicide. Frequency analysis, multiple response analysis, the χ² test, and Latent Class Analysis (LCA) were performed. RESULTS Based on the scores of the Korean version of the teacher-reported SDQ, the group was divided into nonsymptomatic (n = 411) and symptomatic (n = 117) groups. Based on the LCA results, four latent hierarchical models were selected. The four classes of deceased students showed significant differences in school type (χ² = 20.410, P < 0.01), physical illness (χ² = 7.928, P < 0.05), mental illness (χ² = 94.332, P < 0.001), trigger events (χ² = 14.817, P < 0.01), self-harm experience (χ² = 30.618, P < 0.001), suicide attempts (χ² = 24.072, P < 0.001), depressive symptoms (χ² = 59.561, P < 0.001), anxiety (χ² = 58.165, P < 0.001), impulsivity (χ² = 62.241, P < 0.001), and social problems (χ² = 64.952, P < 0.001). CONCLUSION Notably, many students who committed suicide did not have any psychiatric pathology. The proportion of the group with a prosocial appearance was also high. Therefore, the actual suicide warning signals were similar regardless of students' difficulties and prosocial behaviors, so it is necessary to include this information in gatekeeper education.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Center for School Mental Health, Eulji University, Seoul, Korea
| | - Joonbeom Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul, Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea
- Suicide and School Mental Health Institute, Hallym University, Anyang, Korea
| | - Soo-Young Bhang
- Center for School Mental Health, Eulji University, Seoul, Korea
- Department of Psychiatry, Nowon Eulji University Hospital, Eulji University School of Medicine, Seoul, Korea.
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Read A, Lutgens D, Malla A. A Descriptive Overview of Mental Health Services Offered in Post-Secondary Educational Institutions Across Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:101-108. [PMID: 36200430 PMCID: PMC9923134 DOI: 10.1177/07067437221128168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Access to adequate mental health (MH) services is necessary for nearly half of Canadian youth (18-24 years) who enroll in post-secondary education given the relatively high risk of MH problems. Our objectives were to determine the status of MH services available to students in post-secondary institutions in Canada and to determine the extent to which these services are based on the principles of a high-quality youth MH (YMH) service. METHOD Information on MH services was collected from websites of a representative sample (N = 67) of post-secondary institutions across all provinces. Data were analysed descriptively according to four categories (universities with a Faculty of Medicine (FoM) n = 18, other large universities n = 15, small universities n = 16, and colleges n = 18). RESULTS Most institutions provided 24-h crisis line support (84%) and indicated the availability of free counselling or psychotherapy (n = 62 of 67, 92.5%), while only a minority indicated provision of an initial clinical assessment (25%) and provision of multiple sessions of therapy (37%). Wait time for first contact was impressively low (<72 h) in the minority of institutions (40%) which provided this information. Access to either a prescribing physician or psychiatrist was infrequent, though several mentioned an unexplained model of "stepped care" and outside referrals. While relevant information was not uniformly easy to access, larger institutions both with and without a FoM appear to be better poised to provide MH services. None of the institutions appeared to follow all the principles of service delivery recommended for a high-quality YMH, with only two showing early identification activities. CONCLUSIONS MH services in post-secondary institutions may need a transformation similar to YMH services, including a clear pathway to care, an initial clinical assessment, early identification of MHA disorders, and better utilization of institutional resources through greater collaboration and matching of timely interventions to the presenting problems.
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Affiliation(s)
- Alana Read
- Department of Psychology, 6082Capilano University, North Vancouver, British Columbia, Canada
| | - Danyael Lutgens
- Department of Psychology, 6082Capilano University, North Vancouver, British Columbia, Canada
| | - Ashok Malla
- Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada
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Do associations between suicide ideation and its correlates (substance use, anxiety, and depression) differ according to victimization type among youth? A Smart platform study. Prev Med Rep 2022; 29:101944. [PMID: 36161124 PMCID: PMC9502327 DOI: 10.1016/j.pmedr.2022.101944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/14/2022] [Accepted: 08/05/2022] [Indexed: 12/03/2022] Open
Abstract
23% of the youth reported suicide ideation in the past year. Suicide ideation was higher among those victimized by bullying. Suicide ideation was also higher with reported anxiety, or poor subjective health. Poor health did not play a role between victimization and suicide ideation.
