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Karabatsos V, Mantas S, Lord L. Introduction and Impact of a Human Immunodeficiency Virus Education Package on the Knowledge and Confidence of Pharmacists. J Pharm Pract 2024; 37:814-821. [PMID: 37315554 DOI: 10.1177/08971900231182779] [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: 06/16/2023]
Abstract
Background: Without specific pharmaceutical knowledge in specialist areas such as Human Immunodeficiency Virus (HIV) management, pharmacists may lack the ability and confidence to provide optimal pharmaceutical care and optimization of outcomes. Objective: To develop a pharmacy-specific, foundational HIV education and assessment package, and assess impact on pharmacist knowledge and confidence. Methods: A foundational HIV education package with assessment was developed. Participants' baseline knowledge and self-reported confidence in HIV management were determined via an anonymous online questionnaire. Only participants who completed the pre-education questionnaire were then provided access to the self-paced, online education package. Participants completed a second questionnaire after completion of the package at a time of their choosing, within 2 months of the first questionnaire completion. Both questionnaires were similar in knowledge difficulty and addressed similar clinical domains. Mean differences in knowledge and confidence levels were analyzed, with further subgroup analyses of knowledge categories. Results: A total of 57 pharmacists completed both questionnaires. HIV knowledge was higher post-education compared with pre-education (mean correct score of 83.7% and 56.5% respectively, P < .001). The mean self-rated confidence of pharmacists in managing medications of people living with HIV, was higher post-education (73.3%) compared with pre-education (33.9%) (P < .001). Conclusion: The use of a pharmacy-specific, foundational HIV management education package significantly increased pharmacist knowledge in HIV management and improved self-reported confidence in the management of this specialty area. Future studies should assess the sustained impact of educational materials on pharmacist knowledge and confidence and investigate translation into improved outcomes for people living with HIV.
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Affiliation(s)
| | - Stav Mantas
- Human Immunodeficiency Virus Services, Pharmacy Department, Monash Health, Clayton, VIC, Australia
| | - Louise Lord
- Education Services, Pharmacy Department, Monash Health, Clayton, VIC, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
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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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Majidi S, Cohen L, Holt RIG, Clements M, O’Neill S, Renard E, Tynan D, Naranjo D, Messer LH, Klonoff DC, Barnard-Kelly K. Healthcare Professional Experiences and Opinions on Depression and Suicide in People With Diabetes. J Diabetes Sci Technol 2024; 18:667-675. [PMID: 37162023 PMCID: PMC11089883 DOI: 10.1177/19322968231171616] [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: 05/11/2023]
Abstract
OBJECTIVE People with diabetes have an increased risk of depression, intentional self-injury and self-harm (ISI), and suicide compared with the general population. This study aimed to explore experiences and awareness of healthcare professionals (HCPs) regarding depression, ISI, and suicide, and understand resource use and needs among HCPs who care for persons with diabetes (PWD). METHODS Healthcare professionals who see children and/or adults with type 1 diabetes or type 2 diabetes anonymously completed an online survey about their experiences, opinions, barriers, and needs surrounding identification and care of PWD with depression, ISI, and suicide. RESULTS One hundred twenty-nine HCPs participated. The majority were medical doctors (MDs) or advanced practice providers (APPs). Only a quarter of MDs and APPs felt very comfortable asking about ISI or suicidal ideation (SI), whereas 20% felt they had received appropriate training to support those with ISI or SI. The primary needs reported include more training on how to ask, respond, and support those expressing ISI and SI. Healthcare professionals reported wanting better access to resources for PWD. DISCUSSION The HCPs tend to underestimate SI in the diabetes population and rates of training were low. Areas to address include providing education and training to HCPs to improve identification and management of ISI and suicide risk. These data can inform the development of mechanisms to improve discussions of depression and suicide and of resources to help HCPs support PWD.
