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de Santiago-Díaz AI, Barrio-Martínez S, Gómez-Ruiz E, Carceller-Meseguer T, Sastre-Yañez J, Ortíz-García de la Foz V, Ayesa-Arriola R. Effectiveness of early and intensive intervention on suicide prevention: CARS programme. Psychiatry Res 2024; 338:115964. [PMID: 38824711 DOI: 10.1016/j.psychres.2024.115964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/04/2024]
Abstract
The aim of this study was to evaluate the outcomes of the Programme for Management of Suicidal Behaviour and Suicide Prevention (CARS). Individuals treated in the emergency department of University Hospital Marqués de Valdecilla for suicidal thoughts or attempts (N = 401) between 1-March-2016 and 31-December-2018 were considered. No randomization by patients or groups was performed. Student's t-test, chi-square and repeated measure analysis of variance were used. Kaplan-Meier survival function and Cox proportional hazard regression models were employed to estimate the risks of relapse. Outcome of those who voluntary enrol CARS were compared with treatment as usual (TAU) at 6- and 12-months follow-up. The results indicate a significant reduction and delayed occurrence of suicidal behaviour over a 12-month follow-up period with the CARS programme compared to TAU, along with a decreased frequency of hospital admissions. CARS programme demonstrates a substantial impact, significantly reducing the risk of recurrent suicidal behaviour by 35.5 % and the risk of repeated suicidal attempts by 47.2 % at the 12-month follow-up. The programme exhibits a dual protective effect, diminishing suicidal behaviour and fostering improved long-term outcomes. In conclusion, CARS effectively reduced suicidal behaviour recurrence, achieving significant decreases in suicidal thoughts, plans and attempts.
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Affiliation(s)
- Ana Isabel de Santiago-Díaz
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.
| | | | - Elsa Gómez-Ruiz
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Telva Carceller-Meseguer
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Javier Sastre-Yañez
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Víctor Ortíz-García de la Foz
- Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
| | - Rosa Ayesa-Arriola
- Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain.
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Kingi-Uluave D, Taufa N, Tuesday R, Cargo T, Stasiak K, Merry S, Hetrick S. A Review of Systematic Reviews: Gatekeeper Training for Suicide Prevention with a Focus on Effectiveness and Findings. Arch Suicide Res 2024:1-18. [PMID: 38884349 DOI: 10.1080/13811118.2024.2358411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
OBJECTIVES Suicide prevention gatekeeper training (GKT) is considered an important component of an overall suicide-prevention strategy. The primary aim of this study was to conduct the first robust review of systematic reviews of GKT to examine the overall effectiveness of GKT on knowledge, self-efficacy, attitudes, behavioral intentions, and behavioral change. The study also examined the extent to which outcomes were retained long term, the frequency of refresher sessions, and the effectiveness of GKT with Indigenous populations and e-learning delivery. METHODS For this review of reviews, MEDLINE, PsycINFO, Embase; and the Cochrane Database of Systematic Reviews were searched. ROBIS was applied to assess risk of bias and findings were synthesized using narrative synthesis. RESULTS Six systematic reviews were included comprising 61 studies, of which only 10 were randomized controlled trials (RCTs). Immediate positive effects of GKT on knowledge, skills, and self-efficacy were confirmed, including for interventions tailored for Indigenous communities. Evidence was mixed for change in attitude; few studies measured e-learning GKT, retention of outcomes, booster sessions, behavioral intentions, and behavioral change, with some positive results. CONCLUSIONS Evidence supports the immediate effects of GKT but highlights a need for more high-quality RCTs, particularly for Indigenous and e-learning GKT. This review identified a concerning lack of long-term follow-up assessments at multiple time points, which could capture behavioral change and a significant gap in studies focused on post-training interventions that maintain GKT effects over time.
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DeBeer B, Mignogna J, Talbot M, Villarreal E, Mohatt N, Borah E, Russell PD, Bryan CJ, Monteith LL, Bongiovanni K, Hoffmire C, Peterson AL, Heise J, Baack S, Weinberg K, Polk M, Benzer JK. Suicide Prevention Programming: Comparing Four Prominent Frameworks. Psychiatr Serv 2024:appips20230173. [PMID: 38807579 DOI: 10.1176/appi.ps.20230173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
OBJECTIVE Suicide is a significant public health concern. About 48,000 individuals died by suicide in 2021 in the United States, and approximately one in 100 deaths globally are due to suicide. Continuing efforts in program development and evaluation are vital to preventing suicide. Multiple frameworks have been developed to reduce suicide rates, but they have not been compared to assess their comprehensiveness, nor have their components been classified. METHODS In 2019, the authors conducted a narrative review of the literature and identified four major frameworks for suicide prevention: the U.S. Department of Veterans Affairs (VA) Suicide Prevention Program, the Defense Suicide Prevention Program of the U.S. Department of Defense, Zero Suicide in Health and Behavioral Health Care, and the technical package developed by the Centers for Disease Control and Prevention. Program components for these frameworks were identified and classified by using two prevention strategy classification systems: the National Academy of Medicine's (NAM's) continuum-of-care model and the Substance Abuse and Mental Health Services Administration's (SAMHSA's) prevention model. RESULTS The cross-program comparison revealed that no single program included all components of suicide prevention programs. However, the VA program was the most comprehensive in terms of the number of components and their spread across prevention strategy classifications. The programs used few components categorized under NAM's promotion or selective prevention strategy classifications. The SAMHSA prevention strategy classifications of information dissemination, community-based processes, and positive alternatives were also used infrequently. CONCLUSIONS Organizations, health care systems, and policy makers may use these findings as they develop, improve, and implement suicide prevention programs.
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Affiliation(s)
- Bryann DeBeer
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Joseph Mignogna
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Margaret Talbot
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Edgar Villarreal
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Nathaniel Mohatt
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Elisa Borah
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Patricia D Russell
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Craig J Bryan
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Lindsey L Monteith
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Kathryn Bongiovanni
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Claire Hoffmire
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Alan L Peterson
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Jenna Heise
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Sylvia Baack
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Kimberly Weinberg
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Marcy Polk
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Justin K Benzer
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
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Hu D, Comben C, Diminic S, Pagliaro C. Review of Australia's funding commitments for suicide prevention from 2021-22 to 2026-27. AUST HEALTH REV 2024; 48:45-51. [PMID: 38105034 DOI: 10.1071/ah23176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
Objective Examine the distribution of funding for suicide prevention in Australia from 2021-22 to 2026-27. Methods Government websites were reviewed to locate budget documents related to suicide prevention funding. Information was extracted on the program/service to be funded, and the funder entity, duration, and year allocation. Extracted data was reviewed to identify commonly targeted sub-populations. Results The majority of suicide prevention-related funding was allocated to aftercare for persons who have attempted suicide, consistent with the effectiveness of these services, followed by programs targeting the general population. Little funding was allocated to other specific sub-populations, such as young people and Aboriginal and Torres Strait Islander peoples. The amount of funding allocated to suicide prevention varied across jurisdictions, which is only partially explained by suicide rates. Conclusions There is a need for greater investment in care for specific sub-populations who are at higher risk of suicide. This study provides a baseline for comparing future investments in suicide prevention in Australia.