The issues associated with mental health, substance misuse, and suicide ideation are complex and sensitive among youth. We sought to investigate the role that subjective health, internalizing and externalizing risk factors play in the association between victimization and suicide ideation among youth in Canada via used a custom-built digital epidemiological smartphone application (Smart Platform) on their personal smartphones. A sample of 818 youth citizen scientists in Saskatchewan, Canada downloaded the app to provide information on victimization, subjective health, internalizing problems (symptoms of stress, anxiety, and depression), externalizing behaviours (cannabis use, alcohol, smoking), and suicide ideation. Binary regression models were used to estimate associations and controlled for gender, age, perpetration, and ethnicity. From our sample, 23% of youth reported suicide ideation (i.e., thoughts) in the past year. Three types of victimization (cyberbullied, made fun or teased, or bullied via being left out) are associated with a two-times higher risk of suicide ideation. Although certain risk factors (anxiety, poor subjective health, and cannabis use) were associated with higher suicide ideation risk, they did not moderate the association between victimization and suicide ideation. Symptoms of depression were found to be protective against suicide ideation. Suicide ideation is high among this sample of youth in Canada. Certain types of victimization, internalizing and externalizing risk factors, and poor subjective health are associated with a higher risk of suicide ideation. However, our findings confirm that the pathway from victimization to suicide ideation is complex and is potentially moderated by factors other than the ones explored here.
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Cecchin HFG, Murta SG, de Macedo EOS, Moore RA. Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness. PSICOLOGIA, REFLEXAO E CRITICA : REVISTA SEMESTRAL DO DEPARTAMENTO DE PSICOLOGIA DA UFRGS 2022; 35:22. [PMID: 35856124 PMCID: PMC9294115 DOI: 10.1186/s41155-022-00227-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 06/28/2022] [Indexed: 11/10/2022]
Abstract
A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and cost-effectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost–benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation.
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Affiliation(s)
- Hareli Fernanda Garcia Cecchin
- Universidade Federal do Tocantins, Pró-reitoria de Assuntos Estudantis - PROEST, Quadra 109 Norte, Avenida NS-15, Prédio da Reitoria, Plano Diretor Norte, 77001-090, Palmas, Tocantins, Brazil.
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6
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Pichikov A, Popov Y. Problems with Suicidal Behavior Prevention in Adolescents: a Narrative Literature Review. CONSORTIUM PSYCHIATRICUM 2022; 3:5-13. [PMID: 39045124 PMCID: PMC11262105 DOI: 10.17816/cp166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Among the existing issues related to the health and quality of life of Russian adolescents, suicidal behavior is being actively discussed; however, the available comprehensive measures for prevention of suicide and attempts at suicide at this age do not provide an adequate solution. This is due to the fact that suicide is an integrative phenomenon, and the act of suicide itself is interpreted, in essence, as the "tip of the iceberg". What is especially clearly manifested in adolescence is the fact that the readiness to commit suicide is associated not so much with the level of severity of mental pathology and personality dysfunction, but with the general social context lack of well-being of total trouble. Therefore, suicide prevention cannot be based purely on the timely identification of persons at risk for mental pathology. AIM The purpose of this work is to analyze the available literature on current approaches that have demonstrated their efficacy in reducing suicidal behavior in adolescents. METHODS The authors performed a narrative review of the relevant literature published between 2012 and 2021. They analyzed the works presented in the PubMed, MEDLINE, and Web of Science electronic databases. Descriptive analysis was used to generalize the data obtained. RESULTS The article discusses preventive approaches to suicidal behavior in adolescents, which are most often studied, and which are also used in practical healthcare. It outlines the problems associated with the implementation and evaluation of the efficacy of these preventive programs. CONCLUSIONS The continuing high rate of suicide among adolescents calls for an urgent concerted effort to develop, disseminate, and implement more effective prevention strategies. School-based approaches are the most convenient in practical terms, but they require systematic and long-term use of anti-suicidal programs. Digital interventions can reduce the economic burden of their use, including assessing suicidal risk and identifying psychopathology associated with suicidality.