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Affiliation(s)
- Shideh Majidi
- Division of Endocrinology, Children’s National Hospital, Washington, DC, USA
- Barbara Davis Center for Diabetes, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lauren Cohen
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Richard I. G. Holt
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark Clements
- Pediatrics, Endocrinology, Children’s Mercy Hospitals and Clinics, Kansas City, MO, USA
| | - Simon O’Neill
- Health Intelligence and Professional Liaison, Diabetes UK, London, UK
| | - Eric Renard
- Department of Endocrinology and Diabetes, Montpellier University Hospital, and Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Doug Tynan
- Jefferson Medical College, Philadelphia, PA, USA
| | - Diana Naranjo
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Laurel H. Messer
- Barbara Davis Center for Diabetes, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David C. Klonoff
- Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
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Gee MJ, Johnson K, Leonhard C. Brief Virtual Workshop on Gambling Disorder to Raise Knowledge and Awareness Among Health Service Providers. J Gambl Stud 2024; 40:1-20. [PMID: 36538203 PMCID: PMC9765357 DOI: 10.1007/s10899-022-10176-w] [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] [Accepted: 11/26/2022] [Indexed: 12/24/2022]
Abstract
Gambling disorder is a "hidden disease" due to the lack of visible markers. It often negatively affects multiple domains of a person's life and predicts adverse physical, mental, social, and financial outcomes. Health service settings are suited for early detection of gambling disorder because of its comorbid medical conditions and due to the trust patients have in their health service providers (HSPs). However, HSPs often lack the knowledge needed to screen for this disorder and to make appropriate referrals. This paper reports a quasi-experimental wait-list control study (experimental group n = 18; wait-list control group n = 14), with cross-over and a twelve-week follow-up which assessed whether a brief virtual gambling disorder training entitled Gambling Know More could improve gambling disorder knowledge among HSPs. Results showed workshop participation caused a significant increase in gambling disorder knowledge immediately after the workshop and twelve weeks later. Participation in Gambling Know More bodes well for increasing early detection of gambling disorder and appropriate treatment referrals among HSPs. Findings have important policy implications for the training of HSPs.
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Affiliation(s)
- Michael J Gee
- The Chicago School of Professional Psychology at Xavier University of Louisiana, 1 Drexel Dr, P.O. Box 200, New Orleans, LA, 70125, USA
| | - Kelli Johnson
- The Chicago School of Professional Psychology at Xavier University of Louisiana, 1 Drexel Dr, P.O. Box 200, New Orleans, LA, 70125, USA
| | - Christoph Leonhard
- The Chicago School of Professional Psychology at Xavier University of Louisiana, 1 Drexel Dr, P.O. Box 200, New Orleans, LA, 70125, USA.
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, Weich S. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-107. [PMID: 38314750 DOI: 10.3310/vkty5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway. Aims To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment. Objectives To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK. Data sources Databases, including MEDLINE, PsycINFO®, EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites. Review methods A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines. Results From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan. Limitations Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment. Conclusions No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement. Study registration This study is registered as PROSPERO CRD42021276671. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Cantrell
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Katie Sworn
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Andrew Booth
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | | | - Scott Weich
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
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Richard O, Jollant F, Billon G, Attoe C, Vodovar D, Piot MA. Simulation training in suicide risk assessment and intervention: a systematic review and meta-analysis. MEDICAL EDUCATION ONLINE 2023; 28:2199469. [PMID: 37073473 PMCID: PMC10120456 DOI: 10.1080/10872981.2023.2199469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Suicide is a major cause of preventable death worldwide. Adequate training in risk assessment and intervention is key to suicide prevention. The use of simulation (role plays, simulated patients, virtual reality…) for practical training is a promising tool in mental health. The purpose of this study was to assess the effectiveness of simulation training in suicide risk assessment and intervention for healthcare professionals and gatekeepers. METHODS We conducted a systematic review in Medline and PsycINFO up to 31 July 2021 of randomized controlled trials (RCTs), non-randomized controlled trials, and pre/post-test studies. RCTs were furthermore included in a meta-analysis. We assessed the methodological quality of all studies with the Medical Education Research Study Quality Instrument, and the Cochrane Risk of Bias tool 2.0 for RCTs. Primary outcomes were changes in Kirkpatrick criteria: attitudes, skills, knowledge, behaviors, and patient outcomes. RESULTS We included 96 articles representing 43,656 participants. Most pre/post-test (n = 65) and non-randomized controlled (n = 14) studies showed significant improvement in attitudes, skills, knowledge, and behaviors. The meta-analysis of 11 RCTs showed positive changes in attitudes immediately after training and at 2-4 months post-training; in self-perceived skills at 6 months post-training; but not in factual knowledge. Studies assessing benefits for patients are still limited. CONCLUSIONS The heterogeneity of methodological designs, interventions, and trained populations combined with a limited number of RCTs and studies on patients' outcomes limit the strength of the evidence. However, preliminary findings suggest that simulation is promising for practical training in suicidal crisis intervention and should be further studied.
