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Webb M, Cooper C, Hemming L, Dalton A, Unity E, Simmons MB, Bendall S, Robinson J. Involving Young People With Lived and Living Experience of Suicide in Suicide Research. CRISIS 2024; 45:263-270. [PMID: 38353004 DOI: 10.1027/0227-5910/a000938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Background: Research into youth suicide prevention rarely involves young people with lived and living experiences as collaborators. Key barriers include a lack of guidelines or frameworks to inform collaboration, appropriate ethical approval processes, perceived risk, and recruitment. Aim: To develop guidelines for involving young people with lived and living experiences in suicide research as collaborators. Method: A Delphi expert consensus study was conducted with two expert panels: a youth lived and living experiences panel and a traditionally qualified researcher panel. Items rated as essential or important using a five-point Likert scale by more than 80% of both panels were included in the guidelines. Results: Forty-nine experts completed two consensus rounds. The guidelines are organized as follows: (1) preparation, (2) supporting safety and well-being, (3) evaluating involvement, and (4) tips for young people. Limitations: Participants were from English-speaking, Western countries only. Conclusion: These world-first guidelines address the unique challenges and opportunities for involving young people with lived and living experiences in suicide research.
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Affiliation(s)
- Marianne Webb
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charlie Cooper
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Laura Hemming
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | | | | | - Magenta B Simmons
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah Bendall
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Robinson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Strauss P, Marion L, Hill NT, Gilbey D, Waters Z, Moore JK, Costanza M, Lamblin M, Robinson J, Lin A, Perry Y. Development of best practice guidelines for clinical and community service providers to prevent suicide in LGBTQA+ young people: A Delphi expert consensus study. Aust N Z J Psychiatry 2024; 58:425-434. [PMID: 38217434 DOI: 10.1177/00048674231223697] [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] [Indexed: 01/15/2024]
Abstract
OBJECTIVE The aim of this study was to develop best practice guidelines for preventing suicide and reducing suicidal thoughts and behaviours in LGBTQA+ young people (lesbian, gay, bisexual, trans, queer/questioning, asexual, and those of other diverse sexualities and genders) within clinical and community service settings in Australia. METHODS We conducted a Delphi expert consensus study. A systematic literature search and interviews with key informants informed an initial 270-item questionnaire. Two expert panels completed the questionnaire, delivered over two rounds: (1) Australian professionals with expertise in LGBTQA+ mental health/suicide prevention and (2) Australian LGBTQA+ young people aged 14-25 with lived experience of suicidal thoughts and/or behaviours. Items endorsed as 'essential' or 'important' by >80% of both expert panels were included in the guidelines. RESULTS A total of 115 people participated in the Delphi process; n = 52 professionals completed Round 1, and n = 42 completed Round 2; n = 63 LGBTQA+ young people completed Round 1, and n = 50 completed Round 2. A total of 290 items were included in the guidelines and grouped into: (1) general principles for creating an affirming and inclusive environment for LGBTQA+ young people; (2) assessing suicide risk and working with suicidal LGBTQA+ young people; (3) considerations for specific LGBTQA+ populations; and (4) advocating for LGBTQA+ young people. CONCLUSION These guidelines are the first of their kind in Australia. They provide practical support to service providers regardless of prior training in LGBTQ+ identities or mental health, with the aim of reducing suicidal thoughts and behaviours, and preventing suicide, in LGBTQA+ young people.
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Affiliation(s)
- Penelope Strauss
- Telethon Kids Institute, Nedlands, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | | | - Nicole Tm Hill
- Telethon Kids Institute, Nedlands, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Dylan Gilbey
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Zoe Waters
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Julia K Moore
- The Gender Diversity Service, Child and Adolescent Health Service - Mental Health, Perth Children's Hospital, Perth, WA, Australia
| | - Marco Costanza
- Telethon Kids Institute, Nedlands, WA, Australia
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Michelle Lamblin
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Robinson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Yael Perry
- Telethon Kids Institute, Nedlands, WA, Australia
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Zheng H, Gao H, Li J, Li S, Chen L, Li Z, Chen X, Sun Y, Wang C, Liu J, Zhuang J. Social support systems involved in suicide prevention and intervention among adolescents: A Delphi study in Shanghai. Prev Med Rep 2024; 39:102654. [PMID: 38384963 PMCID: PMC10879809 DOI: 10.1016/j.pmedr.2024.102654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
The rotes of attempted and completed suicide among adolescents are increasing globally. Social support can help decrease the risk of adolescent suicide, but this aspect has been rarely studied in China. The present study aimed to use the Delphi methodology to establish a set of guidelines for the development of social support resources, with the goal of collectively reducing suicide risks among adolescents in Shanghai. We commenced the study in April 2021, established a research team, searched the keywords using Web of Science from 2016 to 2021 and ultimately designed a pre-evaluation index. Next, following Donabedian's Structure-Process-Outcome model, the research developed a questionnaire comprising 3 level-1, 12 level-2, and 73 level-3 indicators. Ten experts were enlisted to conduct three rounds of e-mail inquiries in order to finalize the indicator system, resulting in 2 level-1, 11 level-2, and 52 level-3 indicators, as well as expert consensus. Our findings indicate that the social support systems should include parents, schools, psychiatric hospitals, social organizations, and government departments, with the government sector being the most important ((M = 9.4). Furthermore, our study revealed that school counselors and psychologists play similar roles to psychiatrists within the interdisciplinary team (M ± S = 9.2 ± 1.1). As per the expert consensus, social support systems should strengthen government-led and interdisciplinary collaboration, prioritize suicide prevention in schools and encourage greater involvement from social organizations.