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Affiliation(s)
- Di Hu
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
| | - Charlotte Comben
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
| | - Sandra Diminic
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
| | - Claudia Pagliaro
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
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Devin J, Lyons S, Murphy L, O’Sullivan M, Lynn E. Factors associated with suicide in people who use drugs: a scoping review. BMC Psychiatry 2023; 23:655. [PMID: 37670233 PMCID: PMC10478413 DOI: 10.1186/s12888-023-05131-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Suicide is a significant contributor to global mortality. People who use drugs (PWUD) are at increased risk of death by suicide relative to the general population, but there is a lack of information on associated candidate factors for suicide in this group. The aim of this study was to provide a comprehensive overview of existing evidence on potential factors for death by suicide in PWUD. METHODS A scoping review was conducted according to the Arksey and O'Malley framework. Articles were identified using Medline, CINAHL, PsycINFO, SOCIndex, the Cochrane Database of Systematic Reviews and the Campbell Collaboration Database of Systematic Reviews; supplemented by grey literature, technical reports, and consultation with experts. No limitations were placed on study design. Publications in English from January 2000 to December 2021 were included. Two reviewers independently screened full-text publications for inclusion. Extracted data were collated using tables and accompanying narrative descriptive summaries. The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. RESULTS The initial search identified 12,389 individual publications, of which 53 met the inclusion criteria. The majority (87%) of included publications were primary research, with an uncontrolled, retrospective study design. The most common data sources were drug treatment databases or national death indexes. Eleven potential factors associated with death by suicide among PWUD were identified: sex; mental health conditions; periods of heightened vulnerability; age profile; use of stimulants, cannabis, or new psychoactive substances; specific medical conditions; lack of dual diagnosis service provision; homelessness; incarceration; intravenous drug use; and race or ethnicity. Opioids, followed by cannabis and stimulant drugs were the most prevalent drugs of use in PWUD who died by suicide. A large proportion of evidence was related to opioid use; therefore, more primary research on suicide and explicit risk factors is required. CONCLUSIONS The majority of studies exploring factors associated with death by suicide among PWUD involved descriptive epidemiological data, with limited in-depth analyses of explicit risk factors. To prevent suicide in PWUD, it is important to consider potential risk factors and type of drug use, and to tailor policies and practices accordingly.
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Affiliation(s)
- Joan Devin
- Health Research Board, Grattan House, 67–72 Lower Mount Street, Dublin 2, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, 1st Floor Ardilaun House Block B, 111 St Stephen’s Green, Dublin 2, Ireland
| | - Suzi Lyons
- Health Research Board, Grattan House, 67–72 Lower Mount Street, Dublin 2, Ireland
| | - Lisa Murphy
- Health Research Board, Grattan House, 67–72 Lower Mount Street, Dublin 2, Ireland
| | - Michael O’Sullivan
- Health Research Board, Grattan House, 67–72 Lower Mount Street, Dublin 2, Ireland
| | - Ena Lynn
- Health Research Board, Grattan House, 67–72 Lower Mount Street, Dublin 2, Ireland
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Abstract
OBJECTIVES To investigate whether high-lethality suicide attempters align to the demographic and clinical features observed in completed suicide in the national and international literature, and whether low-lethality attempters more closely align with the clinical profile of non-attempter ideators. METHODS A retrospective chart review of adult suicide ideators and attempters presenting to an urban tertiary care hospital was performed. Suicide ideators (n = 50) and attempters (n = 50) were coded for variables including demographics and clinical characteristics (e.g. psychiatric diagnosis and previous suicide attempt). Method and lethality of suicide attempt were coded using the medical Lethality Rating Scale. RESULTS High-lethality attempters were more likely to be younger in age than low-lethality attempters (p = 0.026) and ideators (p = 0.041). The lethality scores of suicide attempts were significantly inversely correlated with age (p = 0.017). CONCLUSIONS Our study adds to the small but increasing body of literature investigating the characteristics of high-lethality suicide attempters and suggests younger adult age is a risk factor for a high-lethality attempt. Further understanding of this unique group would be aided by widespread agreement on the definition of a high-lethality suicide attempt and longitudinal studies of this cohort.
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Affiliation(s)
- A M Doherty
- Psychiatry Registrar, St Patrick's University Hospital, Dublin, Ireland
| | - S Moore
- Consultant Liaison Psychiatrist, Department of Psychiatry, St Vincent's University Hospital, Dublin 4, Ireland
| | - N Corcoran
- Intern, Letterkenny University Hospital, Donegal, Ireland
| | - K M Malone
- Consultant Liaison Psychiatrist, Department of Psychiatry, St Vincent's University Hospital, Dublin 4, Ireland
- Dept. of Psychiatry, Psychotherapy & Mental Health Research, UCD School of Medicine. St. Vincent's University, Elm Park, Dublin 4
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Jahan I, Sharif AB, Hasan ABMN. Suicide stigma and suicide literacy among Bangladeshi young adults: a cross-sectional study. Front Psychiatry 2023; 14:1160955. [PMID: 37252136 PMCID: PMC10213423 DOI: 10.3389/fpsyt.2023.1160955] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/13/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Suicide is one of the leading causes of death worldwide. Owing to poor suicide literacy, people are not aware of the consequences of the suicide stigma, which may affect individuals. This study aimed to examine the status of suicide stigma and literacy among young adults in Bangladesh. Methods This cross-sectional study included 616 male subjects and female subjects residing in Bangladesh aged between 18 and 35 years who were invited to complete an online survey. Suicide literacy and suicide stigma among the respondents were assessed by using the validated Literacy of Suicide Scale and Stigma of Suicide Scale, respectively. Other independent variables that have been found to affect suicide stigma or literacy were included in this study based on prior research. Correlation analysis was used to assess the relationships between the study's main quantitative variables. Multiple linear regression models were used to assess factors affecting suicide stigma and suicide literacy, respectively, after controlling for covariates. Results The mean literacy score was 3.86. The participants' mean scores in the stigma, isolation, and glorification subscale were 25.15, 14.48, and 9.04, respectively. Suicide literacy was negatively associated with stigmatizing attitudes (p = 0.005). Male subjects, unmarried/divorced/widowed, less educated (below HSC), smokers, less exposure to suicide, and respondents with chronic mental illness had lower suicide literacy and more stigmatizing attitudes. Conclusion The findings suggest that addressing suicide literacy and stigma by developing and executing awareness programs on suicide and mental health among young adults may increase knowledge, decrease stigma, and hence prevent suicide among this population.