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Affiliation(s)
- Océane Richard
- Department of child and adolescent psychiatry,Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades, Reference center for autism and learning disorders, Paris, France
| | - Fabrice Jollant
- Department of psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France; Department of psychiatry, CHU Nimes, Nimes, France; Department of Psychiatry, School of Medicine, Paris-Saclay University, le Kremlin-Bicêtre, France; McGill University, McGill Group for Suicide Studies, Montreal, Canada; Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - Grégoire Billon
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Chris Attoe
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dominique Vodovar
- Université Paris Cité, UFR de médecine, 75010 Paris; UMRS 1144, Faculté de pharmacie, 75006 Paris; Centre AntiPoison de Paris, Paris
| | - Marie-Aude Piot
- Department of child and adolescent psychiatry, Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades Reference center for autism and learning disorders; Ilumens, Simulation Center; Paris-Saclay University, Paris, France
- CONTACT Marie-Aude Piot Department of child and adolescent psychiatry, Academic Hospital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
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Jabr S, Mahamid F, Hinnawi Z, Bdier D. Enhancing healthcare providers' diagnostic and intervention skills to deal with suicidal patients at emergency departments in the Palestinian hospitals: a quasi experimental study. BMC Health Serv Res 2023; 23:1213. [PMID: 37932743 PMCID: PMC10629064 DOI: 10.1186/s12913-023-10256-6] [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: 04/05/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Suicide cases in Palestine continue to record a remarkable annual increase, but we lack a comprehensive verified national data collection system of suicide and it is expected that real numbers of attempted/suicide in Palestine are higher because not all suicide or attempted suicide cases are reported. The purpose of this study was to test the effectiveness of a time-limited training intervention in enhancing healthcare providers' diagnostic and intervention skills to deal with suicidal patients who visit emergency departments in Palestinian hospitals. METHODS The sample consisted of 43 healthcare providers who work in public hospitals in the northern of the West Bank of Palestine, ranging from 25 to 56 years, involving 36 males and 7 females. A one-group quasi-experimental design was used, in which the experimental group received a training program to enhance healthcare providers' diagnostic and intervention skills to deal with suicidal ideations and attempts, the intervention lasted for 8 weeks, with 1 session per week. The performance of the experimental group was tested before and after the intervention. RESULTS Our findings revealed the effectiveness of the training intervention in enhancing participants' suicide assessment, diagnosis, and self-care skills. CONCLUSIONS These results suggest that a brief and carefully developed training intervention can potentially change healthcare providers' perceptions and behaviors toward suicide with a possible impact on clinical care therein.
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Affiliation(s)
- Samah Jabr
- Community Mental Health Center, Palestinian Ministry of Health, Ramallah, Palestine
| | - Fayez Mahamid
- Psychology and Counseling Dept, An-Najah National University, Nablus, Palestine.