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Affiliation(s)
- Hong Zheng
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Hui Gao
- Shanghai Changning District Center for Disease Control and Prevention, Shanghai, 200051, China
| | - Jiahui Li
- Fengxian Hospital Affiliated with Anhui University of Science and Technology, Shanghai, 201499, China
| | - Su Li
- School of Journalism and Communication, Wuhan University, Wuhan Province, 430072, China
| | - Liangliang Chen
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
| | - Ziyan Li
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Xuanxuan Chen
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
| | - Yiting Sun
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Chenyu Wang
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
| | - Junsheng Liu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Jianlin Zhuang
- Shanghai Changning District Center for Disease Control and Prevention, Shanghai, 200051, China
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Bailey E, Bellairs-Walsh I, Reavley N, Gooding P, Hetrick S, Rice S, Boland A, Robinson J. Best practice for integrating digital interventions into clinical care for young people at risk of suicide: a Delphi study. BMC Psychiatry 2024; 24:71. [PMID: 38267895 PMCID: PMC10809499 DOI: 10.1186/s12888-023-05448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/07/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Digital tools have the capacity to complement and enhance clinical care for young people at risk of suicide. Despite the rapid rise of digital tools, their rate of integration into clinical practice remains low. The poor uptake of digital tools may be in part due to the lack of best-practice guidelines for clinicians and services to safely apply them with this population. METHODS A Delphi study was conducted to produce a set of best-practice guidelines for clinicians and services on integrating digital tools into clinical care for young people at risk of suicide. First, a questionnaire was developed incorporating action items derived from peer-reviewed and grey literature, and stakeholder interviews with 17 participants. Next, two independent expert panels comprising professionals (academics and clinical staff; n = 20) and young people with lived experience of using digital technology for support with suicidal thoughts and behaviours (n = 29) rated items across two consensus rounds. Items reaching consensus (rated as "essential" or "important" by at least 80% of panel members) at the end of round two were collated into a set of guidelines. RESULTS Out of 326 individual items rated by the panels, 188 (57.7%) reached consensus for inclusion in the guidelines. The endorsed items provide guidance on important topics when working with young people, including when and for whom digital tools should be used, how to select a digital tool and identify potentially harmful content, and identifying and managing suicide risk conveyed via digital tools. Several items directed at services (rather than individual clinicians) were also endorsed. CONCLUSIONS This study offers world-first evidence-informed guidelines for clinicians and services to integrate digital tools into clinical care for young people at risk of suicide. Implementation of the guidelines is an important next step and will hopefully lead to improved uptake of potentially helpful digital tools in clinical practice.
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Affiliation(s)
- Eleanor Bailey
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia.
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.
| | - India Bellairs-Walsh
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Nicola Reavley
- Melbourne School of Population and Global Health, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Piers Gooding
- Melbourne Law School, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Sarah Hetrick
- Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Ave, Grafton, Auckland, 1023, New Zealand
| | - Simon Rice
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Alexandra Boland
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Jo Robinson
- Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
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De Oliveira JM, Dueñas JM, Morales-Vives F, Gallardo-Nieto E. Educational agents and institutions called into action in suicide prevention, intervention, and postvention. Front Psychol 2023; 14:1213751. [PMID: 37780143 PMCID: PMC10539586 DOI: 10.3389/fpsyg.2023.1213751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Suicide is the second leading cause of death in the 15 to 29 age group worldwide, and is a severe public health problem. Adolescent and young adult individuals attend educational institutions which can play an essential role in detecting and preventing suicide. For this reason, the purpose of this research is to identify what educational institutions and agents are called into action in suicide prevention, intervention, and postvention. Methods The method of systematic review of the literature based on the PRISMA protocol was used. The review protocol was registered in PROSPERO (PROSPERO 2020 CRD42020189127). The systematic review yielded 66 articles published between 1990 and February 2023. Results The results show that a wide variety of educational stakeholders are required to intervene for suicide prevention, interventions and postvention between primary education and college. The study describes the different programs that have been provided, the countries in which they have been implemented and the agents who have been targeted. It also identifies gaps in the research on suicide in the educational field. Discussion Overall, educational suicide initiatives report positive effects on participants' understanding, attitudes, and beliefs regarding suicide and suicide prevention, although some studies have expressed some caution.