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Santos-García D, de Deus Fonticoba T, Cores Bartolomé C, Feal Panceiras MJ, García Díaz I, Íñiguez Alvarado MC, Jesús S, Boungiorno MT, Planellas L, Cosgaya M, García Caldentey J, Caballol N, Legarda I, Hernández Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Gómez Mayordomo V, Nogueira V, Puente V, Dotor García-Soto J, Borrué C, Vila BS, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Carrillo Padilla F, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Kulisevsky J, Blázquez Estrada M, Seijo M, Rúiz Martínez J, Valero C, Kurtis M, de Fábregues O, González Ardura J, Alonso Redondo R, Ordás C, López Díaz LM, McAfee D, Martinez-Martin P, Mir P. Suicidal ideation among people with Parkinson's disease and comparison with a control group. Int J Geriatr Psychiatry 2023; 38:e5919. [PMID: 37147900 DOI: 10.1002/gps.5919] [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: 01/15/2023] [Accepted: 04/18/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Detection of suicidal ideation (SI) is key for trying to prevent suicide. The aim of this study was to analyze the frequency of SI and related factors in Spanish people with Parkinson's Disease (PwPD) and to compare them with a control group. METHODS PD patients and controls recruited from the Spanish cohort COPPADIS from January 2016 to November 2017 were included. Two visits were conducted: V0 (baseline); V2 (2-year ± 1 month follow-up). SI was defined as a score ≥1 on item nine of the Beck Depression Inventory-II (BDI-II). Regression analyses were conducted to identify factors related to SI. RESULTS At baseline, 693 PwPD (60.2% males; 62.59 ± 8.91 years old) and 207 controls (49.8% males; 60.99 ± 8.32 years old) were included. No differences between PwPD and controls were detected in SI frequency at either V0 (5.1% [35/693] vs. 4.3% [9/207]; p = 0.421) or at V2 (5.1% [26/508] vs. 4.8% [6/125]; p = 0.549). Major depression (MD) and a worse quality of life were associated with SI at both visits in PwPD: V0 (MD, OR = 5.63; p = 0.003; PDQ-39, OR = 1.06; p = 0.021); V2 (MD, OR = 4.75; p = 0.027; EUROHIS-QOL8, OR = 0.22; p = 0.006). A greater increase in the BDI-II total score from V0 to V2 was the only factor predicting SI at V2 (OR = 1.21; p = 0.002) along with an increase in the total number of non-antiparkinsonian drugs (OR = 1.39; p = 0.041). CONCLUSION The frequency of SI (5%) in PwPD was similar to in controls. Depression, a worse quality of life, and a greater comorbidity were related to SI.
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Affiliation(s)
| | | | | | | | - Iago García Díaz
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | - Silvia Jesús
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Madrid, Spain
| | | | | | | | | | - Nuria Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - Ines Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Jorge Hernández Vara
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Madrid, Spain
- Hospital Universitario Vall d´Hebron, Barcelona, Spain
| | - Iria Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - Isabel González Aramburu
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Madrid, Spain
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Maria A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L´Hospitalet, L´Hospitalet de Llobregat, Barcelona, Spain
| | - Víctor Gómez Mayordomo
- Neurology Department, Institute of Neuroscience, Vithas Madrid La Milagrosa University Hospital, Vithas Hospital Group, Madrid, Spain
| | | | | | | | | | - Berta Solano Vila
- Institut d'Assistència Sanitària (IAS) - Institut Català de la Salut, Girona, Spain
| | | | - Lydia Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - Sonia Escalante
- Hospital de Tortosa Verge de La Cinta (HTVC), Tortosa, Tarragona, Spain
| | - Esther Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | | | | | | | - Maria G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | | | - Jaime Kulisevsky
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Madrid, Spain
- Hospital de Sant Pau, Barcelona, Spain
| | | | - Manuel Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | | | | | | | | | | | | | | | - Darrian McAfee
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Pablo Martinez-Martin
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Madrid, Spain
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Madrid, Spain
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Tanji F, Miyamoto S, Iwasawa A, Ohta H, Ono K. Association Between History of Psychiatric Disorder and Degree of Physical Injury Among Suicide Attempters: Secondary Data Analysis in a Japanese Rural Area. J Prim Care Community Health 2023; 14:21501319231212317. [PMID: 37981733 PMCID: PMC10658764 DOI: 10.1177/21501319231212317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/21/2023] Open
Abstract
INTRODUCTION While there may be differences in the choice of suicide methods between attempters with and those without a history of psychiatric disorders, it is not clear whether these differences predict the actual degree of physical injury. The present study aimed to investigate the association between the history of psychiatric disorder and the degree of physical injury among suicide attempters in a Japanese rural area. METHODS We conducted a cross-sectional study analyzing secondary data of 806 suicide attempters from April 2012 to March 2022 obtained from a Japanese rural city. The exposure variable was a history of psychiatric disorders. The primary outcome was the degree of physical injury of suicide attempters: moderate and severe. We conducted a multivariate Poisson regression analysis to estimate the prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS Among 806 suicide attempters, a significant negative association between the history of psychiatric disorder and the degree of physical injury was observed (PR = 0.40; 95% CI, 0.28-0.59). Those with and without psychiatric disorders were more likely to choose low- and severe-lethality suicide methods such as drug or psychotropic overdoses and hanging or deep wrist injuries, respectively (P < .001). CONCLUSIONS The present study highlights the importance of considering suicide attempters, both with and without psychiatric disorders, while formulating targeted suicide prevention strategies.