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7
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Holmes G, Clacy A, Hermens DF, Lagopoulos J. Evaluating the Longitudinal Efficacy of SafeTALK Suicide Prevention Gatekeeper Training in a General Community Sample. Suicide Life Threat Behav 2021; 51:844-853. [PMID: 33594707 DOI: 10.1111/sltb.12741] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/03/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The majority of individuals experiencing depression or in crisis do not seek assistance through formal support pathways. Thus, the presence of informal "gatekeepers" in the community is vital to identifying and supporting these individuals through crisis. The objective of this study was to evaluate the longitudinal effectiveness of "SafeTALK" suicide prevention gatekeeper training in a general community sample. METHOD Two hundred and sixty-two community members participated in half-day (4-h) gatekeeper training sessions. Surveys were taken pre- and post-training and at 6-month follow-up to evaluate participants' knowledge, preparedness, and efficacy, as well as reluctance to intervene as a suicide prevention gatekeeper. RESULTS Longitudinal effects were revealed for three of four evaluated appraisals. Scores for knowledge, preparedness, and efficacy were significantly higher (improved) 6 months after training, compared to pre-test. While participants showed even greater immediate effects (i.e., pre-test to post-test), follow-up scores indicate that the positive effects of training were sustained over 6 months. CONCLUSIONS This study is the first to evaluate SafeTALK in a community population. SafeTALK was shown to be effective at improving knowledge, preparedness, and efficacy with effects declining over time but remaining significant from pre-test. Community suicide prevention programs can benefit from the inclusion of gatekeeper training programs.
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Affiliation(s)
- Glenn Holmes
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Amanda Clacy
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Daniel F Hermens
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Qld, Australia
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8
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Darling S, Dawson G, Quach J, Smith R, Perkins A, Connolly A, Smith A, Moore CL, Ride J, Oberklaid F. Mental health and wellbeing coordinators in primary schools to support student mental health: protocol for a quasi-experimental cluster study. BMC Public Health 2021; 21:1467. [PMID: 34320975 PMCID: PMC8316894 DOI: 10.1186/s12889-021-11467-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Half of mental health disorders begin before the age of 14, highlighting the importance of prevention and early-intervention in childhood. Schools have been identified globally by policymakers as a platform to support good child mental health; however, the majority of the research is focused on secondary schools, with primary schools receiving very little attention by comparison. The limited available evidence on mental health initiatives in primary schools is hindered by a lack of rigorous evaluation. This quasi-experimental cluster study aims to examine the implementation and effectiveness of a Mental Health and Wellbeing Co-ordinator role designed to build mental health capacity within primary schools. Methods This is a primary (ages 5–12) school-based cluster quasi-experimental study in Victoria, Australia. Before baseline data collection, 16 schools selected by the state education department will be allocated to intervention, and another 16 matched schools will continue as ‘Business as Usual’. In intervention schools, a mental health and well-being coordinator will be recruited and trained, and three additional school staff will also be selected to receive components of the mental health training. Surveys will be completed by consenting staff (at 2-, 5-, 10- and 17-months post allocation) and by consenting parents/carers (at 3-, 10- and 17-months post allocation) in both intervention and business as usual schools. The primary objective is to assess the change in teacher’s confidence to support student mental health and wellbeing using the School Mental Health Self-Efficacy Teacher Survey. Secondary objectives are to assess the indirect impact on systemic factors (level of support, prioritisation of child mental health), parent and teachers’ mental health literacy (stigma, knowledge), care access (school engagement with community-based services), and student mental health outcomes. Implementation outcomes (feasibility, acceptability, and fidelity) and costs will also be evaluated. Discussion The current study will examine the implementation and effectiveness of having a trained Mental Health and Wellbeing Coordinator within primary schools. If the intervention increases teachers’ confidence to support student mental health and wellbeing and builds the capacity of primary schools it will improve student mental health provision and inform large-scale mental health service reform. Trial registration The trial was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) on July 6, 2021. The registration number is ACTRN12621000873820.