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Affiliation(s)
| | - Jorge-Manuel Dueñas
- Research Center for Behavior Assessment, Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain
| | - Fabia Morales-Vives
- Research Center for Behavior Assessment, Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain
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Framework for successful school reintegration after psychiatric hospitalization: A systematic synthesis of expert recommendations. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Schimschal SE, Visentin D, Kornhaber R, Barnett T, Cleary M. Development of a Scale to Measure the Psychological Resources of Grit in Adults. Nurs Health Sci 2022; 24:752-763. [PMID: 35811301 PMCID: PMC9544496 DOI: 10.1111/nhs.12973] [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] [Received: 02/13/2022] [Revised: 05/18/2022] [Accepted: 06/26/2022] [Indexed: 11/28/2022]
Abstract
Grit, a personality trait characterized by having passion and perseverance for long‐term goals, has been linked to increased performance, retention, and well‐being in various fields. In the 15 years since the original grit scale was published, many studies have investigated factors that promote grit. However, a scale has not yet been developed measuring characteristics that can contribute to higher levels of grit. This study aimed to develop a novel scale to measure the psychological resources of grit. The Delphi technique was used to obtain consensus from a national and international panel of academics and practitioners who are experts in grit and related constructs. A total of 30 participants rated 100 scale items over three rounds of online surveys. Experts agreed that items selected for the final scale (n = 20) were essential, with 85% rating them as important or very important. The scale, called the Grit Psychological Resources Scale, has promise as a helpful tool for practitioners involved in staff development and building capabilities that contribute to goal achievement.
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Affiliation(s)
- Sarah E Schimschal
- Centre for Rural Health, School of Health Sciences, University of Tasmania, Australia
| | - Denis Visentin
- School of Health Sciences, University of Tasmania, Australia
| | | | - Tony Barnett
- Centre for Rural Health, School of Health Sciences, University of Tasmania, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Australia
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8
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Williams DY, Wexler L, Mueller AS. Suicide Postvention in Schools: What Evidence Supports Our Current National Recommendations? SCHOOL SOCIAL WORK JOURNAL 2022; 46:23-69. [PMID: 38362045 PMCID: PMC10869049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Suicide is a leading cause of death for school-aged preteens and adolescents and a growing risk for younger children. Schools are the ubiquitous institutional context serving this age group. These trends suggest a need for knowledge and guidance related to school postvention efforts, yet the available research is limited. Focusing on postvention, or the period after a peer suicide occurs, is critical to youth suicide prevention because this is a time of elevated suicide risk for youth. Targeted postvention interventions in schools can mitigate youth suicide risk and limit contagion within a school's student body. This article explores the scientific literature related to school-based suicide postvention, describing the strength and limits of research supporting common recommendations for suicide postvention in schools. It identifies widespread recommendations for school postvention that have only preliminary supportive evidence and notes several areas in need of additional research. With clearer postvention best practices to guide their suicide crisis preparedness plans and postvention procedures, schools can better support students, families, and the community as a whole in order to prevent further tragedies.
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Affiliation(s)
| | - Lisa Wexler
- Recenter for Group Dynamics, Institute for Social Research, at the University of Michigan, Ann Arbor
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Vachon M, Nicolas C, Notredame CE, Séguin M. [Investigating postvention best practices : The Delphi method]. Rev Epidemiol Sante Publique 2021; 69:367-379. [PMID: 34642047 DOI: 10.1016/j.respe.2021.05.049] [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: 05/14/2020] [Revised: 04/23/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Postvention aims to implement services adapted to the needs of a population that may be vulnerable after suicide. While a plethora of postvention programs exist, they are generally based less on solid evidence than on the judgment of health professionals. Using the Delphi method, an Australian study obtained a consensus among experts as to which postvention actions are to be engineered in a postvention program. Since no similar study has been carried out for programs in French-speaking countries, it seemed important to reproduce the same type of study and to compare the respective results. The present study is aimed at establishing a French inventory of postvention actions and at achieving a consensus among experts as to the actions to be included in a postvention program. METHODS A systematic review of the scientific literature (PRISMA method) and the gray literature (documentation on the WEB) made it possible to identify the different actions that have been included in various postvention programs. Using the DELPHI method, experts endeavored to assess their relevance. RESULTS An inventory of 190 postvention actions was established and they were classified according to a sequential axis (pre-event, at the time of the event, and post-event), according to type of action (environment-centered or people-centered). The experts identified 128 actions to be included in a postvention program. CONCLUSION Convergence was observed among the experts, as they identified the practices to be encouraged following a suicide. When comparing the results in French-speaking countries to the 548 actions selected in the Australian study, we observe similarities between the two studies regarding types of postvention actions. This study provides an update for health professionals on the most relevant practices to be included in a postvention program.