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Affiliation(s)
- Fumiya Tanji
- Akita University Graduate School of Health Sciences, Akita, Japan
- Akita University Suicide Prevention Research Center, Akita, Japan
| | - Syohei Miyamoto
- Akita University Suicide Prevention Research Center, Akita, Japan
| | - Atsushi Iwasawa
- Akita University Suicide Prevention Research Center, Akita, Japan
| | - Hidenobu Ohta
- Akita University Graduate School of Health Sciences, Akita, Japan
- Akita University Suicide Prevention Research Center, Akita, Japan
| | - Kyoichi Ono
- Akita University Suicide Prevention Research Center, Akita, Japan
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Fitriana E, Purba FD, Salsabila SP, Danasasmita FS, Afriandi I, Tarigan R, Ichsan A, Pandia V. Psychometric Properties of the Suicidal Ideation Scale in the Indonesian Language. J Prim Care Community Health 2022; 13:21501319221143716. [PMID: 36524691 PMCID: PMC9761796 DOI: 10.1177/21501319221143716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Suicide is one of the leading cause of mortality among adolescents and young adults, especially in low to middle-income countries. Research found that screening for suicidal ideation in non-clinical populations such as schools or communities is an important step toward preventing suicide. Despite so, not all screening tools have the capabilities to accurately detect suicidal ideation among adolescents and young adults in non-clinical populations. The Suicidal Ideation Scale (SIS) is one of the most used questionnaires to measure suicidal thoughts in non-clinical populations. This study aims to investigate the psychometric properties of SIS among adolescents and young adults in Indonesia, especially in non-clinical populations. METHODS After a series of language and cultural adaptations, 1254 senior high school and university students completed the Indonesian version of SIS using 3 standard questionnaires, namely Patient Health Questionnaire-9/PHQ-9, Beck Depression Inventory-II/BDI-II, and Children's Depression Inventory/CDI. The SIS content validity, internal consistency, test-retest reliability and concurrent, as well as internal structure validity, were investigated using content validity index (CVI), Cronbach's Alpha, Pearson product-moment correlation, and confirmatory factor analysis (CFA), respectively. RESULTS The result showed that SIS has good to excellent internal consistency and test-retest reliability. Based on the validity indicators, it has satisfactory content and convergent validity, and further support the one-factor and 2-factor model for factorial validity. Both one-factor and 2 factor model are suitable to use in non-clinical settings. CONCLUSIONS SIS is a valid and reliable tool for suicide ideation screening in adolescents and young adults in non-clinical populations. This validated questionnaire can be used in the early detection of suicidal ideation among adolescents and young adults in non-clinical populations, thus contributing to developing strategies and policies to prevent suicide among Indonesian adolescents and young adults at group and institutional levels.
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Affiliation(s)
- Efi Fitriana
- Department of General and Experimental
Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia,Efi Fitriana, Department of General and
Experimental Psychology, Faculty of Psychology Universitas Padjadjaran,
Kabupaten Sumedang, Jawa Barat, 45363, Indonesia.
| | - Fredrick Dermawan Purba
- Department of Developmental Psychology,
Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Safira Putri Salsabila
- Undergraduate Study Program in
Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Febrianti Santiardi Danasasmita
- Department of Psychiatry, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
| | - Irvan Afriandi
- Department of Public Health, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Rodman Tarigan
- Department of Child Health, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
| | - Abdullah Ichsan
- Department of Psychiatry, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
| | - Veranita Pandia
- Department of Psychiatry, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
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Crisan RM, Băcilă CI, Toboltoc PC, Morar S. Completed Suicide Linked to the COVID-19 Pandemic by Using the Psychological Autopsy Method in Sibiu County, Romania: Case Series and Literature Review. Healthcare (Basel) 2022; 10:healthcare10122377. [PMID: 36553902 PMCID: PMC9777587 DOI: 10.3390/healthcare10122377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The COVID-19 pandemic is associated with suicide, as some data suggests. Our study aims to investigate the emergence of eleven completed suicide cases suspected to be linked to the COVID-19 pandemic during the restrictive measures imposed by the Romanian government, and to identify the consequences of mental health, suicidal motivation, and behavioral changes. To this end, we analyzed the deceased's medical records and applied the psychological autopsy method to the relatives/caregivers of the deceased for a suicidal investigation history, within conducted free-flow discussions. To highlight behavioral changes that occurred in the distant antecedents as well as immediately before the suicidal act, we used two sets of closed questions comprised of fifteen alarm signs, including depressive and/or anxiety symptoms. Our results showed that a deterioration of the mental status, especially concerning depressive and anxiety symptoms, was evident in people without or with pre-existing psychiatric pathology. The suicidal motivation proved to be complex including, in addition to the SARS-CoV-2 infection, social and economic consequences of the COVID-19 pandemic. We noted an intensification of the investigated alarm signs and even the emergence of new warning signs in the recent antecedents. Based on our findings, we reaffirmed the important role of the psychological autopsy method in suicide investigation, proving that it can detect the specific impact of the COVID-19 pandemic on people prone to suicide. This impact can be psycho-emotional, social, and/or economical, and thus we can state that the COVID-19 pandemic and its consequences can be, at least, a triggering factor that enhances completed suicide risk. Further studies are needed in this particular area because correlations between the COVID-19 pandemic and completed suicide do not appear to be accidental.
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Affiliation(s)
- Roxana-Mihaela Crisan
- Doctoral Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
- Forensic Department, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
| | - Ciprian Ionuț Băcilă
- 'Dr. Gheorghe Preda' Clinical Psychiatry Hospital, 550082 Sibiu, Romania
- Dental Medicine and Nursing Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
| | - Paul-Cătălin Toboltoc
- Doctoral Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
- Department of Anatomical Pathology, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
| | - Silviu Morar
- Forensic Department, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
- Preclinical Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
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Lessons to be learned: identifying high-risk medication and circumstances in patients at risk for suicidal self-poisoning. Int J Ment Health Syst 2022; 16:4. [PMID: 35073945 PMCID: PMC8788074 DOI: 10.1186/s13033-021-00513-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 12/23/2021] [Indexed: 12/04/2022] Open
Abstract
Background Although the total number of suicides decreased since the beginning of the 1980s, the number of suicide-related behaviors using self-intoxication increased. Therefore, research on the characteristics of individuals committing self-intoxication becomes of growing importance for risk assessments and the development of preventive measures. Methods In this prospective, observational, monocentric cohort study, all incoming calls at our Poisons Control Centre reporting suicide-related behaviors through self-intoxication, were analyzed via a standardized questionnaire over 12 months. Both univariate and bivariate analyses were performed. Results 1238 cases of deliberate intoxication were included in the study. The majority of cases occurred in the age group between 18 and 44 (n = 607/49%), two-thirds were female (n = 817/66%). The main substances used were antidepressants (n = 420/34%), peripheral analgesics (n = 322/26%) and neuroleptics (n = 282/23%). The majority of patients ingested substances from their prescribed medication (n = 640/82%) with the highest proportion in those aged over 64 years (n = 72/113; 91%, p < 0.001). Substance use was reported for the minority of patients (n = 175/23%). For 704 cases (79%), a psychiatric disorder was documented. Factors associated with recurrent suicide-related behaviors were an underlying psychiatric disorder (OR = 6.2; 95% CI 3.8–10.4), substance use (OR = 2.4; 95% CI 1.5–3.8), and ingestion of neuroleptics (OR = 2.1, 95% CI 1.4–3.0) or antidepressants (OR = 1.6; 95% CI 1.2–2.3). Conclusion This study might contribute to identifying individuals with an increased risk of suicide-related behaviors by deliberate intoxication and to developing preventive strategies for future suicide attempt(s). Supplementary Information The online version contains supplementary material available at 10.1186/s13033-021-00513-8.