| | - Zaynab Hinnawi
- Psychology and Counseling Dept, An-Najah National University, Nablus, Palestine
| | - Dana Bdier
- Psychology and Counseling Dept, An-Najah National University, Nablus, Palestine
- University of Milano-Bicocca, Milan, Italy
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Jeyasingam N, McLean L, Mitchell L, Wand APF. Attitudes to ageing amongst health care professionals: a qualitative systematic review. Eur Geriatr Med 2023; 14:889-908. [PMID: 37553540 PMCID: PMC10587319 DOI: 10.1007/s41999-023-00841-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 07/15/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVES Older adults utilising healthcare may be vulnerable to systemic bias regarding ageing potentially affecting care. Primary aim is to systematically review the qualitative literature examining attitudes to ageing amongst health care professionals (HCPs). Secondary aim is to describe and compare attitudes to ageing between different professional groups. METHODS Studies examining attitudes to ageing of HCPs were identified using four databases. Original qualitative research with HCPs was included, excluding studies examining students alone, reviews, and grey literature. Three authors undertook standardised data extraction and quality rating for each study and thematic synthesis, with a fourth senior author reviewing. Quality appraisal followed the Attree and Milton guidelines (2006), including studies rated A-C. RESULTS Of 5869 citations, 13 met initial inclusion criteria. Synthesis of the 12 studies graded A-C followed (excluding one study rated-D). Nurses, doctors, and social workers were most frequently investigated. Identified themes included Attitudes towards older persons, The role of the older persons' family, Behaviour of HCPs towards older persons, Behaviour of older persons towards HCPs, and Definitions of an older person. An overarching theme emerged of the systemic context of attitudes to ageing. Common attitudes were found across disciplines, with doctors emphasising complexity and dependency and nurses the burden of care. CONCLUSIONS HCP's attitudes to ageing vary and are shaped by professional experiences and systemic factors. HCP attitudes may affect responses to and care of the older person. Therefore, interprofessional research, and systemic and service changes across disciplines are required to foster real and sustainable attitudinal change to support older peoples' care.
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Affiliation(s)
- Neil Jeyasingam
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Chippendale, NSW, 2006, Australia
- Mental Health Drug and Alcohol, Far West Local Health District, Broken Hill, NSW, Australia
| | - Loyola McLean
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Chippendale, NSW, 2006, Australia
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Westmead Psychotherapy Program for Complex Traumatic Disorders, Cumberland Hospital, WSLHD, North Parramatta, Australia
| | | | - Anne P F Wand
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Chippendale, NSW, 2006, Australia.
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Heath, University of New South Wales, Sydney, Australia.
- Older Peoples Mental Health, Sydney Local Health District, Sydney, Australia.
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Kwon CY, Lee B. The Effect of Herbal Medicine on Suicidal Behavior: A Protocol for Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11101387. [PMID: 37239673 DOI: 10.3390/healthcare11101387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Suicide is an important social and medical problem worldwide, including in countries that use traditional East Asian medicine (TEAM). Herbal medicine (HM) has been reported to be effective against several suicide-related conditions. This systematic review aimed to investigate the efficacy and safety of HM in reducing suicidal behavior including suicidal ideation, attempts, or completed suicide. We conduct a comprehensive search in 15 electronic bibliographic databases from inception to September 2022. All types of prospective clinical studies-including randomized controlled clinical trials (RCTs)-involving HM without or with routine care are included. The primary outcomes of this review are validated measures of suicidal ideation including the Beck scale for suicidal ideation. The revised Cochrane's risk of bias tool and other tools including the ROBANS-II tool are used to assess the methodological quality of RCTs and non-RCTs, respectively. A meta-analysis is performed using RevMan 5.4 in cases of homogeneous data from controlled studies. The results of the systematic review provide high-quality evidence to determine the efficacy and safety of HM for suicidal behavior. Our findings are informative for clinicians, policymakers, and researchers, aimed at reducing suicide rates, especially in countries that use TEAM.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-Eui University, 52-57 Yangjeong-ro, Busanjin-gu, Busan 47227, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
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Silla A. Identifying measures with the highest potential to reduce suicides on Finnish railways. APPLIED ERGONOMICS 2022; 102:103748. [PMID: 35349938 DOI: 10.1016/j.apergo.2022.103748] [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: 03/30/2021] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
The purpose of this study was to work systematically through all known measures for preventing railway suicides and to consider their suitability for the Finnish railway environment. The research method included a selection and grouping of measures, definition of assessment criteria, a literature review and compilation of assessment forms, and a workshop for experts in the field. We assessed 21 measures based on 12 specified criteria. Specifically, the aim of these criteria was to support the identification and structuring of the available information on each measure to be in easily exploitable format for railway stakeholders. The measures were listed in order of priority in three categories based on final assessments from the workshop. The measures categorised as top priority with the highest potential to reduce suicides on Finnish railways included training of railway personnel to identify suicidal people (also called Gatekeeper training), camera surveillance, detection systems (radar, movement sensors, etc.), collaboration between organisations, learning from international experience, cooperation between railway organisations, police and fire and rescue services, and training of mental health providers. This prioritisation, together with the information included in the assessment forms and expert's views related to each measure, support the Finnish railway stakeholders in selecting measures and defining implementation strategies to prevent railway suicides on Finnish railways. The insights of Finnish experts on the effectiveness and potential implementation of these different measures are valuable information also for railway stakeholders in other countries when selecting appropriate measures to prevent railway suicides. The results of this study support the safe and effective functioning of the railway system by adding knowledge that will help effectively prevent railway suicides and loss of life, delays to train traffic, and work-related stress and trauma to railway staff, rescue personnel and eyewitnesses.