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Affiliation(s)
- S Darling
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, 3010, USA
| | - G Dawson
- Centre for Program Evaluation, Melbourne Graduate School of Education, University of Melbourne, Carlton, VIC, 3053, USA
| | - J Quach
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA.,Centre for Program Evaluation, Melbourne Graduate School of Education, University of Melbourne, Carlton, VIC, 3053, USA
| | - R Smith
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA. .,Department of Paediatrics, University of Melbourne, Melbourne, VIC, 3010, USA.
| | - A Perkins
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA
| | - A Connolly
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA
| | - A Smith
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA
| | - C L Moore
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA
| | - J Ride
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA.,Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, 207 Bouverie St, Parkville, VIC, 3010, USA
| | - F Oberklaid
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, USA.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, 3010, USA
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Grosselli L, Herzog K, Aseltine RH, Balazs J, Carli V, Ciffone J, De Leo D, van der Feltz-Cornelis C, Hawton K, Hegerl U, Kõlves K, Kutcher S, Mehlum L, Niederkrotenthaler T, Rezaeian M, Renaud J, Schneider B, Lewitzka U, Hoyer J, Knappe S. Dos and Don'ts in Designing School-Based Awareness Programs for Suicide Prevention. CRISIS 2021; 43:270-277. [PMID: 34042491 PMCID: PMC9353877 DOI: 10.1027/0227-5910/a000783] [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: 12/18/2022]
Abstract
Abstract.Background: Despite the promising evidence for the
effectiveness of school-based awareness programs in decreasing the rates of
suicidal thoughts and suicide attempts in young people, no guidelines on the
targets and methods of safe and effective awareness programs exist.
Aims: This study intends to distill recommendations for
school-based suicide awareness and prevention programs from experts.
Method: A three-stage Delphi survey was administered to an
expert panel between November 2018 and March 2019. A total of 214 items obtained
from open-ended questions and the literature were rated in two rounds. Consensus
and stability were used as assessment criteria. Results: The
panel consisted of 19 participants in the first and 13 in the third stage.
Recommended targets included the reduction of suicide attempts, the enhancement
of help-seeking and peer support, as well as the promotion of mental health
literacy and life skills. Program evaluation, facilitating access to healthcare,
and long-term action plans across multiple levels were among the best strategies
for the prevention of adverse effects. Limitations: The study
is based on opinions of a rather small number of experts.
Conclusion: The promotion of help-seeking and peer support
as well as facilitating access to mental health-care utilities appear pivotal
for the success of school-based awareness programs.