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Preston AJ, Rew L. Connectedness, Self-Esteem, and Prosocial Behaviors Protect Adolescent Mental Health Following Social Isolation: A Systematic Review. Issues Ment Health Nurs 2022; 43:32-41. [PMID: 34346800 DOI: 10.1080/01612840.2021.1948642] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Societal trends and COVID-19 quarantines have increased the number of adolescents experiencing social isolation, placing them at heightened risk for mental health issues. The aim of this review is to explore protective factors that might mitigate psychological harm in the presence of social isolation. A systematic literature review was conducted using Fink's step-by-step process. Four library databases were searched, and results were reported using PRISMA. Of the 246 studies reviewed, 12 studies were retained following the quality assessment. The sample includes 14,064 participants from USA, Australia, and Europe, ranging from 10-19 years old. Social connectedness (ie., family connectedness, school connectedness, social support), self-esteem, and prosocial behaviors were the most common protective factors to social isolation. Additional factors such as self-efficacy, optimism, and ethnic identity are discussed. Implications for future research are recommended, including the need to explore spiritual, biological, and sociocultural factors influencing social connectedness and mental health in adolescents.
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Affiliation(s)
| | - Lynn Rew
- School of Nursing, University of Texas, Austin, Texas, USA
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Patel R, Mehta R, Dave K, Chaudhary P. Effectiveness of gatekeepers' training for suicide prevention program among medical professionals and medical undergraduate students of a medical college from Western India. Ind Psychiatry J 2021; 30:217-223. [PMID: 35017803 PMCID: PMC8709527 DOI: 10.4103/ipj.ipj_31_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/20/2021] [Accepted: 06/20/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Suicide risk among Indigenous populations is a multifaceted phenomenon, influenced by biological, psychological, and social factors at the individual level, as well as cultural, political, and economic issues at the family and community level. The global prevalence of depression among medical students was recently estimated to be 28.0 % according to a meta-analysis of 77 studies. In the field of suicide prevention, the term gatekeeper refers to "individuals in a community who have face-to-face contact with large numbers of community members as part of their usual routine." They may be trained to "identify persons at risk of suicide and refer them to treatment or supporting services as appropriate". In our study we aimed to improved attitude and knowledge in gatekeeper to improve detection and referral of individuals who are at risk of suicide. METHODS AND MATERIAL We adapted an evidence-based gatekeeper training into a two-hour, multi-modal and interactive event for medical professional and undergraduate students. Then we evaluated the intervention compared to free-recall knowledge and attitudes questions were examined before and after participation in a student and faculty gatekeeper training program. Focus groups with students enriched interpretation of quantitative results. STATISTICAL ANALYSIS USED Knowledge, attitudes, and skills of both students and teachers were analyzed by Mann-Whitney U-test. Comparison of knowledge, attitudes, and skills between both groups was analyzed by Wilcoxon signed-rank test. RESULTS Undergraduate students developed more positive attitude for suicidal behavior where faculties developed more confident in their skill after training sessions. CONCLUSION brief gatekeeper training found effective in improving knowledge about suicide. Also, increasing participants' accuracy to identify warning signs, risk factors and protective factors about suicide.
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Affiliation(s)
| | - Ritambhara Mehta
- Department of Psychiatry, Government Medical College, Surat, Gujarat, India
| | - Kamlesh Dave
- Department of Psychiatry, Government Medical College, Surat, Gujarat, India
| | - Pradhyuman Chaudhary
- Department of Psychiatry, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India
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Murphy L, Lyons S, O'Sullivan M, Lynn E. Risk factors for completed suicide among people who use drugs: A scoping review protocol. HRB Open Res 2021; 3:45. [PMID: 33634238 PMCID: PMC7885289 DOI: 10.12688/hrbopenres.13098.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Research over the past several decades has shown an increased risk for completed suicide among people who use drugs (PWUD). However, no study to date has attempted to summarise the available literature on the variety of risk factors associated with this increased risk. This paper presents a protocol for a scoping review that aims to systematically map and synthesise the extent and nature of published, unpublished and grey literature related to risk factors for suicide among PWUD. Methods: The following six-stage methodological framework for scoping reviews proposed by Arksey and O’Malley with enhancements by Levac and colleagues will be used: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting/mapping the data, (5) collating, summarising and reporting results and (6) expert consultation. The review will be conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Key inclusion and exclusion criteria will be developed to guide literature screening and data charting. Three reviewers will conduct the initial screening of published, unpublished and grey literature. Identified risk factors will be collated, summarised and categorised iteratively by two independent reviewers. Stakeholder consultation will occur with experts from a national steering committee, a national advisory group, a national suicide prevention centre and a European drug monitoring centre. Conclusion: Collating and thematically categorising the various risk factors for suicide among this high-risk group will hold important implications for future research, policy and practice. The research will be disseminated through publication in a peer-reviewed academic journal and a conference presentation, and by sharing the findings with key stakeholders working within research, policy-making and professional practice contexts.