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Affiliation(s)
- M Vachon
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada.
| | | | - C-E Notredame
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Lille, 59000Lille, France; Centre neurosciences et cognition de Lille, Subjectivité et plasticité, Inserm U1172, Université de Lille, 59000Lille, France
| | - M Séguin
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada; Groupe McGill d'études sur le suicide,; Réseau québécois de recherche sur le suicide, les troubles de l'humeur et les troubles associés,; Institut universitaire en santé mentale de l'Hôpital Douglas, Montréal, Canada
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Saini P, Clements C, Gardner KJ, Chopra J, Latham C, Kumar R, Taylor P. Identifying Suicide and Self-Harm Research Priorities in North West England. CRISIS 2021; 43:35-45. [PMID: 33475010 DOI: 10.1027/0227-5910/a000757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Understanding and effectively managing self-harm and suicide require collaborative research between stakeholders focused on shared priorities. Aims: We aimed to develop a consensus about suicide and self-harm research priorities in the North West of England using the Delphi method. Method: Items for the Delphi survey were generated through group discussions at a workshop with 88 stakeholders and subsequent thematic analysis of key themes. A total of 44 participants who were experts-by-experience, researchers, and clinicians based within health services including third-sector organizations completed the Delphi survey. Results: A three-round survey reached consensus on 55 research priority items identifying key priorities in each of the following groups: offenders, children and young people, self-harm in community settings, and crisis care in the community. Limitations: The pool of delegates at the workshop and subsequent self-selection into the Delphi may have introduced bias into the study. Conclusion: The current paper highlights specific actionable priorities were identified in four areas that can be used to inform research efforts and future policy and practice, based on shared areas of perceived importance and concern. Future work is needed to confirm the significance of these priority areas, including the use of evidence synthesis approaches to ascertain the extent to which these priorities have already been investigated and where gaps in understanding remain.
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Affiliation(s)
- Pooja Saini
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Caroline Clements
- The Manchester Self-Harm Project, Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, UK
| | | | - Jennifer Chopra
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | | | - Rohit Kumar
- School of Medicine, University of Nottingham, UK
| | - Peter Taylor
- Division of Psychology & Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, UK
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Hoare E, Thorp A, Bartholomeusz-Raymond N, McCoy A, Butler H, Berk M. Be You: A national education initiative to support the mental health of Australian children and young people. Aust N Z J Psychiatry 2020; 54:1061-1066. [PMID: 32794411 DOI: 10.1177/0004867420946840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Early learning services and schools provide unique settings for mental health promotion and early intervention due to the potential for population-level dosage and reach in terms of reducing multiple risk factors and enabling protective factors among young people. Educators play a key role in supporting children and young people's experiences of, and access to mental health promotion opportunities, and hold unparalleled opportunity in terms of creating mental health-promoting learning environments. In 2018, the Australian National Mental Health in Education Initiative, Be You, was launched. Be You is a multi-million-dollar Australian government-supported initiative, freely available to all 24,000 early learning services, primary and secondary schools throughout Australia. The potential for subsequent population reach is proposed to potentially exceed that of any mental health promotion initiative for children and young people previously observed in Australia. Be You aims to foster mentally healthy learning communities across Australia through building capacity among educators to embed mental health promotion strategies. The Initiative was developed based on a review and integration of previous national mental health promotion frameworks, with an overall alignment to existing state and territory education, social and emotional well-being frameworks, and the Australian Curriculum. In delivering facilitated support from specialised consultants to early learning services and schools participating in the initiative, Be You draws on professional learning principles designed to build capacity in educators and educational systems relating to mental health promotion. It uses an updated, multi-module online platform providing interactive, evidence-based resources. This paper presents the Be You framework, describes the evidence sources used to inform the underlying principles and objectives, discusses the specific components that form the initiative, details the professional learning modules and content, and discusses potential implications for population mental health and prevention efforts.
