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Zimmermann C, Strohmaier S, Herkner H, Niederkrotenthaler T, Schernhammer E. Suicide rates among physicians compared with the general population in studies from 20 countries: gender stratified systematic review and meta-analysis. BMJ 2024; 386:e078964. [PMID: 39168499 DOI: 10.1136/bmj-2023-078964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
OBJECTIVES To estimate age standardised suicide rate ratios in male and female physicians compared with the general population, and to examine heterogeneity across study results. DESIGN Systematic review and meta-analysis. DATA SOURCES Studies published between 1960 and 31 March 2024 were retrieved from Embase, Medline, and PsycINFO. There were no language restrictions. Forward and backwards reference screening was performed for selected studies using Google Scholar. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Observational studies with directly or indirectly age standardised mortality ratios for physician deaths by suicide, or suicide rates per 100 000 person years of physicians and a reference group similar to the general population, or extractable data on physician deaths by suicide suitable for the calculation of ratios. Two independent reviewers extracted data and assessed the risk of bias using an adapted version of the Joanna Briggs Institute checklist for prevalence studies. Mean effect estimates for male and female physicians were calculated based on random effects models, with subgroup analyses for geographical region and a secondary analysis of deaths by suicide in physicians compared with other professions. RESULTS Among 39 included studies, 38 studies for male physicians and 26 for female physicians were eligible for analyses, with a total of 3303 suicides in male physicians and 587 in female physicians (observation periods 1935-2020 and 1960-2020, respectively). Across all studies, the suicide rate ratio for male physicians was 1.05 (95% confidence interval 0.90 to 1.22). For female physicians, the rate ratio was significantly higher at 1.76 (1.40 to 2.21). Heterogeneity was high for both analyses. Meta-regression revealed a significant effect of the midpoint of study observation period, indicating decreasing effect sizes over time. The suicide rate ratio for male physicians compared with other professions was 1.81 (1.55 to 2.12). CONCLUSION Standardised suicide rate ratios for male and female physicians decreased over time. However, the rates remained increased for female physicians. The findings of this meta-analysis are limited by a scarcity of studies from regions outside of Europe, the United States, and Australasia. These results call for continued efforts in research and prevention of physician deaths by suicide, particularly among female physicians and at risk subgroups. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019118956.
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Affiliation(s)
- Claudia Zimmermann
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Roy N, Paul KD, Tamanna SS, Paul AK, Almerab MM, Mamun MA. Prevalence and risk factors of depression, anxiety, and stress among the Bangladeshi construction workers: A cross-sectional study. PLoS One 2024; 19:e0307895. [PMID: 39159238 PMCID: PMC11332995 DOI: 10.1371/journal.pone.0307895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 07/12/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Construction workers are a population that is at risk for mental illnesses such as depression, anxiety, and even suicide due to the high stress and physical demands of their work. This study aimed to determine the prevalence and risk factors for depression, anxiety, and stress among Bangladeshi construction workers. METHODS From February 2022 to June 2022, community-based cross-sectional research was conducted among construction workers. Survey data was gathered using interviewer administered questionnaires with 502 participants from the construction sites. Data were collected based on the information related to socio-demographics, lifestyle, occupation, health hazards, and mental health (i.e., depression, anxiety, and stress). The results were interpreted using the chi-square test and logistic regression utilizing SPSS statistical software. RESULTS The study revealed the prevalence rates of depression, anxiety, and stress among construction workers to be 17.9%, 30.3%, and 12%, respectively. Key findings indicate that construction workers who maintained a healthy sleep duration were 64% less likely to be depressed compared to those with poor sleep (AOR = 0.36; 95% CI: 0.21-0.61, p<0.001). Workers who did not experience breathing issues upon starting construction work had a 45% lower likelihood of experiencing depression (AOR = 0.55; 95% CI: 0.32-0.97, p = 0.037) and an 82% lower likelihood of experiencing anxiety (AOR = 0.18; 95% CI: 0.11-0.30, p<0.001). Bricklayer construction workers were 72% less likely to experience stress (AOR = 0.28; 95% CI: 0.08-0.95, p = 0.041), and workers without breathing issues after starting construction work were 66% less likely to experience stress (AOR = 0.34; 95% CI: 0.17-0.66, p = 0.001). CONCLUSIONS The study found that depression, anxiety, and stress are prevalent among construction workers in Bangladesh, with breathing issues as a significant risk factor. Thus, there is a need for effective measures to reduce these problems and provide a safe working environment for construction workers to ensure their productivity and the country's overall growth.
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Affiliation(s)
- Nitai Roy
- Department of Biochemistry and Food Analysis, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Kallol Deb Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Sumaiya Sultana Tamanna
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Anup Kumar Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Moneerah Mohammad Almerab
- Department of Psychology, College of Education and Human Development, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
- Department of Public Health, University of South Asia, Dhaka, Bangladesh
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Prahlow SP, Wilson T, Gruszecki AC. Suicide by Ethyl Methacrylate Ingestion. Am J Forensic Med Pathol 2024:00000433-990000000-00210. [PMID: 39088702 DOI: 10.1097/paf.0000000000000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
ABSTRACT This case report characterizes a unique way in which suicide was accomplished through ingestion of chemicals typically used to create acrylic fingernails that resulted in death. Ethyl methacrylate and acrylic powder are commonly combined to form acrylic nails in nail salons. The process of applying acrylic nails utilizes each substance by mixing both before it typically solidifies within seconds of combining the two compounds. Ingestion of these compounds has not been previously described within the medical literature. The decedent was a nail technician at a local salon. He was found unresponsive in his yard which led to a 911 call. At the scene, a mostly empty 16-oz bottle of ethyl methacrylate, a chemical used at the salon where he worked, was found. At autopsy, the decedent's body had a strong chemical odor consistent with odors present at nail salons. Significant gastrointestinal tract damage was seen including discoloration within the esophagus, and the stomach contained a molded, hardened nail compound. The cause of death was ruled as complications of nail acrylic powder and liquid ethyl methacrylate ingestion. This case shows the unusual findings seen at autopsy from a decedent who committed suicide by ingestion of ethyl methacrylate with acrylic powder.
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Affiliation(s)
- Samuel P Prahlow
- From the Philadelphia College of Osteopathic Medicine-South Georgia, Moultrie, GA
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LaMontagne AD, Åberg M, Blomqvist S, Glozier N, Greiner BA, Gullestrup J, Harvey SB, Kyron MJ, Madsen IEH, Hanson LM, Maheen H, Mustard C, Niedhammer I, Rugulies R, Smith PM, Taouk Y, Waters S, Witt K, King TL. Work-related suicide: Evolving understandings of etiology & intervention. Am J Ind Med 2024; 67:679-695. [PMID: 38853462 DOI: 10.1002/ajim.23624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Previously published analyses of suicide case investigations suggest that work or working conditions contribute to 10%-13% of suicide deaths. Yet, the way in which work may increase suicide risk is an underdeveloped area of epidemiologic research. In this Commentary, we propose a definition of work-related suicide from an occupational health and safety perspective, and review the case investigation-based and epidemiologic evidence on work-related causes of suicide. We identified six broad categories of potential work-related causes of suicide, which are: (1) workplace chemical, physical, and psychosocial exposures; (2) exposure to trauma on the job; (3) access to means of suicide through work; (4) exposure to high-stigma work environments; (5) exposure to normative environments promoting extreme orientation to work; and (6) adverse experiences arising from work-related injury or illness. We summarise current evidence in a schema of potential work-related causes that can also be applied in workplace risk assessment and suicide case investigations. There are numerous implications of these findings for policy and practice. Various principle- and evidence-based workplace intervention strategies for suicide prevention exist, some of which have been shown to improve suicide-prevention literacy, reduce stigma, enhance helping behaviours, and in some instances maybe even reduce suicide rates. Prevailing practice in workplace suicide prevention, however, overly emphasises individual- and illness-directed interventions, with little attention directed to addressing the working conditions that may increase suicide risk. We conclude that a stronger emphasis on improving working conditions will be required for workplace suicide prevention to reach its full preventive potential.
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Affiliation(s)
- Anthony D LaMontagne
- Institute for Health Transformation & School of Health & Social Development, Deakin University, Geelong, Victoria, Australia
| | - Maria Åberg
- School of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Sandra Blomqvist
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Jorgen Gullestrup
- Institute for Health Transformation & School of Health & Social Development, Deakin University, Geelong, Victoria, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Michael J Kyron
- Suicide Prevention and Resilience Research Center (SPARRC), School of Psychological Science, Perth, Western Australia, Australia
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- National Institute of Public Health, Copenhagen, Denmark
| | - Linda Magnusson Hanson
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Humaira Maheen
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Isabelle Niedhammer
- Institut National de la Santé et de la Recherche Médicale (INSERM), Univ Angers, Angers, France
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Peter M Smith
- Instutute for Work & Health, Toronto, Ontario, Canada
| | - Yamna Taouk
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Waters
- School of Languages, Cultures and Societies, University of Leeds, Leeds, UK
| | - Katrina Witt
- Orygen Centre for Youth Mental Health, Parkville, Victoria, Australia
| | - Tania L King
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
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Tang H, Lu Y, Donahoo WT, Shao H, Shi L, Fonseca VA, Guo Y, Bian J, Guo J. Glucagon-Like Peptide-1 Receptor Agonists and Risk for Suicidal Ideation and Behaviors in U.S. Older Adults With Type 2 Diabetes : A Target Trial Emulation Study. Ann Intern Med 2024; 177:1004-1015. [PMID: 39008852 DOI: 10.7326/m24-0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND A major concern has recently emerged about a potential link between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and increased risk for suicidal ideation and behaviors based on International Classification of Diseases codes. OBJECTIVE To investigate the association between GLP-1 RAs, compared with sodium-glucose cotransporter-2 inhibitors (SGLT2is) or dipeptidyl peptidase-4 inhibitors (DPP4is), and risk for suicidal ideation and behaviors in older adults with type 2 diabetes (T2D). DESIGN Two target trial emulation studies comparing propensity score (PS)-matched cohorts for GLP-1 RAs versus SGLT2is and GLP-1 RAs versus DPP4is. SETTING U.S. national Medicare administrative data from January 2017 to December 2020. PATIENTS Older adults (≥66 years) with T2D; no record of suicidal ideation or behaviors; and a first prescription for a GLP-1 RA, SGLT2i, or DPP4i. MEASUREMENTS The primary end point was a composite of suicidal ideation and behaviors. New GLP-1 RA users were matched 1:1 on PS to new users of an SGLT2i or DPP4i in each pairwise comparison. A Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% CIs within matched groups. RESULTS This study included 21 807 pairs of patients treated with a GLP-1 RA versus an SGLT2i and 21 402 pairs of patients treated with a GLP-1 RA versus a DPP4i. The HR of suicidal ideation and behaviors associated with GLP-1 RAs relative to SGLT2is was 1.07 (95% CI, 0.80 to 1.45; rate difference, 0.16 [CI, -0.53 to 0.86] per 1000 person-years); the HR relative to DPP4is was 0.94 (CI, 0.71 to 1.24; rate difference, -0.18 [CI, -0.92 to 0.57] per 1000 person-years). LIMITATIONS Low event rate; imprecise estimates; unmeasured confounders, such as body mass index; and potential misclassification of outcomes. CONCLUSION Among Medicare beneficiaries with T2D, this study found no clear increased risk for suicidal ideation and behaviors with GLP-1 RAs, although estimates were imprecise and a modest adverse risk could not be ruled out. PRIMARY FUNDING SOURCE American Foundation for Pharmaceutical Education, Pharmaceutical Research and Manufacturers of America Foundation, National Institute on Aging, and National Institute of Diabetes and Digestive and Kidney Diseases.
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Affiliation(s)
- Huilin Tang
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, Florida (H.T., Y.L.)
| | - Ying Lu
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, Florida (H.T., Y.L.)
| | - William T Donahoo
- Division of Endocrinology, Diabetes and Metabolism, College of Medicine, University of Florida, Gainesville, Florida (W.T.D.)
| | - Hui Shao
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia (H.S.)
| | - Lizheng Shi
- Department of Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana (L.S.)
| | - Vivian A Fonseca
- Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana (V.A.F.)