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Affiliation(s)
- Luna Grosselli
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Kristina Herzog
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Robert H Aseltine
- Division of Behavioral Sciences and Community Health and Center for Population Health, UConn Health, University of Connecticut, Farmington, CT, USA
| | - Judit Balazs
- Institute of Psychology, Eötvös Loránd University Budapest, Hungary.,Department of Psychology, Bjørknes University College, Oslo, Norway
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institute, Stockholm, Sweden
| | | | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, QLD, Australia.,Slovene Suicide Research Centre, Primorska University, Koper, Slovenia
| | | | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, Germany
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, QLD, Australia.,WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Stan Kutcher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, University of Oslo, Norway
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Mohsen Rezaeian
- Occupational Environmental Research Center, Epidemiology and Biostatistics Department, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Johanne Renaud
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, McGill University, Montreal, QC, Canada
| | - Barbara Schneider
- Department for Addictive Behavior, Psychiatry and Psychotherapy, LVR-Klinik Köln, Germany
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Dresden, Germany
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
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Conforti P, Zaheer R, Goldstein BI, Levitt AJ, Schaffer A, Fefergrad M, Cheung AH, Sinyor M. The Feasibility of a Harry Potter-based Cognitive Behavioural Therapy Skills Curriculum on Suicidality and Well-being in Middle Schoolers. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:811-813. [PMID: 32701402 PMCID: PMC7564693 DOI: 10.1177/0706743720944046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Paula Conforti
- College of Psychologists of Ontario, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, 7938University of Toronto, Ontario, Canada
| | - Rabia Zaheer
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Waterloo, Ontario, Canada
| | - Benjamin I Goldstein
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
| | - Anthony J Levitt
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
| | - Ayal Schaffer
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
| | - Mark Fefergrad
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
| | - Amy H Cheung
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
| | - Mark Sinyor
- Department of Psychiatry, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
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11
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Abstract
Throughout the world, approximately 800,000 people die by suicide every year, accounting for 1.5% of all deaths. Suicide is the 10th leading cause of death in North America and the foremost cause of death worldwide among persons 15 to 24 years of age.
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Affiliation(s)
- Seena Fazel
- From the Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom (S.F.); and the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm (B.R.)
| | - Bo Runeson
- From the Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom (S.F.); and the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm (B.R.)
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Torok M, Calear A, Smart A, Nicolopoulos A, Wong Q. Preventing adolescent suicide: A systematic review of the effectiveness and change mechanisms of suicide prevention gatekeeping training programs for teachers and parents. J Adolesc 2019; 73:100-112. [DOI: 10.1016/j.adolescence.2019.04.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 04/03/2019] [Accepted: 04/22/2019] [Indexed: 11/29/2022]
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Affiliation(s)
- David Cawthorpe
- Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alta.
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Suicide portrayal in the Canadian media: examining newspaper coverage of the popular Netflix series '13 Reasons Why'. BMC Public Health 2018; 18:1086. [PMID: 30170588 PMCID: PMC6119255 DOI: 10.1186/s12889-018-5987-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/23/2018] [Indexed: 11/23/2022] Open
Abstract
Background Evidence suggests that the media can influence societal attitudes and beliefs to various social issues. This influence is especially strong for mental health issues, particularly suicide. As such, the aim of this study is to systematically examine Canadian newspaper coverage of the popular fictional Netflix series 13 Reasons Why, wherein the lead character dies by suicide in the final episode. Methods Articles mentioning the series were systematically collected from best-selling Canadian newspapers in the three-month period following series release (April–June 2017). Articles were coded for adherence to key best practice recommendations on how to sensitively report suicide. Frequency counts and proportions were produced. An inductive qualitative thematic analysis was then undertaken to identify common themes within the articles. Results A total of 71 articles met study inclusion criteria. The majority of articles did not mention the suicide method (88.7%) and did not use stigmatizing language such as ‘commit suicide’ (84.5%). Almost half of the articles linked suicide to wider social issues (43.7%) or quoted a mental health professional (45.1%). 25% included information telling others considering suicide where to get help. Our qualitative analysis indicated that articles simultaneously praised and criticized the series. It was praised for (i) promoting dialogue and discussion about youth suicide; (ii) raising awareness of youth suicide issues; (iii) shining a spotlight on wider social issues that may affect suicide. It was criticized for (i) glorifying suicide, (ii) harmfully impacting young viewers; (iii) prompting pushback from educators and schools. Conclusions Newspaper coverage of ‘13 Reasons Why’ generally adhered to core best practice media recommendations, and sensitively discussed suicide from various angles, prompting productive discussion and dialogue about youth suicide. These findings suggest that the media can be an ally in promoting dialogue and raising awareness of important public health issues such as suicide. Electronic supplementary material The online version of this article (10.1186/s12889-018-5987-3) contains supplementary material, which is available to authorized users.