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Affiliation(s)
- Erin Hoare
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food and Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | | | | | | | - Helen Butler
- Independent Consultant, Melbourne, VIC, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, The Florey Institute and the Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
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12
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Malhi GS, Bell E. Suicide in school-age students: A need for psychoeducation and further study. Aust N Z J Psychiatry 2020; 54:863-866. [PMID: 32865448 DOI: 10.1177/0004867420952880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gin S Malhi
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia.,Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Erica Bell
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia.,Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
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Quarshie ENB, Waterman MG, House AO. Adolescents at risk of self-harm in Ghana: a qualitative interview study exploring the views and experiences of key adult informants. BMC Psychiatry 2020; 20:310. [PMID: 32546144 PMCID: PMC7298808 DOI: 10.1186/s12888-020-02718-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/04/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND In Ghana, rates of self-harm in young people are as high as they are in high income countries. Self-reported interpersonal, familial and societal stressors form the most important background, and self-harm is seen by young people as a way of responding to that stress. In the present study, we obtained the views of key adult informants about self-harm among adolescents in Ghana - what they thought as possible reasons for self-harm in young people and what actions might be needed at an individual or population level to respond to the problem. METHODS We interviewed face-to-face 11 adults, using a semi-structured interview guide. We used an experiential thematic analysis technique to analyse the transcribed interviews. RESULTS The analysis identified five themes: "underestimating the prevalence of self-harm in adolescents", "life on the streets makes self-harm less likely", "self-harm in adolescents is socially and psychologically understandable", "ambivalence about responding to adolescent self-harm", and "few immediate opportunities for self-harm prevention in Ghana". Adolescent self-harm was acknowledged but its scale was underestimated. The participants offered explanations for adolescent self-harm in social and psychological terms that are recognisable from accounts in high income countries. Low rates among street-connected young people were explained by their overarching orientation for survival. Participants agreed that identification was important, but they expressed a sense of inadequacy in identifying and supporting adolescents at risk of self-harm. Again, the participants agreed that self-harm in adolescents should be prevented, but they recognised that relevant policies were not in place or if there were policies they were not implemented - mental health and self-harm were not high on public or political priorities. CONCLUSIONS The adults we interviewed about young people who self-harm see themselves as having a role in identifying adolescents at risk of self-harm and see the organisations in which they work as having a role in responding to individual young people in need. These are encouraging findings that point to at least one strand of a policy in Ghana for addressing the problem of self-harm in young people.
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Affiliation(s)
| | | | - Allan O House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Andriessen K, Krysinska K, Kõlves K, Reavley N. Suicide Postvention Service Models and Guidelines 2014-2019: A Systematic Review. Front Psychol 2019; 10:2677. [PMID: 31849779 PMCID: PMC6896901 DOI: 10.3389/fpsyg.2019.02677] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/13/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Suicide bereavement can have a lasting and devastating psychosocial impact on the bereaved individuals and communities. Many countries, such as Australia, have included postvention, i.e., concerted suicide bereavement support, in their suicide prevention policies. While little is known of the effectiveness of postvention, this review aimed to investigate what is known of the effects of postvention service delivery models and the components that may contribute to the effectiveness. Method: Systematic review and quality assessment of peer reviewed literature (Medline, PsycINFO, Embase, EBM Reviews) and gray literature and guidelines published since 2014. Results: Eight studies and 12 guidelines were included, with little evidence of effectiveness. Still, providing support according to the level of grief, involvement of trained volunteers/peers, and focusing the interventions on the grief, seem promising components of effective postvention. Conclusions: Adopting a public health approach to postvention can allow to tailor the service delivery to needs of the bereaved individuals and to align postvention with suicide prevention programs.
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Affiliation(s)
- Karl Andriessen
- Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Karolina Krysinska
- Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Kairi Kõlves
- WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, QLD, Australia
| | - Nicola Reavley
- Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
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The #chatsafe project. Developing guidelines to help young people communicate safely about suicide on social media: A Delphi study. PLoS One 2018. [PMID: 30439958 DOI: 10.1371/journal.pone.0206584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Many countries have developed guidelines advocating for responsible reporting of suicidal behaviour in traditional media. However, the increasing popularity of social media, particularly among young people, means that complementary guidelines designed to facilitate safe peer-peer communication are required. The aim of this study was to develop a set of evidence informed guidelines to assist young people to communicate about suicide via social media with the input of young people as active participants of the study. METHODS Systematic searches of the peer-reviewed and grey literature were conducted resulting in a 284-item questionnaire identifying strategies for safe communication about suicide online. The questionnaire was delivered over two rounds to two panels consisting of Australian youth advocates; and international suicide prevention researchers and media and communications specialists. Items were rerated if they were endorsed by 70-79.5% of both panels, or if 80% or more of one panel rated the item as essential or important. All items that were endorsed as essential or important by at least 80% of both panels were included in the final guidelines. RESULTS A total of 173 items were included in the final guidelines. These items were organised into the following five sections: 1) Before you post anything online about suicide; 2) Sharing your own thoughts, feelings, or experience with suicidal behaviour online; 3) Communicating about someone you know who is affected by suicidal thoughts, feelings or behaviours; 4) Responding to someone who may be suicidal; 5) Memorial websites, pages and closed groups to honour the deceased. DISCUSSION This is the first study to develop a set of evidence-informed guidelines to support young people to talk safely about suicide on social media. It is hoped that they will be a useful resource for young people and those who support them (e.g., parents, teachers, community workers and health professionals).