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida (Y.G., J.B.)
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida (Y.G., J.B.)
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, and Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida (J.G.)
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Stack S. Suicide Among Roofers: Injury, Pain & Substance Misuse. Arch Suicide Res 2024; 28:917-933. [PMID: 37797624 DOI: 10.1080/13811118.2023.2262535] [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: 10/07/2023]
Abstract
OBJECTIVE CDC has called for suicide research on the construction industry, an industry with a high suicide rate. The present study addresses this gap and focuses on roofers. It assesses which risk factors distinguish suicides by roofers from those of the general population. Alcohol and drug misuse, related to their high incidence of injury and pain, are seen as key potential drivers of roofer suicide. METHODOLOGY Data refer to 30,570 suicides and are taken from the National Violent Death Reporting System (NVDRS). Drawing from previous work on the health professions, 15 core predictors are selected, representing psychiatric morbidity, social strains, and demographics. Since the analysis seeks to differentiate roofers' suicides from others, the dependent variable is a dichotomy where roofers' suicides (=1) and other suicides (=0). RESULTS After adjusting for the other 14 risk factors, a multivariate logistic regression analysis found that roofers' suicides were 76% more apt (Odds ratio = 1.76, CI: 1.18, 2.63) than other suicides to have a known substance or alcohol problem that contributed to their suicide. Other constructs differentiating roofers' suicides from other suicides included marital status, gender, and race. Roofers were less protected by marriage. CONCLUSION The results inform prevention efforts and substance misuse can serve as a key warning sign for roofers' suicide. This is the first investigation of the drivers of suicide among roofers, and one of a few drawing links between occupational injury and suicide.
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Dolbec D, Dubreuil P, Larouche L. Farmers' Mental Health: The Mediating Role of Chronic Fatigue. J Agromedicine 2024; 29:307-320. [PMID: 38044536 DOI: 10.1080/1059924x.2023.2289967] [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] [Indexed: 12/05/2023]
Abstract
The agricultural environment is known to be particularly harmful to farmers' psychological health. To better understand how its impact is modulated, this study mainly focuses on the mediating role of chronic fatigue between A) loneliness at work, autonomy, workload, government regulations and policies and financial hardship, and B) life satisfaction, positive affect and psychological distress. The study is based on a sample of 453 Canadian dairy farmers. Structural equation modeling analyses confirmed the mediating role of chronic fatigue in the relationships between the factors studied, with the exception of financial hardship. Implications for research and the psychological burden affecting agricultural workers are discussed.
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Affiliation(s)
- Didier Dolbec
- Department of Psychology, Faculty of Arts and Humanities, Université de Sherbrooke, Sherbrooke, Canada
| | - Philippe Dubreuil
- Department of Human Resources Management, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Laetitia Larouche
- Department of Psychology, Faculty of Arts and Humanities, Université de Sherbrooke, Sherbrooke, Canada
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Niedhammer I, Pineau E, Rosankis E. The associations of psychosocial work exposures with suicidal ideation in the national French SUMER study. J Affect Disord 2024; 356:699-706. [PMID: 38657775 DOI: 10.1016/j.jad.2024.04.070] [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: 10/20/2023] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The literature remains scarce on the work-related risk factors for suicide and suicidal ideation. The objectives were to explore the associations of psychosocial work exposures with suicidal ideation in a nationally representative sample of the working population. METHODS The study was based on the sample of 25,977 employees (14,682 men and 11,295 women) of the national French 2016-17 SUMER survey. The outcome was suicidal ideation assessed using the PHQ-9 instrument. Psychosocial work exposures included various factors from the job strain and effort-reward imbalance models, and other concepts. Statistical analyses were performed using weighted methods, including weighted logistic regression models. Other occupational exposures and covariates were considered. Gender differences were tested. RESULTS The prevalence of suicidal ideation was 3.5 % without any difference between genders. Psychosocial work exposures were found to be associated with suicidal ideation. The strongest association was observed between workplace bullying and suicidal ideation. Associations were also found between job strain model factors, job insecurity, low esteem, work-family conflict, ethical conflict, teleworking, and low meaning, and suicidal ideation. The associations were in general similar for men and women. LIMITATIONS The study had a cross-sectional design and no causal interpretation could be done. A reporting bias and a healthy worker effect may be suspected. CONCLUSION Psychosocial work exposures played a major role in suicidal ideation. More research may be needed to confirm our results, as suicidal ideation is an important warning signal for suicide prevention. More primary prevention towards the psychosocial work environment may be useful to reduce suicidal ideation at the workplace.
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Affiliation(s)
- Isabelle Niedhammer
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, Angers, France.
| | - Elodie Pineau
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, Angers, France
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King KE, Liddle SK, Nicholas A. A qualitative analysis of self-reported suicide gatekeeper competencies and behaviour within the Australian construction industry. Health Promot J Austr 2024; 35:760-769. [PMID: 37793646 DOI: 10.1002/hpja.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/04/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023] Open
Abstract
ISSUE ADDRESSED Construction workers in Australia have suicide rates 84% higher than other workers, with even higher rates for younger and less-skilled workers. Gatekeeper training (GKT) is a suicide prevention strategy that aims to improve knowledge, attitudes and self-efficacy to identify and assist individuals at risk of suicide. However, the impact of GKT on long-term behaviour and suicide prevention is unclear in the construction industry. METHODS Researchers conducted 22 semi-structured interviews with trained Bluehats, who provide support to their colleagues in the construction industry experiencing mental health difficulties and suicidal distress. RESULTS Participants reported high levels of motivation and capability due to lived experience of mental health problems or suicide, training, satisfaction from helping others and feeling valued in their work environment. CONCLUSIONS The study highlighted the importance of physical and social opportunities for participants to support their colleagues. The findings reinforced the need to integrate GKT within comprehensive industry suicide prevention programs that provide a range of interventions for workers and ongoing support to trainees to translate their skills into behaviour. Future GKT should include behaviour change approaches to identify and target contextual and individual-level factors influencing behaviour. SO WHAT?: Understanding the potential and limitations of GKT within the construction industry offers invaluable insights for health promotion. Integrating GKT with holistic prevention programs could lead to more impactful strategies, potentially reducing the high suicide rates and fostering a healthier work environment in the construction sector.
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Affiliation(s)
- Kylie E King
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Sarah K Liddle
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Angela Nicholas
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Hawkins D, Patel J. Suicide mortality according to occupation and method of suicide, Massachusetts, 2010-2019. Am J Ind Med 2024; 67:624-635. [PMID: 38722102 DOI: 10.1002/ajim.23593] [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: 12/31/2023] [Revised: 03/30/2024] [Accepted: 04/26/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Suicide rates in the United States have been increasing. Work-related factors may contribute to risk for suicide. These work-related factors may be reflected in a varied risk for different suicide methods between occupations. This study sought to assess occupational differences in suicide rates according to the method used. METHODS Death certificate data about suicide deaths in Massachusetts between 2010 and 2019 were used to calculate mortality rates and rate ratios with univariable and multivariable models controlling for age, sex, race ethnicity, and educational attainment for suicides overall, and for three specific methods of suicide (hanging/strangulation/suffocation, firearms, and poisoning) by occupation. RESULTS In multivariate models, the risk for suicide was significantly elevated for workers in arts, design, entertainment, sports, and media (relative risk [RR] = 1.84, 95% confidence interval [CI] = 1.53, 2.22); construction trades (RR = 1.68, 95% CI = 1.53, 1.84); protective services (RR = 1.49, 95% CI = 1.26, 1.77); and healthcare support occupations (RR = 1.55, 95% CI = 1.25, 1.93). Occupational risk for suicide differed across different methods. For hanging/strangulation/suffocation, workers in arts, design, entertainment, sports, and media occupations had the highest RR (2.09, 95% CI = 1.61, 2.71). For firearms, workers in protective service occupations had the highest RR (4.20, 95% CI = 3.30, 5.34). For poisoning, workers in life, physical, and social science occupations had the highest RR (2.32, 95% CI = 1.49, 3.60). CONCLUSIONS These findings are useful for identifying vulnerable working populations for suicide. Additionally, some of the occupational differences in the risk for suicide and for specific methods of suicide may be due to workplace factors. Further research is needed to understand these workplace factors so that interventions can be designed for prevention.
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Affiliation(s)
- Devan Hawkins
- Public Health Program, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA
| | - Jagvi Patel
- School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences , Boston, Massachusetts, USA
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Zheng R, Romero-Del Rey R, Ruiz-Moreno F, Garcia-Gonzalez J, Requena-Mullor M, Navarro-Mena AÁ, López-Villén A, Alarcon-Rodriguez R. Depressive symptoms and suicide attempts among farmers exposed to pesticides. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2024; 108:104461. [PMID: 38723701 DOI: 10.1016/j.etap.2024.104461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/20/2024]
Abstract
Pesticides safeguard crop health but may diminish cholinesterase activity in farmers, potentially leading to psychiatric disorders like depression and suicide attempts. This study, with 453 participants (225 pesticide-exposed farmers, 228 non-farmers) in Almería, Spain, aimed to investigate the presence of depressive symptoms and suicide attempts, the decrease acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity, and their relationship with pesticide exposure in farmers. Depressive symptoms were evaluated using the Spanish adaptation of the Beck Depression Inventory, and blood samples were analyzed for AChE and BChE activity. Farmers showed significantly increased risk of moderate/severe depression and suicide attempts compared to non-farmers (OR = 2.18; p = 0.001), with highest risks observed among mancozeb users (OR = 2.76; p = 0.001 for depression) and malathion users (OR = 3.50; p = 0.001 for suicide attempts). Findings emphasize elevated depression and suicide risks among pesticide-exposed farmers, particularly associated with chlorpyrifos, mancozeb, and malathion exposure.
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Affiliation(s)
- Ruirui Zheng
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería 04120, Spain
| | - Raúl Romero-Del Rey
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería 04120, Spain.
| | | | - Jessica Garcia-Gonzalez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería 04120, Spain
| | - Mar Requena-Mullor
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería 04120, Spain
| | | | | | - Raquel Alarcon-Rodriguez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería 04120, Spain
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Pulleyn ECJ, Van der Hallen R. Exploring the Role of Age and Gender on the Impact of Client Suicide in Mental Health Practitioners. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:470-484. [PMID: 35231194 PMCID: PMC11100262 DOI: 10.1177/00302228221075287] [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] [Indexed: 11/17/2022]
Abstract
Objective: Previous research has revealed that mental health professionals (MHPs) often experience severe, yet varying, levels of short-term impact in the aftermath of client suicide. Individual differences are significant, yet what factors help explain these differences remains unclear. The current study investigated the role of the MHPs' and the clients' age and gender upon the impact of client suicide. Method: An international sample of 213 MHPs, aged between 18 and 75, reported on a client's suicide and its short-term impact (IES-R). Results: The results indicate that both MHPs' and clients' gender did not affect impact. MHPs' and clients' age did not affect impact individually, although a significant interaction effect was revealed. Conclusion: Age, not gender, of the MHP and client are relevant in light of the impact of client suicide. Potential implications and suggestions for future research are discussed.