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Affiliation(s)
| | - Suzi Lyons
- Health Research Board, Dublin 2, Ireland
| | | | - Ena Lynn
- Health Research Board, Dublin 2, Ireland
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16
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Ali B, Rockett IRH, Miller TR, Leonardo JB. Racial/Ethnic Differences in Preceding Circumstances of Suicide and Potential Suicide Misclassification Among US Adolescents. J Racial Ethn Health Disparities 2021; 9:296-304. [PMID: 33415703 DOI: 10.1007/s40615-020-00957-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE There is a paucity of research on racial/ethnic differences in preceding circumstances of suicide among adolescents aged 10-19 years and consequential potential misclassification of suicide deaths (i.e., manner of death classified as injury of undetermined intent). This study (1) examined preceding circumstances of suicide among non-Hispanic White, non-Hispanic Black, non-Hispanic Asian/Pacific Islander (A/PI), non-Hispanic American Indian/Alaskan Native (AI/AN), and Hispanic adolescent decedents; and (2) investigated potential suicide misclassification of racial/ethnic minority decedents. METHODS We used data from the 2006-2015 National Violent Death Reporting System Restricted Access Database. Multivariable logistic regression analyses examined differences in depressed mood, mental health problem and treatment, crisis in the past 2 weeks, problems with school, intimate partner, family relationship, and other relationships (e.g., friend) among racial/ethnic minority decedents compared to White decedents. A separate logistic regression analysis assessed potential suicide misclassification of racial/ethnic minority decedents relative to White counterparts. RESULTS Adjusting for sex and suicide history and circumstances, all racial/ethnic minority decedents had significantly lower odds of documented mental health problem and treatment compared to White decedents. Racial/ethnic differences in relationship problems were also identified. Black decedents had significantly higher odds of manner-of-death classification as undetermined intent than did White decedents, suggesting greater likelihood of suicide misclassification. CONCLUSIONS Circumstances contributing to suicide among adolescents differ by race/ethnicity, indicating the need for culturally tailored suicide prevention efforts.
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Affiliation(s)
- Bina Ali
- Pacific Institute for Research and Evaluation, 11720 Beltsville Drive, Suite 900, Calverton, MD, 20705, USA.
| | - Ian R H Rockett
- Department of Epidemiology, West Virginia University, Morgantown, WV, USA.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Ted R Miller
- Pacific Institute for Research and Evaluation, 11720 Beltsville Drive, Suite 900, Calverton, MD, 20705, USA.,School of Public Health, Curtin University, Perth, Australia
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Ali B, Rockett I, Miller T. Variable Circumstances of Suicide Among Racial/Ethnic Groups by Sex and Age: A National Violent-Death Reporting System Analysis. Arch Suicide Res 2021; 25:94-106. [PMID: 31538548 DOI: 10.1080/13811118.2019.1661894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Suicide rates vary by race/ethnicity, but little is known about how the circumstances that contribute to suicide differ across racial/ethnic groups. This study investigated suicide circumstances among non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic Asian/Pacific Islanders, non-Hispanic Native American/Alaskan Natives, and Hispanics by sex and age. Using de-identified National Violent Death Reporting System (NVDRS) Restricted Access Database files from 2006-2015, we examined proximal circumstances of suicide among decedents aged 10 years and older. Hierarchical logistic regression analysis revealed racial/ethnic differentials in non-alcohol substance abuse problem, intimate partner problem, and physical health problem across sex and age, controlling for potential confounders. Study findings highlight priority areas for suicide interventions.
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Murphy L, Lyons S, O'Sullivan M, Lynn E. Risk factors for completed suicide among people who use drugs: A scoping review protocol. HRB Open Res 2020; 3:45. [DOI: 10.12688/hrbopenres.13098.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Research over the past several decades has shown an increased risk for completed suicide among people who use drugs (PWUD). However, no study to date has attempted to summarise the available literature on the variety of risk factors associated with this increased risk. This paper presents a protocol for a scoping review that aims to systematically map and synthesise the extent and nature of published, unpublished and grey literature related to risk factors for suicide among PWUD. Methods: The following six-stage methodological framework for scoping reviews proposed by Arksey and O’Malley with enhancements by Levac and colleagues will be used: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting/mapping the data, (5) collating, summarising and reporting results and (6) expert consultation. The review will be conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Key inclusion and exclusion criteria will be developed to guide literature screening and data charting. Three reviewers will conduct the initial screening of published, unpublished and grey literature. Identified risk factors will be collated, summarised and categorised iteratively by two independent reviewers. Stakeholder consultation will occur with experts from a national steering committee, a national advisory group, a national suicide prevention centre and a European drug monitoring centre. Conclusion: Collating and thematically categorising the various risk factors for suicide among this high-risk group will hold important implications for future research, policy and practice. The research will be disseminated through publication in a peer-reviewed academic journal and a conference presentation, and by sharing the findings with key stakeholders working within research, policy-making and professional practice contexts.
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Murphy L, Lyons S, O'Sullivan M, Lynn E. Risk factors for completed suicide among people who use drugs: A scoping review protocol. HRB Open Res 2020; 3:45. [DOI: 10.12688/hrbopenres.13098.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Research over the past several decades has shown an increased risk for completed suicide among people who use drugs (PWUD). However, no study to date has attempted to summarise the available literature on the variety of risk factors associated with this increased risk. This paper presents a protocol for a scoping review that aims to systematically map and synthesise the extent and nature of published, unpublished and grey literature related to risk factors for suicide PWUD. Methods: The following six-stage methodological framework for scoping reviews proposed by Arksey and O’Malley with enhancements by Levac and colleagues will be used: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting/mapping the data, (5) collating, summarising and reporting results and (6) expert consultation. The review will be conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Key inclusion and exclusion criteria will be developed to guide literature screening and data charting. Three reviewers will conduct the initial screening of published, unpublished and grey literature. Identified risk factors will be collated, summarised and categorised iteratively by two independent reviewers. Stakeholder consultation will occur with experts from a national steering committee, a national advisory group, a national suicide prevention centre and a European drug monitoring centre. Conclusion: Collating and thematically categorising the various risk factors for suicide among this high-risk group will hold important implications for future research, policy and practice. The research will be disseminated through publication in a peer-reviewed academic journal and a conference presentation, and by sharing the findings with key stakeholders working within research, policy-making and professional practice contexts.