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Affiliation(s)
- Anne Silla
- VTT Technical Research Centre of Finland Ltd, P.O. Box 1000, 02044, VTT, Finland.
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Schmied EA, Glassman LH, Carinio SR, Dell'Acqua RG, Bryan CJ, Thomsen CJ. Suicide-Specific Training Experiences and Needs Among Military Mental Health Providers. Arch Suicide Res 2022:1-15. [PMID: 35510759 DOI: 10.1080/13811118.2022.2067510] [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: 11/02/2022]
Abstract
BACKGROUND Military suicide rates have risen over the past two decades, with a notable spike in recent years. To address this issue, military mental health providers must be equipped with the skills required to provide timely and effective care; yet little is known about the suicide-specific training experiences or needs of these professionals. METHODS Thirty-five mental health care providers who treat active duty personnel at military treatment facilities participated in this mixed-methods study. All participants completed a survey assessing training and clinical experiences, comfort and proficiency in working with patients at risk for suicide, and perceived barriers to obtaining suicide-specific training. A sub-set of participants (n = 8) completed a telephone interview to further describe previous experiences and perceived challenges to obtaining training. RESULTS The majority of participants (79.4%) had 6+ years of clinical experience, had a patient who had attempted suicide (85.3%), and completed at least one suicide-related training since finishing their education (82.4%). Survey results showed the leading barrier to enrolling in suicide-specific trainings was perceived lack of training opportunities (40.7% reported it was a barrier "quite often" or more), followed by lack of time (25%). Interview results revealed lack of time, location and logistical issues, and low perceived need for additional training among providers could impede enrollment. CONCLUSIONS Study results identified several modifiable barriers to receiving suicide-specific continuing education among military mental health providers. Future efforts should develop accessible training programs that can be easily integrated into routine clinical operations to mount the best defense against suicide. HIGHLIGHTSMilitary mental health providers report significant experience and relatively high degrees of comfort and proficiency working with patients at high risk for suicide.Most providers reported receiving training in suicide assessment and screening; few reported prior training in management of suicidality.Study results identified several modifiable barriers to receiving suicide-prevention continuing education among military mental health care providers; future efforts should seek to develop accessible training programs that can be easily integrated into routine clinical operations to mount the best defense against suicide.
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Pisnoli I, Van der Hallen R. Attitudes toward Suicide and the Impact of Client Suicide: A Structural Equation Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5481. [PMID: 35564873 PMCID: PMC9102844 DOI: 10.3390/ijerph19095481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023]
Abstract
Previous research has revealed that mental health professionals (MHPs) often experience significant short- and long-term impacts in the aftermath of client suicide. Individual differences are significant, yet what factors explain these differences remain unclear. The current study aimed to investigate to what extent MHPs' attitudes toward (client) suicide could predict the short- and long-term impacts of client suicide. A total of 213 MHPs, aged between 18 and 75, reported on a client suicide and their attitudes toward (client) suicide using self-report questionnaires. The results indicate that MHPs who believe it is one's "rightful choice" to die by suicide report less and MHPs who believe "suicide can and should be prevented" report more impact of client suicide. Predictability and preventability of client suicide proved strongly, positively correlated; yet, neither predicted the impact of client suicide. Taken together, these findings highlight the importance of MHPs' attitudes toward (client) suicide with respect to clients and MHPs (self-)care.