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Affiliation(s)
- Edward C. J. Pulleyn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Netherlands
| | - Ruth Van der Hallen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Netherlands
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13
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Hammer LB, Dimoff J, Mohr CD, Allen SJ. A Framework for Protecting and Promoting Employee Mental Health through Supervisor Supportive Behaviors. OCCUPATIONAL HEALTH SCIENCE 2024; 8:243-268. [PMID: 39042735 PMCID: PMC10962005 DOI: 10.1007/s41542-023-00171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 07/25/2024]
Abstract
The attention to workplace mental health is timely given extreme levels of burnout, anxiety, depression and trauma experienced by workers due to serious extraorganizational stressors - the COVID-19 pandemic, threats to climate change, and extreme social and political unrest. Workplace-based risk factors, such as high stress and low support, are contributing factors to poor mental health and suicidality (Choi, 2018; Milner et al., 2013, 2018), just as low levels of social connectedness and belonging are established risk factors for poor mental health (Joiner et al., 2009), suggesting that social support at work (e.g., from supervisors) may be a key approach to protecting and promoting employee mental health. Social connections provide numerous benefits for health outcomes and are as, or more, important to mortality as other well-known health behaviors such as smoking and alcohol consumption (Holt-Lundstad et al., 2015), and can serve as a resource or buffer against the deleterious effects of stress or strain on psychological health (Cohen & Wills, 1985). This manuscript provides an evidence-based framework for understanding how supervisor supportive behaviors can serve to protect employees against psychosocial workplace risk factors and promote social connection and belongingness protective factors related to employee mental health. We identify six theoretically-based Mental Health Supportive Supervisor Behaviors (MHSSB; i.e., emotional support, practical support, role modeling, reducing stigma, warning sign recognition, warning sign response) that can be enacted and used by supervisors and managers to protect and promote the mental health of employees. A brief overview of mental health, mental disorders, and workplace mental health is provided. This is followed by the theoretical grounding and introduction of MHSSB. Suggestions for future research and practice follow, all with the focus of developing a better understanding of the role of supervisors in protecting and promoting employee mental health in the workplace.
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Affiliation(s)
- Leslie B. Hammer
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Jennifer Dimoff
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Cynthia D. Mohr
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Shalene J. Allen
- Department of Psychology, Portland State University, Portland, OR, USA
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O'Donnell S, Egan T, Clarke N, Richardson N. Prevalence and associated risk factors for suicidal ideation, non-suicidal self-injury and suicide attempt among male construction workers in Ireland. BMC Public Health 2024; 24:1263. [PMID: 38720265 PMCID: PMC11077913 DOI: 10.1186/s12889-024-18483-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Suicide among male construction workers are reported to be disproportionally high compared to the working age population. However, there is minimal understanding of the prevalence and associated factors for suicidal ideation, non-suicidal self-injury, and suicide attempt among this occupational group globally. METHODS A cross-sectional study was conducted on a large sample of male construction workers in Ireland (n = 1,585). We investigated the prevalence of suicidal ideation, non-suicidal self-injury and suicide attempts and sociodemographic, occupational, and mental health factors associated with these three outcomes. Multivariable Poisson regression was performed to estimate the prevalence rate ratio of suicidal ideation (model 1 primary outcome), while multivariable logistic regression was used to estimate the odds ratio of non-suicidal self-injury (model 2 primary outcome), and suicide attempt (model 3 primary outcome). RESULTS The lifetime prevalence rate for suicidal ideation was 22%, 6% for non-suicidal self-injury, and 6% for suicide attempt. In univariate modelling, socio-demographic and occupation-specific factors associated with the three outcomes included younger age (suicidal ideation and non-suicidal self-injury), not being in a relationship (suicide attempt) and working 35-44 h per week (suicidal ideation and suicide attempt). The mental health factors generalized anxiety disorder, depression, and suicide bereavement were significantly associated with increased risk of the three outcomes. In fully adjusted multivariable models, increasing severity of generalized anxiety disorder and depression were associated with an increased prevalence rate ratio of suicidal ideation, and a higher odds ratio of non-suicidal self-injury and suicide attempt. CONCLUSION Suicidal ideation, non-suicidal self-injury and suicide attempt are significant issues for male construction workers that require specific attention. Findings highlight a need to support younger male construction workers and those bereaved by suicide. They also highlight the need for the early detection and treatment of generalized anxiety disorder and depression in order to intervene in, and potentially prevent, suicidality among male construction workers.
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Affiliation(s)
- Shane O'Donnell
- National Centre for Men's Health, South East Technological University (Carlow Campus), Kilkenny Road, Carlow, Ireland.
| | - Tom Egan
- School of Business, South East Technological University (Waterford Campus), Cork Road, Waterford, Ireland
| | - Nicholas Clarke
- RCSI University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin, Ireland
| | - Noel Richardson
- National Centre for Men's Health, South East Technological University (Carlow Campus), Kilkenny Road, Carlow, Ireland
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Mehlig K, Torén K, LaMontagne AD, Wahlström V, Nyberg J, Waern M, Åberg M. Occupation-specific risk estimates for suicide and non-fatal self-harm from a Swedish cohort of male construction workers followed 1987-2018. Occup Environ Med 2024; 81:142-149. [PMID: 38418223 PMCID: PMC10958292 DOI: 10.1136/oemed-2023-109246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/05/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVES While suicidal behaviour has become less prevalent in non-manual workers in recent decades, rates have increased in manual workers. We aimed to identify occupations within the construction industry with excess risk of suicide and non-fatal self-harm. METHODS This cohort of Swedish construction workers comprises 389 132 individuals examined 1971-1993 and followed 1987-2018 using national hospital and cause of death registers. More than 200 job titles were merged into 22 occupational groups. For 296 891 men alive in 1987 and active in the construction sector, survival was calculated from baseline to first event of non-fatal self-harm or suicide and censored for emigration, long-term unemployment, disability pension, retirement, death from other causes or end of follow-up. HRs with 95% CIs were obtained from multiple Cox proportional hazard regression. RESULTS Overall, 1618 cases of suicide and 4774 events of non-fatal self-harm were registered. Self-harm before baseline was the single largest risk factor for suicide, HR 9.3 (95% CI 7.5 to 11.6). Compared with the overall mean, labourers and rock workers had excess risk for suicide, HR 1.4 (95% CI 1.1 to 1.7) and 1.5 (95% CI 1.0 to 2.3), respectively, while electricians, clerks and foremen had reduced risk. Labourers, concrete workers, sheet metal workers, painters, glaziers and the group 'other construction workers' were at increased risk for non-fatal self-harm. Almost all categories of manual workers were at increased risk for suicidal behaviour relative to clerks and foremen. CONCLUSIONS Specific occupations within the construction sector were associated with excess risk for suicidal behaviour. Future studies should identify underlying risk factors to inform tailored interventions.
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Affiliation(s)
- Kirsten Mehlig
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Kjell Torén
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Anthony D LaMontagne
- Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Viktoria Wahlström
- Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
| | - Jenny Nyberg
- Section for Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Maria Åberg
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
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Scheyett A, Marburger IL, Scarrow A, Hollifield SM, Dunn JW. What Do Farmers Need for Suicide Prevention: Considerations for a Hard-to-Reach Population. Neuropsychiatr Dis Treat 2024; 20:341-352. [PMID: 38410688 PMCID: PMC10896109 DOI: 10.2147/ndt.s452561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
Purpose Farmers have suicide rates much higher than the general population, with elevated mental health symptoms and high stress levels. Farmers are a hard-to-reach population due to occupational demands and a culture where conversations about mental health are often stigmatizing. This study explored ways to tailor suicide prevention strategies to unique characteristics of farmers by speaking with groups close to farmers who were open to discussing stress and suicide prevention: women married to farmers and agricultural Extension agents. Methods Focus groups with women married to farmers (N=29) and interviews with agricultural agents from the university's local Cooperative Extension offices (N=13) from rural Georgia counties explored effective ways outreach and education about suicide prevention, mental health, and coping could be provided to farmers. Using a thematic analysis approach, qualitative coding was completed by two researchers (Cohens kappa=0.86), with initial codes collapsed into common themes. Results Four themes were identified: 1) Barriers due to the nature of farming, including time demands of farming and cultural stigma in help-seeking; 2) Acceptable messaging, including framing conversations as part of general health; 3) Make information accessible by making it brief, clear, and omnipresent through multiple media; and 4) Elements of effective information and education, including emphasizing "you're not alone" and connection, how to access supports and crisis services, educating people close to farmers, and motivating farmers by emphasizing that they could help another farmer with the information. Conclusion Due to farmers' stoic identities and reluctance to admit mental health struggles, speaking with those close to farmers may help us better understand what is needed to tailor farmer suicide prevention strategies. The insights shared by participants suggest that culturally responsive outreach and education strategies, strengthening relationships through peer support, and gatekeeper training with specific trusted others are important ways to tailor suicide prevention strategies for this hard-to-reach group.
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Affiliation(s)
- Anna Scheyett
- College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA, USA
- School of Social Work, University of Georgia, Athens, GA, USA
| | | | - Andrea Scarrow
- College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA, USA
| | - Stephanie M Hollifield
- College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA, USA
| | - Jennifer Ward Dunn
- College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA, USA
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Roberts SE, John A, Carter T, G Williams J. Suicide rates in the UK Armed Forces, compared with the general workforce and merchant shipping during peacetime years since 1900. BMJ Mil Health 2024:e002309. [PMID: 37028908 DOI: 10.1136/military-2022-002309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/02/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION The main objective was to compare suicide rates and their trends across the three UK Armed forces (Royal Navy, Army and Royal Air Force) from 1900 to 2020. Further objectives were to compare suicide rates with those in the corresponding general population and in UK merchant shipping and to discuss preventative measures. METHODS Examination of annual mortality reports and returns, death inquiry files and official statistics. The main outcome measure was the suicide rate per 100 000 population employed. RESULTS Since 1990, there have been significant reductions in suicide rates in each of the Armed Forces, although a non-significant increase in the Army since 2010. Compared with the corresponding general population, during the most recent decade from 2010 up to 2020, suicide rates were 73% lower in the Royal Air Force, 56% lower in the Royal Navy and 43% lower in the Army. Suicide rates have been significantly decreased in the Royal Air Force since the 1950s, in the Royal Navy since the 1970s and in the Army since the 1980s (comparisons for the Royal Navy and the Army were not available from the late 1940s to the 1960s).During the earliest decades from 1900 to the 1930s, suicide rates in the Armed Forces were mostly quite similar or moderately increased compared with the general population, but far lower than in merchant shipping. Following legislative changes in the last 30 years, suicide rates through poisoning by gases and through firearms or explosives have fallen sharply. CONCLUSIONS The study shows that suicide rates in the Armed Forces have been lower than in the general population over many decades. The sharp reductions in suicide rates over the last 30 years suggest the effectiveness of recent preventative measures, including reductions in access to a method of suicide and well-being initiatives.
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Affiliation(s)
| | - A John
- Medical School, Swansea University, Swansea, UK
| | - T Carter
- Norwegian Centre for Maritime and Diving Medicine, Haukeland Universitetssjukehus, Bergen, Norway
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Arif AA, Adeyemi O, Laditka SB, Laditka JN. Suicide Rates and Risks Across U.S. Industries: A 29-Year Population-Based Survey. Arch Suicide Res 2024:1-26. [PMID: 38193926 DOI: 10.1080/13811118.2023.2300324] [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: 01/10/2024]
Abstract
OBJECTIVE Suicide rates in the working-age U.S. population have increased by over 40% in the last two decades. Although suicide may be linked with characteristics of workplaces and their industries, few studies have reported industry-level suicide rates. No study has reported suicide rates by industry using nationally representative data. This study estimates suicide risks across industries in the U.S. working population. METHODS Industry-level estimates of suicide risks require substantial data; we combined 29 years of U.S. suicide data using the National Health Interview Survey (NHIS)-Mortality Linked data from 1986 through 2014, with mortality follow-up through 2015. We conducted survey-weighted Poisson regression analyses to estimate suicide mortality rates and rate ratios across all populations and stratified by gender. All analyses were adjusted first for age, and then for age, employment status, marital status, race/ethnicity, and rurality/urbanicity (demographic-adjusted). Rate ratios compared results for workers in each industry to those for all industries, accounting for the NHIS survey design. RESULTS A total of 1,943 suicide deaths were recorded. Age-adjusted suicide rates per 100,000 were highest in the furniture, lumber, and wood industry group (29.3), the fabricated metal industry (26.3), and mining (25.8). Demographic-adjusted rates were higher among men than women in most industries. Demographic-adjusted rate ratios were significantly elevated in the furniture, lumber, and wood industries (Rate Ratio, RR = 1.60, 95% confidence interval, CI = 1.18-2.18); chemicals and allied products (RR = 1.49, 95%CI = 1.04-2.13); and construction (RR = 1.21, 95% CI = 1.03-1.41). CONCLUSION Several industries had significantly high suicide rates. Suicide prevention efforts may be particularly useful for workers in those industries.