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Robinson J, Hill NTM, Thorn P, Battersby R, Teh Z, Reavley NJ, Pirkis J, Lamblin M, Rice S, Skehan J. The #chatsafe project. Developing guidelines to help young people communicate safely about suicide on social media: A Delphi study. PLoS One 2018; 13:e0206584. [PMID: 30439958 PMCID: PMC6237326 DOI: 10.1371/journal.pone.0206584] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/16/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Many countries have developed guidelines advocating for responsible reporting of suicidal behaviour in traditional media. However, the increasing popularity of social media, particularly among young people, means that complementary guidelines designed to facilitate safe peer-peer communication are required. The aim of this study was to develop a set of evidence informed guidelines to assist young people to communicate about suicide via social media with the input of young people as active participants of the study. METHODS Systematic searches of the peer-reviewed and grey literature were conducted resulting in a 284-item questionnaire identifying strategies for safe communication about suicide online. The questionnaire was delivered over two rounds to two panels consisting of Australian youth advocates; and international suicide prevention researchers and media and communications specialists. Items were rerated if they were endorsed by 70-79.5% of both panels, or if 80% or more of one panel rated the item as essential or important. All items that were endorsed as essential or important by at least 80% of both panels were included in the final guidelines. RESULTS A total of 173 items were included in the final guidelines. These items were organised into the following five sections: 1) Before you post anything online about suicide; 2) Sharing your own thoughts, feelings, or experience with suicidal behaviour online; 3) Communicating about someone you know who is affected by suicidal thoughts, feelings or behaviours; 4) Responding to someone who may be suicidal; 5) Memorial websites, pages and closed groups to honour the deceased. DISCUSSION This is the first study to develop a set of evidence-informed guidelines to support young people to talk safely about suicide on social media. It is hoped that they will be a useful resource for young people and those who support them (e.g., parents, teachers, community workers and health professionals).
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Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Nicole T. M. Hill
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Pinar Thorn
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Rikki Battersby
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
| | - Zoe Teh
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
| | - Nicola J. Reavley
- Centre for Mental Health, The Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, The Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Michelle Lamblin
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Jaelea Skehan
- Everymind, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
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Affiliation(s)
- Ella Arensman
- 1 President, International Association for Suicide Prevention (IASP).,2 Director of Research, National Suicide Research Foundation, Department of Epidemiology and Public Health, University College Cork, Ireland.,3 WHO Collaborating Centre for Surveillance and Research in Suicide Prevention, Cork, Ireland
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Pitman A, Khrisna Putri A, De Souza T, Stevenson F, King M, Osborn D, Morant N. The Impact of Suicide Bereavement on Educational and Occupational Functioning: A Qualitative Study of 460 Bereaved Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040643. [PMID: 29614731 PMCID: PMC5923685 DOI: 10.3390/ijerph15040643] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 11/16/2022]
Abstract
People bereaved by suicide are at an increased risk of suicide and of dropping out of education or work. Explanations for these associations are unclear, and more research is needed to understand how improving support in educational or work settings for people bereaved by suicide might contribute to reducing suicide risk. Our objective was to explore the impact of suicide on occupational functioning. We conducted a cross-sectional online study of bereaved adults aged 18-40, recruited from staff and students of British higher educational institutions in 2010. We used thematic analysis to analyse free text responses to two questions probing the impact of suicide bereavement on work and education. Our analysis of responses from 460 adults bereaved by suicide identified three main themes: (i) specific aspects of grief that impacted on work performance, cognitive and emotional domains, and social confidence; (ii) structural challenges in work or educational settings including a lack of institutional support, the impact of taking time off, and changes to caring roles; and (iii) new perspectives on the role of work, including determination to achieve. Institutional support should be tailored to take account of the difficulties and experiences described.