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Sareen J, Holens P, Turner S, Jetly R, Kennedy S, Heisel M, Cooper K, Mota N, Comtois K, Stein MB, Schaffer A, Thompson J, Heber A. Report of the 2016 Mental Health Expert Panel on suicide prevention in the Canadian Armed Forces. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2018. [DOI: 10.3138/jmvfh.2017-0043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Pamela Holens
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarah Turner
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rakesh Jetly
- Directorate of Mental Health, Canadian Forces Health Services Group, Department of National Defense, Ottawa, Ontario, Canada
| | - Sidney Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Marnin Heisel
- Departments of Psychiatry, Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Ken Cooper
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katherine Comtois
- Department of Psychiatry and Behavioural Sciences, University of Washington, Seattle, Washington, USA
| | - Murray B Stein
- Departments of Psychiatry, Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jim Thompson
- Research Medical Advisor, Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Alexandra Heber
- Chief of Psychiatry, Health Professionals Division, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
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Singer JB, Erbacher TA, Rosen P. School-Based Suicide Prevention: A Framework for Evidence-Based Practice. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9245-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Murphy AL, Hillier K, Ataya R, Thabet P, Whelan AM, O'Reilly C, Gardner D. A scoping review of community pharmacists and patients at risk of suicide. Can Pharm J (Ott) 2017; 150:366-379. [PMID: 29123596 DOI: 10.1177/1715163517733482] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Medications are commonly used in suicide attempts. Pharmacists are inextricably linked to medications and may have roles in helping those at risk of suicide. We conducted a scoping review to characterize the existing literature and make recommendations about future research. Methods We used a 6-step approach based on an existing scoping review methodological framework, including identifying the research question; identifying relevant studies and other literature; study and literature selection; data charting; collating, summarizing and reporting results; and dissemination of results. We searched electronic databases, various grey literature sources and mobile app stores. Results Thirty-five articles were included following screening of 1013 database citations. Of 1085 results from grey literature searches, we included 12. Most publications were opinion pieces (n = 22), followed by survey studies (n = 9), primarily assessing pharmacists' knowledge and attitudes. Themes included education and training to impact knowledge and attitudes, gatekeeping of medication supply, collaboration and integration, and role perception. Public perspectives on pharmacists' roles were limited. Conclusions Research regarding pharmacists' roles in the care of people at risk for suicide is limited. The areas that have dominated the literature include legal liability, especially with respect to gatekeeping medications, ethical decision making and education and training. Research is needed to determine what methods, outcomes and measures are required to best serve in building the evidence base for policy and practice decisions in this area.
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Affiliation(s)
- Andrea Lynn Murphy
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Katelyn Hillier
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Randa Ataya
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Pierre Thabet
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Anne Marie Whelan
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Claire O'Reilly
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - David Gardner
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
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Riblet NBV, Shiner B, Young-Xu Y, Watts BV. Strategies to prevent death by suicide: meta-analysis of randomised controlled trials. Br J Psychiatry 2017; 210:396-402. [PMID: 28428338 DOI: 10.1192/bjp.bp.116.187799] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 01/30/2017] [Accepted: 03/04/2017] [Indexed: 01/17/2023]
Abstract
BackgroundFew randomised controlled trials (RCTs) have shown decreases in suicide.AimsTo identify interventions for preventing suicide.MethodWe searched EMBASE and Medline from inception until 31 December 2015. We included RCTs comparing prevention strategies with control. We pooled odds ratios (ORs) for suicide using the Peto method.ResultsAmong 8647 citations, 72 RCTs and 6 pooled analyses met inclusion criteria. Three RCTs (n = 2028) found that the World Health Organization (WHO) brief intervention and contact (BIC) was associated with significantly lower odds of suicide (OR = 0.20, 95% CI 0.09-0.42). Six RCTs (n = 1040) of cognitive-behavioural therapy (CBT) for suicide prevention and six RCTs of lithium (n = 619) yielded non-significant findings (OR = 0.34, 95% CI 0.12-1.03 and OR = 0.23, 95% CI 0.05-1.02, respectively).ConclusionsThe WHO BIC is a promising suicide prevention strategy. No other intervention showed a statistically significant effect in reducing suicide.