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Bandara P, Page A, Reifels L, Krysinska K, Andriessen K, Schlichthorst M, Flego A, Le LKD, Mihalopoulos C, Pirkis J. Attributable risk of suicide for populations in Australia. Front Psychiatry 2024; 14:1285542. [PMID: 38260778 PMCID: PMC10800872 DOI: 10.3389/fpsyt.2023.1285542] [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: 08/30/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Each year approximately 3,000 Australians die by suicide. We estimated the population attributable risk for identified target populations to provide evidence on how much of the overall burden of suicide in the Australian population is experienced by each of them. Methods We identified 17 demographic and clinical target populations at risk of suicide and calculated the population attributable fraction (PAF) using a single or pooled suicide risk and the proportional representation of each target population within Australia. Results Large PAF estimates were found for men (52%, 95% confidence interval (CI) 51%-53%), people bereaved by suicide (35%, 95% CI 14%-64%), people with a mental health or behavioural condition (33%, 95%CI 17%-48%), people with a chronic physical condition (27%, 95%CI 18%-35%), adults aged 25-64 years (13%, 95%CI 12%-14%), LGB populations (9%, 95%CI 6%-13%), offenders (9%, 95%CI 8%-10%), and people employed in blue collar occupations (8%, 95%CI 4%-12%). Limitations The PAF is limited by assumptions, namely, that risk factors are independent, and that the relationship between risk factors and outcomes are unidirectional and constant through time. Conclusions and implications for public health Considerable reductions in the overall suicide rate in Australia may occur if risk factors are addressed in identified populations with large PAF estimates. These estimates should be considered as an adjunct to other important inputs into suicide prevention policy priorities.
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Affiliation(s)
- Piumee Bandara
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Marisa Schlichthorst
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Anna Flego
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Long Khanh-Dao Le
- Health Economics Group, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- Health Economics Group, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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Skaczkowski G, Hull M, Smith AE, Dollman J, Jones M, Gunn KM. Understanding farmers' barriers to health and mental health-related help-seeking: The development, factor structure, and reliability of the Farmer Help-Seeking Scale. J Rural Health 2024; 40:64-74. [PMID: 37210709 DOI: 10.1111/jrh.12768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/05/2023] [Accepted: 04/27/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE The aim of this research was to develop a contextually and culturally appropriate scale to assess farmers' barriers to health-related help-seeking. METHODS An initial pool of items was developed from the academic literature and input from an expert panel of farmers, rural academics, and rural clinicians. A draft 32-item questionnaire was then developed and sent to farmers registered with FARMbase, which is an Australian national farmer database. FINDINGS Two hundred and seventy-four farmers completed the draft questionnaire (93.7% male, 73.7% aged 56-75 years). An exploratory factor analysis identified 6 factors; "Health Issues are a Low Priority," "Concerns about Stigma," "Structural Health System Barriers," "Minimization and Normalization," "Communication Barriers," and "Continuity of Care.". Test-retest reliability was examined with a further 10 farmers (90% male, Mean age = 57, SD = 5.91), who completed the questionnaire twice (at 2- to 3-week intervals). Results indicated moderate-good test-retest reliability. CONCLUSIONS The resulting 24-item Farmer Help-Seeking Scale provides a measure of help-seeking that is specifically designed to capture the unique context, culture, and attitudes that can interfere with farmers' help-seeking, and inform the development of strategies to increase health-service utilization in this at-risk group.
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Affiliation(s)
- Gemma Skaczkowski
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Melissa Hull
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - James Dollman
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
- School of Nursing and Midwifery, La Trobe University, Bundoora, Melbourne, Australia
| | - Kate M Gunn
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Tyler S, Hunkin H, Pusey K, Gunn K, Clifford B, McIntyre H, Procter N. Disentangling Rates, Risk, and Drivers of Suicide in the Construction Industry. CRISIS 2024; 45:74-83. [PMID: 36345928 PMCID: PMC10808888 DOI: 10.1027/0227-5910/a000885] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 08/22/2022] [Accepted: 09/04/2022] [Indexed: 01/23/2024]
Abstract
Background: Research suggests construction industry workers (CIWs) face increased suicide vulnerability. Aims: The current study synthesizes international evidence examining rates, risk, and drivers of CIW suicide. Method: Comprehensive searches of MEDLINE, PsycInfo, Embase, Emcare, Web of Science, Scopus, and gray literature were undertaken, identifying studies that discussed, theorized about, or demonstrated risks and/or rates and/or drivers of CIW suicide, without inclusion of other industries. Results: A number of included studies statistically analyzed suicide outcomes in a variety of CIW populations, with the majority reporting increased rate and/or risk, however significant heterogeneity limited comparisons. Twenty-five potential drivers were identified and classified as personal- or industry-related. Disentanglement highlighted the relevance of previously understood personal drivers, need for future focus on industry drivers, and potential interplay between drivers. Limitations: Exclusion of non-English articles as well as inability to extend analysis to fully understand rates and/or risk of CIW suicide and tenuous links between suggested drivers and suicide outcomes. Conclusion: Despite limitations, this paper aids understanding in relation to the suggestion that CIWs are at increased suicide vulnerability. Disentanglement of potential drivers demonstrates the importance of future research focused on industry drivers to assist in prevention strategies.
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Affiliation(s)
- Simon Tyler
- Mental Health and Suicide Prevention Research and Education Group, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Hugh Hunkin
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, SA, Australia
| | - Kelly Pusey
- Mental Health and Suicide Prevention Research and Education Group, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Kate Gunn
- Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - Bob Clifford
- MATES in Construction South Australia, Adelaide, SA, Australia
| | - Heather McIntyre
- Mental Health and Suicide Prevention Research and Education Group, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Nicholas Procter
- Mental Health and Suicide Prevention Research and Education Group, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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Raittila S, Kouvonen A, Koskinen A, Väänänen A. Occupational class differences in male suicide risk in Finland from 1970 to 2019. Eur J Public Health 2023; 33:1014-1019. [PMID: 37802915 PMCID: PMC10710325 DOI: 10.1093/eurpub/ckad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND In the last few decades, suicide rates have decreased in most European countries. However, periodic changes in risk by occupational class have not been studied as much in detail. METHODS Representative cohorts of Finnish working-age men were followed for nine years on suicide mortality starting from five different census years (1970, 1980, 1990, 2000, 2010). Each cohort included between 300 970 and 332 318 men. Cox regression modelling was used to estimate hazard ratios by census year, occupational class and their interactions. Further models adjusted for age and its interactions with census year and occupational class. RESULTS The risk of male suicide has more than halved between 1991 and 2019. The relative hazard ratio of suicide in manual workers compared to managers and professionals was around 1.6 to 1.8 times higher. The period when the suicide risk started to decline differed by occupational class: a significant decrease compared to 1970s' levels was seen for managers and professionals already in the 1990s and for lower non-manual employees around 10 years later (in the 2000s). Manual workers only reached the 1970s suicide risk of managers and professionals in the 2000s and 2010s. CONCLUSION A delayed reduction of suicide rates among lower occupational classes suggests that the impact of social changes can occur at different speed in different population groups.
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Affiliation(s)
- Simo Raittila
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Favril L, Yu R, Geddes JR, Fazel S. Individual-level risk factors for suicide mortality in the general population: an umbrella review. Lancet Public Health 2023; 8:e868-e877. [PMID: 37898519 PMCID: PMC10932753 DOI: 10.1016/s2468-2667(23)00207-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Deaths by suicide remain a major public health challenge worldwide. Identifying and targeting risk factors for suicide mortality is a potential approach to prevention. We aimed to summarise current knowledge on the range and magnitude of individual-level risk factors for suicide mortality in the general population and evaluate the quality of the evidence. METHODS In this umbrella review, five bibliographic databases were systematically searched for articles published from database inception to Aug 31, 2022. We included meta-analyses of observational studies on individual-level risk factors for suicide mortality in the general population. Biological, genetic, perinatal, and ecological risk factors were beyond the scope of this study. Effect sizes were synthesised and compared across domains. To test robustness and consistency of the findings, evidence for small-study effects and excess significance bias (ie, the ratio between the overall meta-analysis effect size and that of its largest included study) was examined, and prediction intervals were calculated. Risk of bias was assessed by the Risk of Bias in Systematic Reviews instrument. The protocol was pre-registered with PROSPERO (CRD42021230119). FINDINGS We identified 33 meta-analyses on 38 risk factors for suicide mortality in the general population. 422 (93%) of the 454 primary studies included in the meta-analyses were from high-income countries. A previous suicide attempt and suicidal ideation emerged as strong risk factors (with effect sizes ranging from 6 to 16). Psychiatric disorders were associated with a greatly elevated risk of suicide mortality, with risk ratios in the range of 4-13. Suicide risk for physical illnesses (such as cancer and epilepsy) and sociodemographic factors (including unemployment and low education) were typically increased two-fold. Contact with the criminal justice system, state care in childhood, access to firearms, and parental death by suicide also increased the risk of suicide mortality. Among risk factors for which sex-stratified analyses were available, associations were generally similar for males and females. However, the quality of the evidence was limited by excess significance and high heterogeneity, and prediction intervals suggested poor replicability for almost two-thirds of identified risk factors. INTERPRETATION A wide range of risk factors were identified across various domains, which underscores suicide mortality as a multifactorial phenomenon. Prevention strategies that span individual and population approaches should account for the identified factors and their relative strengths. Despite the large number of risk factors investigated, few associations were supported by robust evidence. Evidence of causal inference will need to be tested in high-quality study designs. FUNDING Wellcome Trust.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK.
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Sarigül A, Kaya A, Aziz IA, Yıldırım M, Özok HI, Chirico F, Zaffina S. General work stress and suicide cognitions in health-care workers: mediating effect of hopelessness and job satisfaction. Front Public Health 2023; 11:1254331. [PMID: 37942250 PMCID: PMC10629234 DOI: 10.3389/fpubh.2023.1254331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/02/2023] [Indexed: 11/10/2023] Open
Abstract
Individuals with a satisfactory level of job satisfaction are much less likely to feel hopeless about their future and are more likely to perform efficiently in the workplace. General work stress (i.e., the work-related stress subjectively experienced) is a significant predictor of suicide cognitions. Furthermore, it has been posited that satisfaction and hope are fundamental to life from an existential perspective. We, therefore, tested a hypothetical model of general work stress, suicide cognitions, hopelessness, and job satisfaction. The data were collected from 416 health-care workers through a convenience sampling method. The mediation analysis results revealed significant negative and positive relationships among general work stress, suicide conceptions, hopelessness, and job satisfaction. The findings indicate that hopelessness and job satisfaction have a parallel mediating effect in the relationship between general work stress and suicide cognitions. The result of the study is of great importance, which suggests that interventions to alleviate hopelessness and work stress and to boost the job satisfaction of medical staff may help prevent suicide cognitions.