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Wang J, Sumner SA, Simon TR, Crosby AE, Annor FB, Gaylor E, Xu L, Holland KM. Trends in the Incidence and Lethality of Suicidal Acts in the United States, 2006 to 2015. JAMA Psychiatry 2020; 77:684-693. [PMID: 32320023 PMCID: PMC7177650 DOI: 10.1001/jamapsychiatry.2020.0596] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/17/2020] [Indexed: 01/09/2023]
Abstract
Importance Understanding changes in the incidence rates and lethality of suicidal acts may explain increasing suicide rates. Objective To examine trends in the incidence rates and lethality of suicidal acts from 2006 to 2015 among persons aged 10 to 74 years. Design, Setting, and Participants This cross-sectional study was conducted from May 2, 2018, to January 30, 2019. Medically treated nonfatal suicide attempts were identified from the 2006 to 2015 Nationwide Inpatient Sample and Nationwide Emergency Department Sample databases. Suicides were identified from the 2006 to 2015 mortality files of the National Vital Statistics System. Main Outcomes and Measures The incidence rate of suicidal acts was calculated by dividing the number of total suicidal acts by the US population. Lethality was measured through the case fatality rates (CFRs) of suicidal acts by dividing the number of suicides by the total number of suicidal acts. Results A total of 1 222 419 (unweighted) suicidal acts, which included both suicides and nonfatal suicide attempts, were identified from 2006 to 2015. Overall, the incidence rates of total suicidal acts increased 10% from 2006 to 2015 (annual percentage change [APC], 0.8%; 95% CI, 0.3%-1.3%), and the CFRs of suicidal acts increased 13% during the 2006 to 2015 period (APC, 2.3%; 95% CI, 1.3%-3.3%). In subgroup analyses, incidence rates increased by 1.1% (95% CI, 0.6%-1.6%) per year for female individuals during the 2006 to 2015 period but remained stable for male individuals. The CFRs increased for both sexes (APC, 5.0% [95% CI, 3.1%-6.9%] since 2010 for female individuals; 1.6% [95% CI, 0.6%-2.5%] since 2009 for male individuals). Incidence rates increased among adolescents from 2011 to 2015 and among older adults aged 65 to 74 years throughout the 2006 to 2015 period. Conversely, the CFRs increased since 2009 among persons aged 20 to 44 years (APC, 3.7%; 95% CI, 2.5%-5.0%) and since 2012 for those aged 45 to 64 years (APC, 2.7%; 95% CI, 0.0%-5.4%). Persons aged 20 to 44 years and 45 to 64 years experienced increases in suicidal acts by more lethal means, whereas adolescents and older adults aged 65 to 74 years showed increased incidence by all means. Conclusions and Relevance This study found increased suicidal acts among female persons, adolescents, and older adults aged 65 to 74 years, implying the need to address emerging or exacerbating suicide risk factors for these populations. The findings on the increased lethality particularly among persons aged 20 to 64 years highlighted the need to reduce access to materials that could be used as lethal means among persons at risk of suicide. These findings on population-level epidemiologic patterns can be used to guide the development of comprehensive suicide prevention strategies.
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Affiliation(s)
- Jing Wang
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Steven A. Sumner
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomas R. Simon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alex E. Crosby
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Francis B. Annor
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth Gaylor
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Likang Xu
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristin M. Holland
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
Efforts in research, prevention, and treatment of suicidal behavior have produced mixed results. One of the main barriers to combating suicidal behavior lies in the very conceptualization of suicide, a phenomenon that is at once sociological, psychiatric, and even philosophical, and one that has not always been included in the field of health care. There are also many barriers at the social level, ranging from stigma against people with suicidal behavior to stigma towards psychiatric care, as well as the controversial role of the media. The media plays an important role in society and depending on its attitude it can be either beneficial or harmful in our fight against suicidal behavior. Differences between countries - in the provision of resources, in the way of understanding the phenomenon or in the manner of providing official figures - pose an additional challenge to suicide prevention on a global level. In the field of research, predicting suicidal behavior by identifying effective risk markers is severely hampered by the low occurrence of suicide in the population, which limits the statistical power of studies. The authors recommend combining various risk factors to build predictive models. This, in addition to employing increasingly precise machine learning techniques, is a step in the right direction, although there is still a long way to go before the expected results can be obtained. Finally, adequate training of health professionals, both specialized and non-specialized, as well as gatekeeper training, is crucial for implementing suicide prevention strategies in the population.
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Brito MDLDS, Silva Júnior FJGD, Costa APC, Sales JCES, Gonçalves AMDS, Monteiro CFDS. Comportamento suicida e estratégias de prevenção sob a ótica de professores. ESCOLA ANNA NERY 2020. [DOI: 10.1590/2177-9465-ean-2020-0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar conhecimentos sobre comportamento suicida e estratégias de prevenção adotadas por professores do ensino fundamental. Método Estudo qualitativo, apoiado na pesquisa-ação, realizado em escola pública do município de Teresina, Piauí, Brasil. Participaram nove professores de ensino fundamental. Realizaram-se três encontros, uma reunião de negociação e dois seminários temáticos. Os discursos foram submetidos à análise temática. Resultados O conhecimento dos professores acerca do comportamento suicida envolveu identificação dos sinais de alerta, tendo a automutilação como atitude suicida mais recorrente. Como estratégias apontaram a necessidade de prevenção por meio da identificação do aluno em risco, da observação, do diálogo, do monitoramento e utilização de redes de apoio. Os desafios elencados pelos professores foram a inabilidade na identificação e associação dos sinais de alerta com o comportamento suicida, a dificuldade na abordagem do aluno em crise, a ausência de equipe de saúde mental nas escolas e de temas transversais nos currículos escolares. Conclusão e implicações para a prática Observa-se a necessidade de ações voltadas para a capacitação desses profissionais, tendo em vista sua posição privilegiada para promoção de ambientes saudáveis, bem como para prevenção e identificação dos adolescentes em risco, com manejo adequado e encaminhamento compartilhado aos serviços de saúde.
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Lindquist-Grantz R, Abraczinskas M. Using Youth Participatory Action Research as a Health Intervention in Community Settings. Health Promot Pract 2018; 21:573-581. [PMID: 30577698 DOI: 10.1177/1524839918818831] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Youth participatory action research (YPAR) emphasizes positive youth development by engaging young people as co-researchers and change agents on complex issues to produce solutions that are relevant to youth. YPAR has primarily been used in classroom and youth organization settings, which means there are very few examples of its usage in other community-based settings or as a health intervention approach. Additionally, there is a need for further study of YPAR implementation processes and the effect on youth development and well-being outcomes. In this article, we highlight the innovative use of YPAR as a community-based health intervention through two case studies in which the adolescent health issues of physical activity and suicide were addressed. We describe the design of each YPAR health intervention and the studies that were conducted to link participatory research processes to youth development and health outcomes. Using the lessons learned from these YPAR interventions, we propose best practices for the design, implementation, and evaluation of YPAR as a health intervention strategy in a community setting.