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Affiliation(s)
- Irene Pisnoli
- Clinical Psychology, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands
| | - Ruth Van der Hallen
- Clinical Psychology, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands
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Teismann T, Düwel H, Eidt L, Brailovskaia J, Cwik JC. Psychotherapists' Knowledge of Guideline Recommendations for the Treatment of Depressed Suicidal Patients. Front Psychiatry 2022; 13:873127. [PMID: 35492714 PMCID: PMC9046867 DOI: 10.3389/fpsyt.2022.873127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/25/2022] [Indexed: 12/04/2022] Open
Abstract
Objective Clinical practice guidelines present expert consensus on the treatment of mental disorders. Yet, studies have shown that knowledge of and adherence to recommendations are moderate. The aim of the present study was to investigate, whether and to what extent psychotherapists are aware of and follow the German guideline recommendations for the treatment of suicidal depressed patients. Methods 174 participants (licensed psychotherapists, psychotherapists-in-training) were presented with five groups of guideline recommendations (referring to inpatient admission, psychotherapy, acute pharmacotherapy, pharmacologic relapse prevention, follow-up appointments) and were asked to identify the guideline recommendation and indicate whether they provided treatment according to the guideline. Results Knowledge and adherence to the guidelines recommendations on psychotherapy and inpatient admission were well present. However, knowledge about pharmacological treatment recommendations was low; same as the knowledge on the necessity of immediate follow-up appointments after discharge of patients hospitalized due to suicidality. Discussion The results highlight the importance of greater dissemination of various facts about the management of suicidal patients.
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Affiliation(s)
- Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Helena Düwel
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Leandra Eidt
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Julia Brailovskaia
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Jan Christopher Cwik
- Department of Clinical Psychology and Psychotherapy, Universität zu Köln, Cologne, Germany
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Kramer BJ, Weintraub NT, Richter-Lagha RA. Infusing geriatrics in Indian Health Service general primary care clinics: extending VA workforce development training. GERONTOLOGY & GERIATRICS EDUCATION 2022:1-10. [PMID: 35377832 DOI: 10.1080/02701960.2022.2056735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
As federal partners, the Veterans Health Administration (VA) and the Indian Health Service (IHS) agreed to share resources, such as education. The VA Geriatric Scholars Program, a workforce development program, provides one of its training programs on team-based primary care of elders to clinicians working in IHS and Tribal Health Programs. The practical impact of that training is described. A mixed methods approach was applied to the course's evaluation survey at five clinics in the Northwestern Plains, Southwest, Pacific Coast, and Alaska. Quantitative approaches assessed participants' self-reported intention to improve recognition and assessment of common geriatric syndromes. A qualitative approach applied to open-ended text responses revealed intensions to improve team-based care. Among the 51 respondents in our sample, we found significant improvements in self-reported ability to recognize previously unfamiliar potential risks to elders' health and safety, t(49) = 8.0233, p < .001, as well as increased comfort with conducting geriatric assessments and increased confidence in interprofessional team-based communication. Improvements to team-based care included enhanced clinical skills, organizational factors and the need to train additional employees. This evaluation demonstrates the value of sharing resources among federal partners and its value for participants in IHS and Tribal Health Programs.