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Affiliation(s)
- Abdulselami Sarigül
- Department of Therapy and Rehabilitation, Ağrı İbrahim Çeçen University, Ağrı, Türkiye
| | - Alican Kaya
- Department of Guidance and Psychological Counselling, Ağrı İbrahim Çeçen University, Ağrı, Türkiye
| | - Izaddin Ahmad Aziz
- Special Education Department, College of Education, Salahaddin University, Erbil, Iraq
- Department of English, College of Education, Bayan University, Erbil, Iraq
| | - Murat Yıldırım
- Faculty of Science and Letters, Department of Psychology, Ağrı İbrahim Çeçen University, Ağrı, Türkiye
- Graduate Studies and Research, Lebanese American University, Beyrut, Lebanon
| | - Halil Ibrahim Özok
- Department of Measurement and Assessment, Van Yüzüncü Yıl University, Van, Türkiye
| | - Francesco Chirico
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy
| | - Salvatore Zaffina
- Occupational Medicine/Health Technology Assessment and Safety Research Unit, Clinical-Technological Innovations Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Rugulies R, Aust B, Greiner BA, Arensman E, Kawakami N, LaMontagne AD, Madsen IEH. Work-related causes of mental health conditions and interventions for their improvement in workplaces. Lancet 2023; 402:1368-1381. [PMID: 37838442 DOI: 10.1016/s0140-6736(23)00869-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 02/11/2023] [Accepted: 04/27/2023] [Indexed: 10/16/2023]
Abstract
Mental health problems and disorders are common among working people and are costly for the affected individuals, employers, and whole of society. This discussion paper provides an overview of the current state of knowledge on the relationship between work and mental health to inform research, policy, and practice. We synthesise available evidence, examining both the role of working conditions in the development of mental disorders, and what can be done to protect and promote mental health in the workplace. We show that exposure to some working conditions is associated with an increased risk of the onset of depressive disorders, the most studied mental disorders. The causality of the association, however, is still debated. Causal inference should be supported by more research with stronger linkage to theory, better exposure assessment, better understanding of biopsychosocial mechanisms, use of innovative analytical methods, a life-course perspective, and better understanding of the role of context, including the role of societal structures in the development of mental disorders. There is growing evidence for the effectiveness of interventions to protect and promote mental health and wellbeing in the workplace; however, there is a disproportionate focus on interventions directed towards individual workers and illnesses, compared with interventions for improving working conditions and enhancing mental health. Moreover, research on work and mental health is mainly done in high-income countries, and often does not address workers in lower socioeconomic positions. Flexible and innovative approaches tailored to local conditions are needed in implementation research on workplace mental health to complement experimental studies. Improvements in translating workplace mental health research to policy and practice, such as through workplace-oriented concrete guidance for interventions, and by national policies and programmes focusing on the people most in need, could capitalise on the growing interest in workplace mental health, possibly yielding important mental health gains in working populations.
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Affiliation(s)
- Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland; National Suicide Research Foundation, University College Cork, Cork, Ireland; Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Junpukai Foundation, Okayama, Japan
| | - Anthony D LaMontagne
- School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Tyler S, Hunkin H, Pusey K, Gunn K, Clifford B, Procter N. Suicide in the Construction Industry: A Targeted Meta-analysis. Arch Suicide Res 2023; 27:1134-1146. [PMID: 36229995 DOI: 10.1080/13811118.2022.2131488] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE With research suggesting an increased risk of suicide for those employed in the construction industry the present review aimed to provide an updated, targeted, and rigorous estimate of the relative risk of suicide for this population. METHOD Comprehensive searches of Medline, Psycinfo, Embase, Emcare, Web of Science, and Scopus databases, as well as grey literature and reference lists, were undertaken to identify studies which reported the rate or risk of construction industry workers' suicide. Only samples that did not incorporate other industries and utilized reference groups deemed representative of the general or employed populations, were included. RESULTS Eleven studies were included in the review. Primary analysis was undertaken on seven studies deemed to have wholly samples wholly representative of the construction industry. Despite a high level of heterogeneity (I2 = 98%), results suggest increased risk of construction worker suicide compared to the wider population. Random effect meta-analysis indicated a pooled relative suicide risk = 1.25 (95% CI 1.03-1.52), reported. A sensitivity analysis using less stringent inclusion criteria, demonstrated the robustness of these findings. CONCLUSION Despite limitations, this paper suggests that construction industry employees may have an elevated risk of suicide. Additionally, this review highlights the need for further research, using standardized methodologies, to generate more robust understandings. Future research will benefit by accounting for locale-specific cultural and socio-political factors and attempting to quantify more specific drivers of suicide risk for this population.
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Kabir H, Chowdhury SR, Roy AK, Chowdhury SA, Islam MN, Chomon RJ, Akter M, Hossain A. Association of workplace bullying and burnout with nurses' suicidal ideation in Bangladesh. Sci Rep 2023; 13:14641. [PMID: 37669987 PMCID: PMC10480219 DOI: 10.1038/s41598-023-41594-4] [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: 01/16/2023] [Accepted: 08/29/2023] [Indexed: 09/07/2023] Open
Abstract
Suicidal ideation is a complex phenomenon influenced by several predisposing, contextual, and mediating factors that seem more common among healthcare workers, especially nurses. We investigated the association of bullying and burnout with suicidal ideation among Bangladeshi nurses and identified the associated factors. We conducted a cross-sectional study among 1264 nurses in Bangladesh between February 2021 and July 2021. We applied a modified Poisson regression model with robust error variance to determine the association of bullying and burnout with suicidal ideation. Among 1264 nurses, the female was 882 (70.02%), and the mean age was 28.41 (SD = 5.54) years. The prevalence of high levels of suicidal ideation was 13.26%. In the Poison regression model, high risk bullying (RR = 6.22, 95% CI 3.13-12.38), targeted to bullying (RR = 7.61, 95% CI 3.53-16.38), and burnout (RR = 8.95, 95% CI 2.84-28.20) were found to be significantly associated with suicidal ideation. Furthermore, we found significant interaction between workplace bullying and burnout with suicidal ideation (p < 0.05). The high prevalence of bullying, burnout, suicidal ideation, and their association indicate an unsafe workplace for the nurses. Initiatives are needed to make a favorable work environment to improve nurses' overall mental health and reduce suicide ideation.
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Affiliation(s)
- Humayun Kabir
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh.
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
| | - Saifur Rahman Chowdhury
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh.
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
| | - Anjan Kumar Roy
- Department of Nursing and Health Science, Jashore University of Science and Technology, Jashore, 7408, Bangladesh
| | - Samiul Amin Chowdhury
- Department of Public Health, Leading University, Sylhet, 3112, Bangladesh
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada
| | - Md Nazrul Islam
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada
| | - Rifat Jahan Chomon
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Masuda Akter
- Faculty of Medicine, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Ahmed Hossain
- Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Global Health Institute, North South University, Dhaka, 1229, Bangladesh
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Watterson TL, Steege LM, Mott DA, Ford JH, Portillo EC, Chui MA. Sociotechnical Work System Approach to Occupational Fatigue. Jt Comm J Qual Patient Saf 2023; 49:485-493. [PMID: 37407330 PMCID: PMC10530575 DOI: 10.1016/j.jcjq.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION TO THE PROBLEM Occupational fatigue is a characteristic of excessive workload and depicts the limited capacity to complete demands. The impact of occupational fatigue has been studied outside of health care in fields such as transportation and heavy industry. Research in health care professionals such as physicians, medical residents, and nurses has demonstrated the potential for occupational fatigue to affect patient, employee, and organizational outcomes. A conceptual framework of occupational fatigue that is informed by a sociotechnical systems approach is needed to (1) describe the multidimensional facets of occupational fatigue, (2) explore individual and work system factors that may affect occupational fatigue, and (3) anticipate downstream implications of occupational fatigue on employee well-being, patient safety, and organizational outcomes. CONCEPTUAL FRAMEWORK OF OCCUPATIONAL FATIGUE The health care professional occupational fatigue conceptual framework is outlined following the Systems Engineering Initiative for Patient Safety (SEIPS) model and adapted from the Conceptual Model of Occupational Fatigue in Nursing. Future research may apply this conceptual framework to health care professionals as a tool to describe occupational fatigue, identify the causes, and generate solutions. Interventions to mitigate and resolve occupational fatigue must address the entire sociotechnical system, not just individual or employee changes.
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Descatha A, Fadel M. Mental health of people in the agricultural sector: insights from massive database in occupational health. THE LANCET REGIONAL HEALTH. EUROPE 2023; 31:100691. [PMID: 37502108 PMCID: PMC10368898 DOI: 10.1016/j.lanepe.2023.100691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Alexis Descatha
- University Angers, CHU Angers, University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Angers, France
- Department of Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, USA
| | - Marc Fadel
- University Angers, CHU Angers, University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Angers, France
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Tyler S, Gunn K, Clifford B, Procter N. "And you feel like you're suffocating … how the fuck am I going to get out of all this?" Drivers and experiences of suicidal ideation in the Australian construction industry. Front Psychiatry 2023; 14:1144314. [PMID: 37252151 PMCID: PMC10213289 DOI: 10.3389/fpsyt.2023.1144314] [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] [Received: 01/14/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction This research was designed to generate understandings of drivers and experiences of suicidal ideation and distress among Australian Construction Industry (ACI) workers, as well as what helped during these experiences. Methods Fifteen participants, from a variety of ACI or closely associated roles, with an average age of 45 years (29-66), engaged in individual, semi-structured interviews. Interviews were audio-recorded with consent and analyzed using descriptive thematic analysis. Results Eight themes relating to what may drive the presence of suicidal ideation and distress were identified; 1) challenges of working within the ACI, 2) relationship and family issues, 3) social disconnection, 4) personal financial hardship, 5) perceived lack of support, 6) alcohol and drug use, 7) child custody/access and legal issues, and 8) experience of mental health challenges, trauma, or a significant adverse life event. Four themes relating to experience and expression of suicidal ideation and distress were identified: 1) suicidal thoughts, 2) impaired thinking, 3) observable expressions of suicidal distress, and 4) lack of observable expressions of suicidal distress. Six themes relating to what helped during experiences and well as what can be done by the ACI to help mitigate experiences, were identified: 1) presence of colleague and managerial support, 2) MATES in Construction, 3) engagement with non-work activities and social support, 4) personal skills and knowledge relating to suicide and mental health, 5) high level industry integration and engagement with support programs, and 6) work hours and expectations changes. Discussion Findings highlight several industry and personal related challenges that may drive experiences, with many potentially mitigatable by ACI changes and focused prevention strategies. Participant suicidal thought descriptions align with previously identified constructs deemed central in suicidal trajectories. While findings highlight several observable expressions of suicidal ideation and distress, challenges associated with identifying and assisting individuals in the ACI who may be struggling were also reported. Several factors that helped ACI workers during their experiences, as well as what the ACI can do to mitigate future experiences, were identified. Recommendations are made based on these findings, encouraging a more supportive work environment, as well as continued development and increased awareness of support and education systems.
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Affiliation(s)
- Simon Tyler
- Mental Health and Suicide Prevention Research and Education Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Kate Gunn
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Bob Clifford
- MATES in Construction South Australia, Adelaide, SA, Australia
| | - Nicholas Procter
- Mental Health and Suicide Prevention Research and Education Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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Zimmermann C, Strohmaier S, Niederkrotenthaler T, Thau K, Schernhammer E. Suicide mortality among physicians, dentists, veterinarians, and pharmacists as well as other high-skilled occupations in Austria from 1986 through 2020. Psychiatry Res 2023; 323:115170. [PMID: 37001488 DOI: 10.1016/j.psychres.2023.115170] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/02/2023] [Accepted: 03/14/2023] [Indexed: 04/17/2023]
Abstract
Some evidence puts health professionals at increased risk of suicide, especially females, whereas other research suggests a lower risk in high-skilled occupations. This study investigated the suicide risk of four health professions (physicians, dentists, veterinarians, pharmacists) and three other high-skilled occupations (notaries, lawyers, tax advisors/public accountants) in Austria compared to the general population, and analyzed suicide methods across occupations. Data was collected from professional associations and Austrian cause-of-death statistics to determine suicide cases. Gender-specific standardized mortality ratios (SMRs), crude and age-adjusted suicide rates and frequencies for suicide methods were calculated for each profession (maximum time span 1986-2020). Among males, only veterinarians had a significantly elevated suicide risk compared to the general population. Physicians and tax advisors/public accountants had a significantly lower suicide risk. Among females, the veterinarians, physicians, and pharmacists had a significantly elevated suicide risk; for dentists, it was also elevated, though non-significantly. Age-adjusted suicide rates showed a smaller gap between men and women in all professions compared to the general population. Poisoning was the predominant suicide method among health professions, except dentists. These findings are consistent with some of the prior literature and call for specific suicide prevention efforts in health professions, focusing on women.