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Hogan MF, Grumet JG. Suicide Prevention: An Emerging Priority For Health Care. Health Aff (Millwood) 2018; 35:1084-90. [PMID: 27269026 DOI: 10.1377/hlthaff.2015.1672] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings. In particular, we consider Zero Suicide, a model for better identification and treatment of patients at risk for suicide. The approach incorporates new tools for screening, treatment, and support; it has been deployed with promising results in behavioral health programs and primary care settings. Broader adoption of improved suicide prevention care may be an effective strategy for reducing deaths by suicide.
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Affiliation(s)
- Michael F Hogan
- Michael F. Hogan is a clinical professor in the Department of Psychiatry at Case Western Reserve University School of Medicine, in Cleveland, Ohio
| | - Julie Goldstein Grumet
- Julie Goldstein Grumet is the director of health and behavioral health initiatives at the Suicide Prevention Resource Center, in Washington, D.C
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Ivey-Stephenson AZ, Crosby AE, Jack SPD, Haileyesus T, Kresnow-Sedacca MJ. Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death - United States, 2001-2015. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2017; 66:1-16. [PMID: 28981481 PMCID: PMC5829833 DOI: 10.15585/mmwr.ss6618a1] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PROBLEM/CONDITION Suicide is a public health problem and one of the top 10 leading causes of death in the United States. Substantial geographic variations in suicide rates exist, with suicides in rural areas occurring at much higher rates than those occurring in more urban areas. Understanding demographic trends and mechanisms of death among and within urbanization levels is important to developing and targeting future prevention efforts. REPORTING PERIOD 2001-2015. DESCRIPTION OF SYSTEM Mortality data from the National Vital Statistics System (NVSS) include demographic, geographic, and cause of death information derived from death certificates filed in the 50 states and the District of Columbia. NVSS was used to identify suicide deaths, defined by International Classification of Diseases, 10th Revision (ICD-10) underlying cause of death codes X60-X84, Y87.0, and U03. This report examines annual county level trends in suicide rates during 2001-2015 among and within urbanization levels by select demographics and mechanisms of death. Counties were collapsed into three urbanization levels using the 2006 National Center for Health Statistics classification scheme. RESULTS Suicide rates increased across the three urbanization levels, with higher rates in nonmetropolitan/rural counties than in medium/small or large metropolitan counties. Each urbanization level experienced substantial annual rate changes at different times during the study period. Across urbanization levels, suicide rates were consistently highest for men and non-Hispanic American Indian/Alaska Natives compared with rates for women and other racial/ethnic groups; however, rates were highest for non-Hispanic whites in more metropolitan counties. Trends indicate that suicide rates for non-Hispanic blacks were lowest in nonmetropolitan/rural counties and highest in more urban counties. Increases in suicide rates occurred for all age groups across urbanization levels, with the highest rates for persons aged 35-64 years. For mechanism of death, greater increases in rates of suicide by firearms and hanging/suffocation occurred across all urbanization levels; rates of suicide by firearms in nonmetropolitan/rural counties were almost two times that of rates in larger metropolitan counties. INTERPRETATION Suicide rates in nonmetropolitan/rural counties are consistently higher than suicide rates in metropolitan counties. These trends also are observed by sex, race/ethnicity, age group, and mechanism of death. PUBLIC HEALTH ACTION Interventions to prevent suicides should be ongoing, particularly in rural areas. Comprehensive suicide prevention efforts might include leveraging protective factors and providing innovative prevention strategies that increase access to health care and mental health care in rural communities. In addition, distribution of socioeconomic factors varies in different communities and needs to be better understood in the context of suicide prevention.
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Affiliation(s)
| | - Alex E. Crosby
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Shane P. D. Jack
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Tadesse Haileyesus
- Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, CDC
| | - Marcie-jo Kresnow-Sedacca
- Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, CDC
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Abstract
The World Health Organization report Preventing Suicide: A Global Imperative provides governments with guidance for comprehensive suicide prevention strategies. However, it does not mention the role that compulsory admission to hospital of psychiatric patients should have in policies for suicide prevention. This was a missed opportunity for international discussion and guidance about a measure that, although widely used, is becoming increasingly controversial in light of the existing evidence and human rights norms.
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Nasir BF, Hides L, Kisely S, Ranmuthugala G, Nicholson GC, Black E, Gill N, Kondalsamy-Chennakesavan S, Toombs M. The need for a culturally-tailored gatekeeper training intervention program in preventing suicide among Indigenous peoples: a systematic review. BMC Psychiatry 2016; 16:357. [PMID: 27769204 PMCID: PMC5073837 DOI: 10.1186/s12888-016-1059-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/04/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death among Indigenous youth worldwide. The aim of this literature review was to determine the cultural appropriateness and identify evidence for the effectiveness of current gatekeeper suicide prevention training programs within the international Indigenous community. METHOD Using a systematic strategy, relevant databases and targeted resources were searched using the following terms: 'suicide', 'gatekeeper', 'training', 'suicide prevention training', 'suicide intervention training' and 'Indigenous'. Other internationally relevant descriptors for the keyword "Indigenous" (e.g. "Maori", "First Nations", "Native American", "Inuit", "Metis" and "Aboriginal") were also used. RESULTS Six articles, comprising five studies, met criteria for inclusion; two Australian, two from USA and one Canadian. While pre and post follow up studies reported positive outcomes, this was not confirmed in the single randomised controlled trial identified. However, the randomised controlled trial may have been underpowered and contained participants who were at higher risk of suicide pre-training. CONCLUSION Uncontrolled evidence suggests that gatekeeper training may be a promising suicide intervention in Indigenous communities but needs to be culturally tailored to the target population. Further RCT evidence is required.
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Affiliation(s)
- Bushra Farah Nasir
- Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
| | - Leanne Hides
- School of Psychology & Counselling, Queensland University of Technology, Brisbane, QLD Australia
| | - Steve Kisely
- Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD Australia ,Departments of Psychiatry, Community Health & Epidemiology, Dalhouise University, Halifax, Canada
| | - Geetha Ranmuthugala
- Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD Australia ,School of Rural Medicine, University of New England, Armidale, NSW Australia
| | - Geoffrey C. Nicholson
- Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD Australia
| | - Emma Black
- Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD Australia
| | - Neeraj Gill
- Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD Australia
| | | | - Maree Toombs
- Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD Australia
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