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Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK.
| | - Adelia Khrisna Putri
- UGM Faculty of Psychology, Universitas Gadjah Mada, Jl. Sosio Humaniora 1, Sleman, Yogyakarta 55281, Indonesia.
| | - Tanisha De Souza
- North East London NHS Foundation Trust, Memory Service, Broad Street Health Centre, Morland Road, Dagenham, Essex, RM10 9HU, UK.
| | - Fiona Stevenson
- UCL Research Department of Primary Care & Population Health, Rowland Hill St, London NW3 2PF, UK.
| | - Michael King
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
| | - David Osborn
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK.
| | - Nicola Morant
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
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Andriessen K, Lobb E, Mowll J, Dudley M, Draper B, Mitchell PB. Help-seeking experiences of bereaved adolescents: A qualitative study. DEATH STUDIES 2018; 43:1-8. [PMID: 29393826 DOI: 10.1080/07481187.2018.1426657] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provided a critical appraisal of positive and negative experiences, and noted barriers and facilitators for help-seeking. As adolescents bereaved through suicide may receive less social support, professional help is a much-needed auxiliary. Parental encouragement is important in accessing adequate professional help.
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Affiliation(s)
- Karl Andriessen
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
| | - Elizabeth Lobb
- b Calvary Health Care , Kogarah , NSW , Australia
- c Cunningham Centre for Palliative Care , Darlinghurst , NSW , Australia
- d School of Medicine , University of Notre Dame , Darlinghurst , NSW , Australia
| | - Jane Mowll
- e School of Social Sciences , University of New South Wales , Sydney , NSW , Australia
| | - Michael Dudley
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
| | - Brian Draper
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
| | - Philip B Mitchell
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
- f Black Dog Institute , Randwick , NSW , Australia
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Gould MS, Lake AM, Kleinman M, Galfalvy H, Chowdhury S, Madnick A. Exposure to Suicide in High Schools: Impact on Serious Suicidal Ideation/Behavior, Depression, Maladaptive Coping Strategies, and Attitudes toward Help-Seeking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E455. [PMID: 29509702 PMCID: PMC5877000 DOI: 10.3390/ijerph15030455] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 02/22/2018] [Accepted: 02/28/2018] [Indexed: 11/16/2022]
Abstract
Adolescents' exposure to a peer's suicide has been found to be associated with, as well as to predict, suicidal ideation and behavior. Although postvention efforts tend to be school-based, little is known about the impact of a schoolmate's suicide on the school's student population overall. The present study seeks to determine whether there is excess psychological morbidity among students in a school where a schoolmate has died by suicide, and whether students' attitudes about coping and help-seeking strategies are more or less problematic in such schools. Students in twelve high schools in Suffolk and Westchester counties in New York State-2865 students at six schools where a student had died by suicide within the past six months, and 2419 students at six schools where no suicide had occurred within the current students' tenure-completed an assessment of their suicidal ideation and behavior, depressive symptoms, coping and help-seeking attitudes, stressful life events, and friendship with suicide decedent (if applicable). No excess morbidity (i.e., serious suicidal ideation/behavior and depression) was evident among the general student population after a schoolmate's death by suicide; however, the risk of serious suicidal ideation/behavior was elevated among students at exposed schools who had concomitant negative life events. There was a significant relationship between friendship with the decedent and morbidity, in that students who were friends, but not close friends, of the decedents had the greatest odds of serious suicidal ideation/behavior. Overall, students in exposed schools had more adaptive attitudes toward help-seeking; but this was not true of the decedents' friends or students with concomitant negative life events. The implications of the findings for postvention strategies are discussed.
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Affiliation(s)
- Madelyn S Gould
- Division of Child & Adolescent Psychiatry and Department of Epidemiology, Columbia University Medical Center and The New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 10032, USA.
| | - Alison M Lake
- Division of Child & Adolescent Psychiatry, The New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 10032, USA.
| | - Marjorie Kleinman
- Division of Child & Adolescent Psychiatry, The New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 10032, USA.
| | - Hanga Galfalvy
- Departments of Psychiatry and Biostatistics, Columbia University Medical Center, 722 West 168 Street, New York, NY 10032, USA.
| | - Saba Chowdhury
- Division of Child & Adolescent Psychiatry, The New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 10032, USA.
| | - Alison Madnick
- Division of Child & Adolescent Psychiatry, The New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 10032, USA.