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Affiliation(s)
- B Josea Kramer
- VA Greater Los Angeles Healthcare System, Geriatric Research, Education, Clinical Center, North Hills, USA
- David Geffen School of Medicine, University of California at Los Angeles, Division of Geriatric Medicine, Los Angeles, USA
| | - Nancy T Weintraub
- VA Greater Los Angeles Healthcare System, Geriatric Research, Education, Clinical Center, North Hills, USA
- David Geffen School of Medicine, University of California at Los Angeles, Division of Geriatric Medicine, Los Angeles, USA
| | - Regina A Richter-Lagha
- VA Greater Los Angeles Healthcare System, Geriatric Research, Education, Clinical Center, North Hills, USA
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Alonzo D, Popescu M, Zubaroglu-Ioannides P. Effects of brief training on mental health provider's knowledge of working with youth at risk of suicide in Guatemala. Int J Soc Psychiatry 2022; 68:281-287. [PMID: 33356739 DOI: 10.1177/0020764020983860] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Resources for mental healthcare are lacking in Guatemala, yet rates of mental illness and suicide are quite high. Mental healthcare providers often lack the knowledge needed to effectively work with young at-risk of suicide. To address this gap, we developed a training program for mental health professionals focused on increasing knowledge and understanding of engaging and working with youth at risk of suicide and present its acceptability and preliminary effectiveness. METHODS Mental health providers (N = 17) from a low SES community participated in the training, Formacion CUIDAR (Comunidades Unidos para Individuales De Alto Riesgo; CARE Training; Communities United for Individuals at High Risk). Mixed methods were used to explore outcomes including, self-reported knowledge and understanding of warning signs; risk and protective factors; effective risk assessment; and, techniques for working with at-risk youth. RESULTS Findings indicate that the training was effective at increasing all targeted domains of knowledge (t = 2.46, p < .05, Cohen's d = .56). Acceptability was also rated as high. CONCLUSION Scarcity of mental health specialists and lack of training on suicide assessment and management have resulted in inadequate resources for at-risk youth in need of mental health services in Guatemala. Results of our study demonstrate that our training is an acceptable, effective program for practicing mental health providers to address their lack of specialized training on how to work with individuals at risk of suicide. Further examination of the training in a larger RCT is required to attain more robust indictors of effectiveness and to assess long-term impact.
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Affiliation(s)
- Dana Alonzo
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
| | - Marciana Popescu
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
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16
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Airey ND, Iqbal Z. Are Clinicians Confident in the Risk Assessment of Suicide?: A Systematic Literature Review. Arch Suicide Res 2022; 26:1-13. [PMID: 32669055 DOI: 10.1080/13811118.2020.1792019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Suicide reduction is recognized as a vital focus for mental health clinicians. Clinician confidence to undertake suicide risk assessment, though poorly understood, appears related to job performance, though overconfidence has also been evident in clinical practice. A systematic literature search was undertaken on PSYCinfo and MEDLINE using the terms: suicide risk assessment, confidence, clinician. Of 192 papers identified, 10 articles were deemed pertinent. These for the most part suggested clinician confidence above the 50% chance level though statistical evidence was lacking for all but two. The literature fails to provide sufficient and objective evidence of the impact of clinician confidence in practice. Recommendations are provided for future research.
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Van der Hallen R. Suicide Exposure and the Impact of Client Suicide: A Structural Equation Modeling Approach. Arch Suicide Res 2021; 27:426-438. [PMID: 34961396 DOI: 10.1080/13811118.2021.2020190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Client suicide, used to refer to situations where a mental health practitioner (MHP) is exposed, affected, or bereaved by a client's suicide, is known to have a profound impact on MHPs. The current study investigated (1) the short- and long-term impact of client suicide and (2) to what extent gender, years of experience, therapeutic background, and exposure to suicidality predicted impact. METHODS An international sample of 213 mental health practitioners completed an online survey on the impact of client suicide. RESULTS AND CONCLUSION Overall, results indicate MHPs are significantly affected by client suicide. A two-factor model in which impact of client suicide was predicted by two latent variables, MHP Characteristics and Exposure to Suicidality, explained 43% of short-term, 69% of long-term emotional, and 60% of long-term professional impact. Whereas MHP characteristics did not significantly predict any of the three impact variables (ps >.05), Exposure to Suicidality significantly predicted all three outcome variables (ps <.001). Interestingly, lived experience or exposure to suicidality of friends/family members predicted more impact, while exposure to suicidality at work predicted less impact of client suicide. Implications for both research and clinical practice are discussed.HIGHLIGHTSMHPs are significantly affected by client suicide;Previous exposure to suicidality predicts the impact of client suicide;MHP characteristics do not predict the impact of client suicide.