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Affiliation(s)
- Claudia Zimmermann
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Kenneth Thau
- Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, United States of America
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Reid M, Laing J, Tumpney M, Cunningham K, Chaneco A, Batista M, Sparer-Fine E. Suicides in Massachusetts by Industry and Occupation, 2016-2019. J Occup Environ Med 2023; 65:413-418. [PMID: 36728002 PMCID: PMC10175088 DOI: 10.1097/jom.0000000000002798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine suicide deaths among working-age residents in Massachusetts and to determine industries and occupations with high numbers and rates of suicides. METHODS The Massachusetts Violent Death Reporting System and Massachusetts death certificates were used to analyze suicide deaths from 2016 to 2019. Counts and rates were generated by demographics and industry and occupation groupings. RESULTS There were 2199 working-age Massachusetts residents who died by suicide. Higher suicide rates were associated with being male, 65 years or older, White, and non-Hispanic or having military background. Suicide rates were higher among the construction industry sector and the construction and extraction occupational group compared with the average rate for all Massachusetts workers. CONCLUSIONS Suicide rates differed between industries and occupations, suggesting that work-related factors may play a role and should be considered when planning outreach initiatives and interventions.
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Affiliation(s)
- Michelle Reid
- Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, MA
| | - James Laing
- Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, MA
| | - Matthew Tumpney
- Injury Surveillance Program, Massachusetts Department of Public Health, Boston, MA
| | - Kelley Cunningham
- Suicide Prevention Program, Massachusetts Department of Public Health, Boston, MA
| | - Aynsley Chaneco
- Suicide Prevention Program, Massachusetts Department of Public Health, Boston, MA
- Injury Prevention and Control Program, Massachusetts Department of Public Health, Boston, MA
| | - Mariel Batista
- Suicide Prevention Program, Massachusetts Department of Public Health, Boston, MA
| | - Emily Sparer-Fine
- Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, MA
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Madigan A, Daly M. Socioeconomic status and depressive symptoms and suicidality: The role of subjective social status. J Affect Disord 2023; 326:36-43. [PMID: 36709827 DOI: 10.1016/j.jad.2023.01.078] [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] [Received: 08/16/2022] [Revised: 01/11/2023] [Accepted: 01/21/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Low socioeconomic status (SES) confers access to material resources and social standing and is an established risk factor of both depressive symptoms and suicidality. Subjective social status (SSS) assesses how people perceive their position within the social hierarchy and has been proposed to impact mental health. This study examined the relationship between SES and depressive symptoms and suicidality and tested whether SSS mediated these associations. METHODS This study drew on publicly available survey data from the US National Longitudinal Study of Adolescent to Adult Health (Add Health). Participants were surveyed at baseline in 2008 (N = 4948; aged 28.8 years) and at followed up in 2016-2018 (N = 3509; aged 37.8 years). SES was gauged using personal and household income, assets, education, and job prestige. SSS was assessed using the MacArthur Scale. Depressive symptoms were assessed using four-items from the Centre for Epidemiological Studies Scale of Depression (CESD) and participants reported suicidal ideation and suicide attempts in the past year. RESULTS Both low SES and SSS were associated with elevated levels of depressive symptoms, suicidal ideation, and suicide attempts in cross-sectional and prospective analyses. SSS explained 27 % of the association between SES and depressive symptoms, 51 % of the relationship between SES and suicidal ideation, and 37 % of the link between SES and suicide attempts on average. CONCLUSIONS These findings contribute to understanding the long-term effects of SSS and suggest that perceptions of status may be a key mechanism through which low SES forecasts the development of depressive symptoms and suicidality.
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Affiliation(s)
- Anna Madigan
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Michael Daly
- Department of Psychology, Maynooth University, Co. Kildare, Ireland.
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Burnett ACR, Wong Q, Zeritis S, Deady M, Torok M. Occupational class suicide risk: 12-year study of national coronial data. Br J Psychiatry 2023; 222:234-240. [PMID: 36927474 DOI: 10.1192/bjp.2023.22] [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: 03/18/2023]
Abstract
BACKGROUND Previous research showed that the Global Financial Crisis (GFC) was associated with a widening disparity in suicide rates between lower-class occupations and the highest-class occupations in Australia. There has been no research investigating whether this trend continued post-GFC. AIMS This study aimed to investigate suicide rates by occupational class among employed Australians aged 15 years and over, between 2007 and 2018. METHOD A population-level retrospective mortality study was conducted using data from the National Coronial Information System. Adjusted suicide rates were calculated over the period 2007 to 2018. Negative binomial regression models were used to assess the relationship between occupational class, gender and time, comparing post-GFC years (2010-2012, 2013-2015 and 2016-2018) with GFC years (2007-2009). RESULTS Relative to the GFC period of 2007-2009, a significant reduction in suicide disparity between managers and other occupation groups was only observed among male labourers (rate ratios (RR) = 0.65, 95% CI 0.49-0.86) and male technicians/trades workers (RR = 0.73, 95% CI 0.56-0.96) for the period 2013-2015. CONCLUSION Skilled manual and lower-skilled occupational classes remain at elevated risk of suicide in Australia. While a decreasing divergence in suicide rates was only observed between labourer and manager occupational classes post-GFC, this trend was not maintained over the later part of the study period (2016-2018). There is a need to further understand the relationship between contextual factors associated with suicide among the employed population, especially during periods of economic downturn.
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Affiliation(s)
| | - Quincy Wong
- Western Sydney University, Sydney, Australia
| | | | - Mark Deady
- University of NSW, Black Dog Institute, Sydney, Australia
| | - Michelle Torok
- University of NSW, Black Dog Institute, Sydney, Australia
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Padilla KE. A Descriptive Study of Police Officer Access to Mental Health Services. JOURNAL OF POLICE AND CRIMINAL PSYCHOLOGY 2023; 38:1-7. [PMID: 37359945 PMCID: PMC10015532 DOI: 10.1007/s11896-023-09582-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 06/28/2023]
Abstract
The culture of policing is thought to emphasize maladaptive methods of coping with stress, such as the use of alcohol, rather than seeking out mental health services. The current paper seeks to better understand police officers' knowledge about mental health services offered by their department and their willingness to engage in and utilize such services. Pen and paper surveys were administered at daily briefings with 134 members of a Southwestern police department. This descriptive study indicates that while only 34% of officers were explicitly aware that their department provided services to alleviate stress or mental health issues, and 38% of officers were unsure of exactly what those services were, over 60% of officers were willing to participate in an annual mental health checkup or mental health class. Ultimately, officers may now be more willing to participate in and take advantage of mental health and wellness opportunities, but the knowledge of what those services are often acts as one barrier, among others, to accessing those services. Knowledge dissemination of mental health and wellness opportunities represents one way to engage more officers in preventative health options.
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Affiliation(s)
- Kathleen E. Padilla
- School of Criminal Justice & Criminology, Texas State University, San Marcos, TX USA
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Campos AI, Garcia-Marin LM, Christensen H, Batterham PJ, van Velzen LS, Schmaal L, Rabinowitz JA, Jahanshad N, Martin NG, Cuellar-Partida G, Ruderfer D, Mullins N, Rentería ME. Genomics-driven screening for causal determinants of suicide attempt. Aust N Z J Psychiatry 2023; 57:423-431. [PMID: 35403454 DOI: 10.1177/00048674221091499] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Each year, around one million people die by suicide. Despite its recognition as a public health concern, large-scale research on causal determinants of suicide attempt risk is scarce. Here, we leverage results from a recent genome-wide association study (GWAS) of suicide attempt to perform a data-driven screening of traits causally associated with suicide attempt. METHODS We performed a hypothesis-generating phenome-wide screening of causal relationships between suicide attempt risk and 1520 traits, which have been systematically aggregated on the Complex-Traits Genomics Virtual Lab platform. We employed the latent causal variable (LCV) method, which uses results from GWAS to assess whether a causal relationship can explain a genetic correlation between two traits. If a trait causally influences another one, the genetic variants that increase risk for the causal trait will also increase the risk for the outcome inducing a genetic correlation. Nonetheless, a genetic correlation can also be observed when traits share common pathways. The LCV method can assess whether the pattern of genetic effects for two genetically correlated traits support a causal association rather than a shared aetiology. RESULTS Our approach identified 62 traits that increased risk for suicide attempt. Risk factors identified can be broadly classified into (1) physical health disorders, including oesophagitis, fibromyalgia, hernia and cancer; (2) mental health-related traits, such as depression, substance use disorders and anxiety; and (3) lifestyle traits including being involved in combat or exposure to a war zone, and specific job categories such as being a truck driver or machine operator. CONCLUSIONS Suicide attempt risk is likely explained by a combination of behavioural phenotypes and risk for both physical and psychiatric disorders. Our results also suggest that substance use behaviours and pain-related conditions are associated with an increased suicide attempt risk, elucidating important causal mechanisms that underpin this significant public health problem.
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Affiliation(s)
- Adrian I Campos
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Luis M Garcia-Marin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Laura S van Velzen
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina Del Rey, CA, USA
| | - Nicholas G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gabriel Cuellar-Partida
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Douglas Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Miguel E Rentería
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
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King T, Maheen H, Taouk Y, LaMontagne A. Suicide in the Australian mining industry: assessment of rates among male workers using 19 years of Coronial data. Saf Health Work 2023. [DOI: 10.1016/j.shaw.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
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King TL, Fleitas Alfonzo L, Batterham P, Mackinnon A, Lockwood C, Harvey S, Kelly B, Lingard H, Cox L, LaMontagne TD. A blended face-to-face and smartphone intervention to improve suicide prevention literacy and help-seeking intentions among construction workers: a randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02429-9. [PMID: 36757436 PMCID: PMC9909155 DOI: 10.1007/s00127-023-02429-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 01/12/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE In Australia and elsewhere, suicide rates among construction workers remain high. Construction workplaces are thus an important setting for targeted suicide prevention programs. This study aimed to compare suicide prevention literacy and help-seeking intentions among participants receiving face-to-face suicide prevention training, with those receiving face-to-face training augmented by a smartphone application. METHODS A two-arm randomised controlled trial of a smartphone suicide prevention intervention was conducted among construction workers in four Australian states (trial registration number: ACTRN12619000625178). All participants received face-to-face training and were randomised to the control condition (face-to-face only, n = 575), or MATESmobile condition (face-to-face + smartphone application, n = 509). Surveys administered at baseline and 3-month follow-up measured suicide prevention literacy and help-seeking intentions for personal/emotional problems and suicidal thoughts. A mixed-model repeated measures (MMRM) analysis included all 1084 randomised participants. RESULTS Outcomes did not differ significantly for suicide prevention literacy, nor help-seeking intentions from formal sources, informal sources outside the workplace, or no one (did not intend to seek help from anyone). However, relative to those in the control condition, those in the MATESmobile group showed greater increase in help-seeking intentions for emotional problems from a MATES worker/Connector (mean difference 0.54, 95% CI 0.22-0.87) and help-seeking intentions for suicidal thoughts from a workmate (mean difference 0.47, 95% CI 0.10-0.83) or MATES worker/Connector (mean difference 0.47, 95% CI 0.09-0.85). CONCLUSION Results indicate that the MATESmobile application, together with face-to-face training, is beneficial in enhancing help-seeking intentions from MATES workers/Connectors and workmates to a greater extent than face-to-face training only. While this research provides some evidence that smartphone applications may support suicide prevention training, further research is needed.