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Affiliation(s)
- Natalie B V Riblet
- Natalie B. V. Riblet, MD, MPH, Brian Shiner, MD, MPH, Veterans Affairs Medical Center, Vermont, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA; Yinong Young-Xu, DSc, MS, Bradley V. Watts, MD, MPH, Veterans Affairs Medical Center, Vermont, and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Brian Shiner
- Natalie B. V. Riblet, MD, MPH, Brian Shiner, MD, MPH, Veterans Affairs Medical Center, Vermont, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA; Yinong Young-Xu, DSc, MS, Bradley V. Watts, MD, MPH, Veterans Affairs Medical Center, Vermont, and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Yinong Young-Xu
- Natalie B. V. Riblet, MD, MPH, Brian Shiner, MD, MPH, Veterans Affairs Medical Center, Vermont, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA; Yinong Young-Xu, DSc, MS, Bradley V. Watts, MD, MPH, Veterans Affairs Medical Center, Vermont, and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Bradley V Watts
- Natalie B. V. Riblet, MD, MPH, Brian Shiner, MD, MPH, Veterans Affairs Medical Center, Vermont, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA; Yinong Young-Xu, DSc, MS, Bradley V. Watts, MD, MPH, Veterans Affairs Medical Center, Vermont, and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Kutcher S. Child and Youth Mental Health. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:232-234. [PMID: 28363263 PMCID: PMC5407554 DOI: 10.1177/0706743717698670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Stan Kutcher
- 1 WHO Collaborating Center, Dalhousie University and the IWK Health Centre, Halifax, Nova Scotia
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Grunau M. Suicide Prevention Involves All of Us, Together. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:295. [PMID: 28363259 PMCID: PMC5407552 DOI: 10.1177/0706743717695086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mara Grunau
- Centre for Suicide Prevention, Calgary, Alberta
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Kutcher S, Wei Y, Behzadi P. Suicide Prevention. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:296-297. [PMID: 28363260 PMCID: PMC5407553 DOI: 10.1177/0706743717695087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Holliday CE, Wynne M, Katz J, Ford C, Barbosa-Leiker C. A CBPR Approach to Finding Community Strengths and Challenges to Prevent Youth Suicide and Substance Abuse. J Transcult Nurs 2016; 29:64-73. [DOI: 10.1177/1043659616679234] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To improve health and reduce health disparities, research partnerships with American Indian and Alaska Native communities should build on existing traditions and strengths. The overall goal of this pilot project was to clarify the needs of tribal community members and determine strengths and resources available to the community. Design: Community-based participatory research was the approach used to obtain community input. Data collection methods included, Photovoice ( n = 16), digital storytelling ( n = 4), and community capacity surveys ( n = 128). Results: Quantitative and qualitative findings supported the need to (1) address youth suicide and substance abuse on the reservation and (2) use preexisting resources available in the community. The results led to the development of a strengths-based intervention incorporating the Gathering of Native American’s curriculum. Conclusion: Integral to the development, implementation, and sustainability of the intervention was the truly reciprocal relationship developed between community and university partners.
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Affiliation(s)
| | - Melodi Wynne
- University of Hawai’i at Mānoa, Spokane, WA, USA
| | - Janet Katz
- Washington State University College of Nursing, Spokane, WA, USA
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