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Why We Need to Enhance Suicide Postvention: Evaluating a Survey of Psychiatrists' Behaviors after the Suicide of a Patient. J Nerv Ment Dis 2017; 205:507-511. [PMID: 28590263 PMCID: PMC5962958 DOI: 10.1097/nmd.0000000000000682] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Suicide prevention efforts are increasing to enhance capabilities and better understand risk factors and etiologies. Postvention, or how clinicians manage the postsuicide aftermath, strengthens suicide prevention, destigmatizes the tragedy, operationalizes the confusing aftermath, and promotes caregiver recovery. However, studies regarding its efficacy are minimal. The Psychopathology Committee of the Group for the Advancement for Psychiatry surveyed a convenience sample of psychiatrists to better understand postvention activities. Ninety psychiatrists completed the survey; they were predominantly men (72%) with an average of 24.6 years of experience (SD, 16.7 years). Most had contact with the patient's family within 6 months of the suicide, and most psychiatrists sought some form of support. Few psychiatrists used a suicide postvention procedure or toolkit (9%). No psychiatrists stopped clinical practice after a patient suicide, although 10% stopped accepting patients they deemed at risk of suicide. Postvention efforts, therefore, should be improved to better address survivor care.
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The impact of a student's suicide: Teachers' perspectives. J Affect Disord 2017; 207:276-281. [PMID: 27736739 DOI: 10.1016/j.jad.2016.09.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/17/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The impact of suicide of adolescents is devastating, yet little is known about the distressing impact for teachers. The aim of this study therefore is to explore the impact student suicide on teachers' personal and professional lives. METHODS A cross-sectional anonymous online survey of primary and secondary school teachers was conducted in Australia. The Impact of Event Scale - Revised, questions about personal and professional impact, help seeking, perceived needs and experiences after student's suicide were included in the analysis. RESULTS In total, 229 teachers commenced the questionnaire, with 138 (60.3%) completing the full questionnaire. Questions about exposure to students' suicide were completed by 145 teachers (63.3%). In total, 35.9% (n=52) were exposed to at least the suicide of one student (two or more: 54.8%). The most recent suicide of a student had (some or great) impact on the personal life of 76% of teachers and on the professional life of 85.7%. Impact on personal life was significantly higher for female teachers. The most frequent source for help seeking was family or partner (65.3%); use of professional help was also reported, with the school counsellor being the most frequent (30.6%). Following the most recent suicide of a student, 27.1% of teachers exposed to suicide felt that they needed more support. LIMITATIONS The potential for selection bias through the use of an online survey, and the relatively small sample. CONCLUSION The study showed high levels of distress among teachers after exposure to a student's suicide and greater need for help than that obtained.
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Robinson J, Too LS, Pirkis J, Spittal MJ. Spatial suicide clusters in Australia between 2010 and 2012: a comparison of cluster and non-cluster among young people and adults. BMC Psychiatry 2016; 16:417. [PMID: 27876026 PMCID: PMC5120558 DOI: 10.1186/s12888-016-1127-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A suicide cluster has been defined as a group of suicides that occur closer together in time and space than would normally be expected. We aimed to examine the extent to which suicide clusters exist among young people and adults in Australia and to determine whether differences exist between cluster and non-cluster suicides. METHODS Suicide data were obtained from the National Coronial Information System for the period 2010 and 2012. Data on date of death, postcode, age at the time of death, sex, suicide method, ICD-10 code for cause of death, marital status, employment status, and aboriginality were retrieved. We examined the presence of spatial clusters separately for youth suicides and adult suicides using the Scan statistic. Pearson's chi-square was used to compare the characteristics of cluster suicides with non-cluster suicides. RESULTS We identified 12 spatial clusters between 2010 and 2012. Five occurred among young people (n = 53, representing 5.6% [53/940] of youth suicides) and seven occurred among adults (n = 137, representing 2.3% [137/5939] of adult suicides). Clusters ranged in size from three to 21 for youth and from three to 31 for adults. When compared to adults, suicides by young people were significantly more likely to occur as part of a cluster (difference = 3.3%, 95% confidence interval [CI] = 1.8 to 4.8, p < 0.0001). Suicides by people with an Indigenous background were also significantly more likely to occur in a cluster than suicide by non-Indigenous people and this was the case among both young people and adults. CONCLUSIONS Suicide clusters have a significant negative impact on the communities in which they occur. As a result it is important to find effective ways of managing and containing suicide clusters. To date there is limited evidence for the effectiveness of those strategies typically employed, in particular in Indigenous settings, and developing this evidence base needs to be a future priority. Future research that examines in more depth the socio-demographic and clinical factors associated with suicide clusters is also warranted in order that appropriate interventions can be developed.
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Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10, Parkville, VIC, 3052, Australia.
| | - Lay San Too
- Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Jane Pirkis
- Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Matthew J. Spittal
- Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, Carlton, VIC 3053 Australia
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