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Affiliation(s)
- Tania L. King
- grid.1008.90000 0001 2179 088XCentre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010 Australia
| | - Ludmila Fleitas Alfonzo
- grid.1008.90000 0001 2179 088XCentre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010 Australia
| | - Philip Batterham
- grid.1001.00000 0001 2180 7477Australian National University, Canberra, Australia
| | - Andrew Mackinnon
- grid.1008.90000 0001 2179 088XCentre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010 Australia ,grid.1005.40000 0004 4902 0432University of New South Wales, Sydney, Australia
| | | | - Samuel Harvey
- grid.1005.40000 0004 4902 0432University of New South Wales, Sydney, Australia
| | - Brian Kelly
- grid.266842.c0000 0000 8831 109XUniversity of Newcastle, Newcastle, Australia
| | - Helen Lingard
- grid.1017.70000 0001 2163 3550RMIT University, Melbourne, Australia
| | - Laura Cox
- MATES in Construction, Spring Hill, Australia
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Kirakosian N, Stanton AM, McKetchnie SM, King D, Dolotina B, O'Cleirigh C, Grasso C, Potter J, Mayer KH, Batchelder AW. Suicidal Ideation Disparities Among Transgender and Gender Diverse Compared to Cisgender Community Health Patients. J Gen Intern Med 2023; 38:1357-1365. [PMID: 36650322 PMCID: PMC9844943 DOI: 10.1007/s11606-022-07996-2] [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: 04/13/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Transgender and gender diverse (TGD) individuals experience more severe psychological distress and may be at higher risk for suicide compared to cisgender individuals. The existing literature largely consists of small-sample studies that do not assess subgroup differences. OBJECTIVE To examine rates of self-reported suicidal ideation among four TGD groups compared to cisgender individuals. DESIGN Data were extracted from the electronic health records of patients receiving primary care at a community health center specializing in sexual and gender minority health. A logistic regression was used to examine the relationship between sociodemographic variables and the presence of current suicidal ideation. PARTICIPANTS 29,988 patients receiving care at a community health center in Northeastern US between 2015 and 2018. MAIN MEASURES Demographic questionnaire, 9-item Patient Health Questionnaire KEY RESULTS: Younger age, sexual and gender minority identity, and public/grants-based insurance were associated with significantly higher odds of suicidal ideation. Relative to cisgender men, transgender men (OR=2.08; 95% CI=1.29-3.36; p=.003), transgender women (OR=3.08; 95% CI=2.05-4.63; p<.001), nonbinary (NB) individuals assigned male at birth (AMAB; OR=3.55; 95% CI=1.86-6.77; p<001), and NB individuals assigned female at birth (AFAB; OR=2.49; 95% CI=1.52-4.07; p<001) all endorsed significantly higher odds of current suicidal ideation, controlling for age, race, ethnicity, sexual orientation, and insurance status. Larger proportions of transgender women (23.6%) and NB AMAB individuals (26.7%) reported suicidal ideation not only compared to cisgender men (6.1%) and women (6.6%), but also compared to transgender men (17.4%; χ2[5, n=25,959]=906.454, p<0.001). CONCLUSIONS TGD patients were at significantly increased risk of suicidal ideation, even after accounting for age, race, ethnicity, sexual orientation, and insurance status. Findings suggest distinct risk profiles by assigned sex at birth. Consistent assessment of and intervention for suicidal ideation should be prioritized in settings that serve TGD patients.
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Affiliation(s)
- Norik Kirakosian
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Amelia M Stanton
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Samantha M McKetchnie
- School of Social Work, Boston College, Newton, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Dana King
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Brett Dolotina
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Conall O'Cleirigh
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Jennifer Potter
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Abigail W Batchelder
- The Fenway Institute, Fenway Health, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Evaluation of a workplace suicide prevention program in the Australian manufacturing industry: protocol for a cluster-randomised trial of MATES in manufacturing. BMC Psychiatry 2022; 22:799. [PMID: 36536388 PMCID: PMC9761021 DOI: 10.1186/s12888-022-04464-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Males are at higher risk of death by suicide than females in Australia, and among men, blue-collar males are at higher risk compared to other working males. In response, MATES in Construction developed a workplace suicide prevention program for the construction sector in 2007 that has been widely implemented in Australia. In the current project, this program is being adapted and trialled in the manufacturing sector. The common aims of MATES programs are to improve suicide prevention literacy, help-seeking intentions, and helping behaviours. The program will be evaluated using a cluster randomised-controlled trial design with waitlist controls across up to 12 manufacturing worksites in Australia. We hypothesise that after 8 months of the MATES in Manufacturing program, there will be significantly greater improvements in help-seeking intentions (primary outcome) compared to waitlist controls. The project is led by Deakin University in collaboration with the University of Melbourne, and in partnership with MATES in Construction and a joint labour-management Steering Group.Trial registration: The trial was registered retrospectively with the Australian New Zealand Clinical Trials Registry on 25 January 2022 (ACTRN12622000122752).Protocol version: 2.0, November 2022.
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Balestrieri M, Rucci P, Murri MB, Caruso R, D'Agostino A, Ferrari S, Nanni MG, Palagini L, Pini S, Politi P, Rocchetti M, Zerbinati L, Grassi L. Suicide risk in medically ill inpatients referred to consultation-liaison psychiatric services: A multicenter study. J Affect Disord 2022; 319:329-335. [PMID: 36057291 DOI: 10.1016/j.jad.2022.08.113] [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] [Received: 01/24/2022] [Revised: 05/23/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this multicenter study was to investigate the suicide risk in medically ill patients admitted to six Italian hospitals for whom a consultation-liaison intervention was requested. METHODS Participants completed socio-demographic and clinical report forms and the Brief Illness Perception Questionnaire. Suicidality was assessed using the P4 screener that investigates the presence of Past suicide attempts, Plans to commit a suicide, Probability of completing suicide, and Preventive factors. Participants were categorized as being at no, low or high suicide risk. Univariate and multivariable associations of categorical and continuous variables with suicide risk were investigated using multinomial logistic regression. RESULTS Of the 641 inpatients, with mean age 60 years (SD = 16.9) and 49.2 % male, 13.2 % were at high suicidal risk (HR), 7.6 % low risk (LR) and 79.2 % no risk. Contacts with psychiatrists in the previous six months were associated with LR and HR (OR = 2.159 and 2.634, respectively), ongoing benzodiazepine use was associated with a threefold likelihood of LR (OR = 3.005), and the experienced intensity of illness symptoms was associated with LR and HR (OR = 1.257 and OR = 1.248, respectively). CL psychiatrists prescribed appropriate psychotropic drugs and activated liaison interventions and psychological support for the level of suicidal risk. LIMITATIONS The use of self-report measures bears the risk of recall bias. CONCLUSIONS Our findings based on psychiatric consultations in the general hospital underscore the need to include suicide risk in the routine assessment of inpatients referred to CL psychiatric services and to plan an appropriate management of suicidal risk after discharge.
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Affiliation(s)
- Matteo Balestrieri
- Psychiatric Unit, Department of Medicine, University of Udine, Udine, Italy.
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
| | - Armando D'Agostino
- Department of Health Sciences, University of Milan, Italy; Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy.
| | - Silvia Ferrari
- Department of Diagnostic-Clinical Medicine and Public Health, Section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
| | - Laura Palagini
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy.
| | - Pierluigi Politi
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy.
| | - Matteo Rocchetti
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy.
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
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Gunn KM, Skaczkowski G, Dollman J, Vincent AD, Brumby S, Short CE, Turnbull D. A Self-Help Online Intervention Is Associated With Reduced Distress and Improved Mental Wellbeing in Australian Farmers: The Evaluation and Key Mechanisms of www.ifarmwell.com.au. J Agromedicine 2022; 28:378-392. [DOI: 10.1080/1059924x.2022.2156642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kate M. Gunn
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, ADELAIDE, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, ADELAIDE, Australia
| | - Gemma Skaczkowski
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, ADELAIDE, Australia
| | - James Dollman
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, ADELAIDE, Australia
| | - Andrew D. Vincent
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, ADELAIDE, Australia
| | - Susan Brumby
- National Centre for Farmer Health, Western District Health Service, Hamilton, Australia
- School of Medicine, Deakin University, Waurn Ponds, Australia
| | - Camille E. Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, University of Melbourne, Parkville, Australia
| | - Deborah Turnbull
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, ADELAIDE, Australia
- School of Psychology, The University of Adelaide, Adelaide, Australia
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Vélez JC, Kovasala M, Collado MD, Friedman LE, Juvinao-Quintero DL, Araya L, Castillo J, Williams MA, Gelaye B. Pain, mood, and suicidal behavior among injured working adults in Chile. BMC Psychiatry 2022; 22:766. [PMID: 36471330 PMCID: PMC9724445 DOI: 10.1186/s12888-022-04391-3] [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] [Received: 06/27/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Chronic pain is comorbid with psychiatric disorders, but information on the association of chronic pain with depressive symptoms, generalized anxiety, and suicidal behavior among occupational cohorts is inadequate. We investigated these associations among employed Chilean adults. METHODS A total of 1946 working adults were interviewed during their outpatient visit. Pain was assessed using the Short Form McGill Pain questionnaire (SF-MPG) while depression and generalized anxiety were examined using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. The Columbia-Suicide Severity Rating Scale was used to assess suicidal behavior and suicidal ideation. Multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95%CI) for the association of chronic pain with mood disorders, as well as suicidal behavior. RESULTS High chronic pain (SF-MPG > 11) was reported by 46% of participants. Approximately two-fifths of the study participants (38.2%) had depression, 23.8% generalized anxiety, 13.4% suicidal ideation, and 2.4% suicidal behavior. Compared to those with low pain (SF-MPG ≤11), participants with high chronic pain (SF-MPG > 11) had increased odds of experiencing depression only (aOR = 2.87; 95% CI: 2.21-3.73), generalized anxiety only (aOR = 2.38; 95% CI: 1.42-3.99), and comorbid depression and generalized anxiety (aOR = 6.91; 95% CI: 5.20-9.19). The corresponding aOR (95%CI) for suicidal ideation and suicidal behavior were (aOR = 2.20; 95% CI: 1.58-3.07) and (aOR = 2.18 = 95% CI: 0.99-4.79), respectively. CONCLUSIONS Chronic pain is associated with increased odds of depression, generalized anxiety, and suicidal behavior. Mental health support and appropriate management of patients experiencing chronic pain are critical.
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Affiliation(s)
- Juan Carlos Vélez
- grid.414619.f0000 0004 0628 8121Departamento de Rehabilitación, Hospital del Trabajador, Santiago, Chile
| | - Michael Kovasala
- grid.38142.3c000000041936754XMultidisciplinary International Research Training (MIRT) Program, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Michele Demi Collado
- grid.38142.3c000000041936754XMultidisciplinary International Research Training (MIRT) Program, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Lauren E. Friedman
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave Room 505F, Boston, MA 02115 USA
| | - Diana L. Juvinao-Quintero
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave Room 505F, Boston, MA 02115 USA
| | - Lisette Araya
- grid.414619.f0000 0004 0628 8121Servicio de Psiquiatría y Psicología, Hospital del Trabajador, Santiago, Chile
| | - Jessica Castillo
- grid.414619.f0000 0004 0628 8121Servicio de Psiquiatría y Psicología, Hospital del Trabajador, Santiago, Chile
| | - Michelle A. Williams
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave Room 505F, Boston, MA 02115 USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave Room 505F, Boston, MA, 02115, USA. .,The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA. .,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Phalp L, Corcoran R, Eames C, Naik A. An exploration of the relationship between adverse events on the farm and suicidal ideation in farmers. Int J Soc Psychiatry 2022; 68:1682-1688. [PMID: 34791918 DOI: 10.1177/00207640211057712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The risk of suicide for agricultural workers in parts of the United Kingdom (UK) is almost twice the national average. Existing literature has suggested that adverse farming events, where failure is determined by uncontrollable and unpredictable forces, may be to blame. Yet, the impact of such events on farmer suicidality has not been explicitly explored. AIMS The present paper therefore aimed to investigate the relationship between adverse farming events and suicidal ideation in farmers. METHODS A cross-sectional questionnaire battery was disseminated between July 2018 and February 2019, and completed by 170 adult farmers. RESULTS Over a 12-month period, 88.8% reported that they had experienced an adverse farming event and 32.9% said that they had experienced suicidal thoughts. Correlational analysis revealed a relationship between these variables. CONCLUSIONS The high prevalence of suicidal ideation within farmers demonstrates a critical need for intervention. Likewise, the prevalence of adverse farming events suggests that interventions need to be appropriately tailored, with greater understanding about the impact of such events on the mental wellbeing of farmers.
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Bazo-Alvarez JC, Bazalar-Palacios J, Bazalar J, Flores EC. Mental health among the sugarcane industry farmers and non-farmers in Peru: a cross-sectional study on occupational health. BMJ Open 2022; 12:e064396. [PMID: 36368754 PMCID: PMC9660661 DOI: 10.1136/bmjopen-2022-064396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Describe the occupational characteristics of farmer and non-farmer workers and investigate critical occupational risk factors for mental disorders in sugarcane farmers in Peru. METHOD We conducted a cross-sectional study with occupational health and safety focus among farmers and non-farmers. Mental disorder symptoms were evaluated through the local validated version of the 12-Item General Health Questionnaire (GHQ-12). We explored the association between mental disorder symptoms, work conditions and known occupational risk factors (weekly working hours, pesticide exposures, heat stress and heavy workload). Negative binomial regression models were fitted, and 95% CIs were calculated. RESULTS We assessed 281 workers between December 2019 and February 2020. One hundred and six (37.7%) respondents identified themselves as farmworkers. The mean GHQ-12 scores for farmers and non-farmers were 3.1 and 1.3, respectively. In the fully adjusted multivariable model, mental disorder symptom counts among farmers were more than twice as high as those of non-farmers (β: 2.11; 95% CI: 1.48 to 3.01). The heavy workload increased the mean number of mental disorder symptoms by 68% (95% CI: 21% to 133%), and each additional working hour per day increased the mean number of mental disorder symptoms by 13% (95% CI: 1% to 25%). CONCLUSION Farmers have higher mental disorder symptoms than non-farmers. A heavy workload and more working hours per day are independently associated with more mental disorder symptoms. Our findings highlight the importance of including mental health within occupational programmes and early interventions tailored to sugarcane industrial mill workers in the Latin American context.
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Affiliation(s)
- Juan Carlos Bazo-Alvarez
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo, Peru
- Research Department of Primary Care and Population Health, University College London (UCL), London, UK
| | - Janina Bazalar-Palacios
- Universidad Privada Norbert Wiener, Lima, Peru
- Peruvian Research Institute of Educational and Social Psychology PSYCOPERU, Lima, Peru
| | | | - Elaine C Flores
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Stanford Center for Innovation in Global Health, Stanford School of Medicine, Stanford, California, USA
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Nicholas A, Krysinska K, King KE. A rapid review to determine the suicide risk and risk factors of men who are survivors of sexual assault. Psychiatry Res 2022; 317:114847. [PMID: 36126347 DOI: 10.1016/j.psychres.2022.114847] [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] [Received: 04/04/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 01/04/2023]
Abstract
This rapid review assessed the suicide risk and risk factors of men who are survivors of sexual assault. We searched three academic databases (Cochrane, Medline and PsycINFO) for peer-reviewed articles in English published between 2010 and 2022. We rated the quality of the evidence based on the National Health and Medical Research Council Levels of Evidence. One systematic review and 16 papers featuring primary studies were included relating to suicide rates and risk. Findings suggest men who have been sexually assaulted (as a child or adult) are at increased risk of suicidal thoughts, attempts and behaviours compared with men who have not been sexually assaulted. Factors such as frequency of abuse and other concurrent forms of childhood abuse may further increase the risk of suicidal thoughts and behaviours. This evidence base was rated as good. The strength of this evidence supports a need for targeted suicide prevention in this high risk group.
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Affiliation(s)
- Angela Nicholas
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Kylie E King
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
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Bovio N, Grzebyk M, Arveux P, Bulliard JL, Chiolero A, Fournier E, Germann S, Konzelmann I, Maspoli M, Rapiti E, Guseva Canu I. Work-Related Factors and Lung Cancer Survival: A Population-Based Study in Switzerland (1990-2014). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13856. [PMID: 36360735 PMCID: PMC9657856 DOI: 10.3390/ijerph192113856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/09/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
While previous Swiss studies have demonstrated differences in lung cancer mortality between occupational groups, no estimates are available on the association of occupation-related factors with lung cancer survival. This study aimed at determining whether occupation or work-related factors after diagnosis affect lung cancer survival. We used cancer registry records to identify lung cancer patients diagnosed between 1990 and 2014 in western Switzerland (n = 5773) matched with the Swiss National Cohort. The effect of occupation, the skill level required for the occupation, and the socio-professional category on 5-year lung cancer survival was assessed using non-parametric and parametric methods, controlling for histological type and tumour stage. We found that the net survival varied across skill levels and that the lowest skill level was associated with worse survival in both men and women. In the parametric models with minimal adjustment, we identified several occupational groups at higher risk of mortality compared to the reference category, particularly among men. After adjustment for histological type of lung cancer and tumour stage at diagnosis, most hazard ratios remained higher than 1, though non-statistically significant. Compared to top managers and self-employed workers, workers in paid employment without specific information on occupation were identified as the most at-risk socio-professional category in nearly all models. As this study was conducted using a relatively small sample and limited set of covariates, further studies are required, taking into account smoking habits and administrated cancer treatments. Information on return to work and working conditions before and after lung cancer diagnosis will also be highly valuable for analysing their effect on net lung cancer survival in large nationwide or international studies. Such studies are essential for informing health and social protection systems, which should guarantee appropriate work conditions for cancer survivors, beneficial for their quality of life and survival.
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Affiliation(s)
- Nicolas Bovio
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland
| | - Michel Grzebyk
- Department of Occupational Epidemiology, National Research and Safety Institute (INRS), 54500 Vandoeuvre lès Nancy, France
| | - Patrick Arveux
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland
| | - Jean-Luc Bulliard
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland
- Neuchâtel and Jura Cancer Registry, 2000 Neuchâtel, Switzerland
| | - Arnaud Chiolero
- Population Health Laboratory, University of Fribourg, 1700 Fribourg, Switzerland
- Valais Cancer Registry, Valais Health Observatory, 1950 Sion, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- School of Population and Global Health, McGill University, Montréal, QC H3A 1G1, Canada
| | - Evelyne Fournier
- Geneva Cancer Registry, University of Geneva, 1211 Geneva, Switzerland
| | - Simon Germann
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland
| | | | - Manuela Maspoli
- Neuchâtel and Jura Cancer Registry, 2000 Neuchâtel, Switzerland
| | - Elisabetta Rapiti
- Geneva Cancer Registry, University of Geneva, 1211 Geneva, Switzerland
| | - Irina Guseva Canu
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland
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48
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Baker CN, Strong R, McCord C, Redwine T. Evaluating the Effects of Social Capital, Self-Stigma, and Social Identity in Predicting Behavioral Intentions of Agricultural Producers to Seek Mental Health Assistance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912110. [PMID: 36231410 PMCID: PMC9566455 DOI: 10.3390/ijerph191912110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 05/12/2023]
Abstract
Mental illness significantly impacts agricultural producers, whose occupation puts them at increased risk for compromised mental health and related disorders. Help-seeking intention, which can be mediated by variables such as social identity, social capital, and self-stigma, can lead to improved mental health outcomes. This cross-sectional study aimed to describe the intention of agricultural producers to seek mental health assistance and determine whether these three variables are associated with help-seeking intention. Researchers administered a cross-sectional survey of agricultural producers from two regions in 32 Texas counties. Researchers surveyed a sample of Texas agricultural producers (n = 429) to understand their social identity, social capital, and degree of self-stigma, and their intent to seek help for personal or emotional problems and for suicide ideation. Researchers identified a relationship between social identity and social capital, which indicated that social identity is moderately associated with greater levels of social capital. The multiple linear regression analyses confirmed that social capital and self-stigma are significant predictors of producers' help-seeking intention for both help-seeking types. These results signify the importance of efforts to increase social capital, increase mental health literacy and tailor training to address self-stigma and enhance positive help-seeking behavior among agricultural producers.
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Affiliation(s)
- Carrie N. Baker
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, 600 John Kimbrough Blvd, College Station, TX 77843, USA
- Correspondence: ; Tel.: +1-309-368-2279
| | - Robert Strong
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, 600 John Kimbrough Blvd, College Station, TX 77843, USA
| | - Carly McCord
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, 2900 E. 29th Street, Bryan, TX 77802, USA
- Department of Educational Psychology, Texas A&M University, Health Professions Education Building, 8447 Riverside Pkwy, Bryan, TX 77807, USA
| | - Tobin Redwine
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, 600 John Kimbrough Blvd, College Station, TX 77843, USA
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Barry R, Rehm J, de Oliveira C, Gozdyra P, Chen S, Kurdyak P. Rurality as a Risk Factor for Attempted Suicide and Death by Suicide in Ontario, Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:679-689. [PMID: 34792420 PMCID: PMC9449140 DOI: 10.1177/07067437211053300] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aims to examine rural and urban differences in attempted suicide and death by suicide in Ontario, Canada. METHOD This is a population-based nested case-control study. Data were obtained from administrative databases held at ICES, which capture all hospital and emergency department visits across Ontario between 2007 and 2017. All adults living in Ontario who attempted suicide or died by suicide are included in the study, and controls were matched by sex and age. Suicides were captured using vital statistics. Suicide attempts were determined using emergency department service codes. RESULTS Rurality is a risk factor for attempted suicide and death by suicide. Rural males are more likely to die by suicide compared with urban males (adjusted odds ratio(AOR) = 1.70, 95% confidence interval (CI), 1.49 to 1.95), and the odds of death by suicide increase with increasing levels of rurality. Rural males and females have an increased risk of attempted suicide compared with their urban counterparts (males: AOR = 1.37, 95% CI, 1.24 to 1.50) (females: AOR = 1.26, 95% CI, 1.14 to 1.39), with a pattern of increasing risk of suicide attempts with increasing rurality. Rural females are not at increased risk of suicide compared with urban females (AOR = 1.08, 95% CI, 0.80 to 1.45). Sensitivity analyses corroborated the results. CONCLUSIONS Rural males are almost two times more likely to die by suicide compared with urban males, and both rural males and females have an elevated risk of suicide attempts compared with urban residents. Future research should examine potential mediators of the relationship between rurality and suicide.
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Affiliation(s)
- Rebecca Barry
- University of Toronto, Toronto, Ontario
- Rebecca Barry, University of Toronto, 33
Russell Street, Toronto, ON, Canada M5S 2S1.
| | - Jürgen Rehm
- University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health,
Toronto, Ontario, Canada
- Dresden University of Technology,
Dresden, Germany
| | - Claire de Oliveira
- University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health,
Toronto, Ontario, Canada
- Centre for Health Economics and Hull York Medical School, University of York, York, United Kingdom
| | | | | | - Paul Kurdyak
- University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health,
Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
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50
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Jang J, Kim I. Mortality of Suicide and Cerebro-Cardiovascular Diseases by Occupation in Korea, 1997-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10001. [PMID: 36011632 PMCID: PMC9408394 DOI: 10.3390/ijerph191610001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Although studies on occupational mortality have been conducted in Korea, the results for occupations with high mortality around 2010 are inconsistent. This study aimed to examine occupational mortality from overwork-related suicide and cerebro-cardiovascular diseases (CCVD) from 1997 to 2020. We used microdata of the Causes of Death Statistics (CDS) and Economically Active Population Survey (EAPS) to obtain indirect standardized mortality ratio (SMR) and standardized proportional mortality ratio (PMR) of suicide (X60-X84) and CCVD deaths (I20-I25 and I60-I69) by gender and eight occupational categories. The trend of SMR of suicide and CCVD by occupation was similar within individual genders. The SMR of managers (MNG) was the highest for men and women in 2012-2017 and 2008-2020, respectively, whereas the SMR of professionals and related workers (PRF) was consistently low. Despite the similar socioeconomic status of MNG and PRF, we suggest that their mortality should be analyzed separately in Korea. SMR of suicide and CCVD in female MNG were consistently highest, although the PMR was low. Female MNG may have been more directly affected by the economic crisis. There is a need for work-related stress management, early intervention, and prevention policies in occupations vulnerable to mortality.
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Affiliation(s)
- Jungwon Jang
- Institute for Health and Society, Hanyang University, Seoul 04763, Korea
| | - Inah Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
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