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Hawgood J, Krysinska K, Mooney M, Ozols I, Andriessen K, Betterridge C, De Leo D, Kõlves K. Suicidology Post Graduate Curriculum: Priority Topics and Delivery Mechanisms for Suicide Prevention Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9926. [PMID: 34574848 PMCID: PMC8469380 DOI: 10.3390/ijerph18189926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There has been limited attention to the development and delivery of tertiary suicide prevention curricula. The aim of this work was to describe the status of postgraduate suicide prevention education, with specific attention on examining the needs of the suicide prevention sector in Australia. METHOD An online survey was completed by 76 stakeholders in Australia. Current curriculum learning outcomes from Griffith University's postgraduate suicidology programs guided the development of the survey. RESULTS Four key learning domains were rated highest in importance by stakeholders. According to most stakeholders, skills-based qualifications were the most relevant type of qualification, and online modulized education was the most preferred delivery mode. Half of stakeholders supported suicide prevention professional development through a combination of financial support and study leave. CONCLUSIONS The survey provided invaluable feedback regarding the priorities of Australia's suicide prevention sector for content domains and delivery mechanisms for tertiary suicidology education. The findings showed the preferred type of organizational (employer) support that may be provided for employees to undertake such education. These findings will inform the future developments of Griffith University's suicidology programs and may motivate other universities to consider offering same or a similar type of education to support the suicide prevention sector toward saving lives.
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Affiliation(s)
- Jacinta Hawgood
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3010, Australia; (K.K.); (K.A.)
| | - Maddeline Mooney
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Ingrid Ozols
- Department of Psychiatry, The University of Melbourne, Melbourne 3002, Australia;
- Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3800, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3010, Australia; (K.K.); (K.A.)
| | | | - Diego De Leo
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Kairi Kõlves
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
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Walukevich-Dienst K, Crapanzano KA, Zielinski MH, Vath RJ, Tucker RP. Integration of a Suicide-Specific Treatment Program Within a Psychiatric Residency and Large Hospital System of Care: a Twelve-Month Journey. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:297-300. [PMID: 32124406 DOI: 10.1007/s40596-020-01209-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/12/2020] [Indexed: 06/10/2023]
Affiliation(s)
| | | | - Mark H Zielinski
- Louisiana State University Health Sciences Center, Baton Rouge, LA, USA
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Singleton JA, Lau ET, Nissen LM. Exploring Australian pharmacists’ perceptions and attitudes towards dispensing HIV medicines in the community setting. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2021. [DOI: 10.1002/jppr.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Judith A. Singleton
- Faculty of Health School of Clinical Sciences Queensland University of Technology(QUT) Brisbane Australia
- Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology Brisbane Australia
| | - Esther T.L. Lau
- Faculty of Health School of Clinical Sciences Queensland University of Technology(QUT) Brisbane Australia
- Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology Brisbane Australia
| | - Lisa M. Nissen
- Faculty of Health School of Clinical Sciences Queensland University of Technology(QUT) Brisbane Australia
- Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology Brisbane Australia
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21
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Monahan MF, Karver MS. Are they ready yet?: A theory-driven evaluation of suicide risk assessment trainings in psychology graduate programs. J Clin Psychol 2021; 77:1614-1628. [PMID: 34004040 DOI: 10.1002/jclp.23171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/22/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The present study sought to understand the state of suicide risk assessment trainings in clinical psychology graduate programs. METHODS We surveyed 167 clinical psychology doctoral students' behavioral competency in responding to suicidal clients and their attitudes, perceived behavioral control, subjective norms, and intentions related to suicide risk assessment. Hypotheses were tested using path analysis. RESULTS Ninety six percent of participants reported receiving some type of suicide risk assessment training at their program. Results provided partial support for significant relationships between attitudes, perceived behavioral control, subjective norms, and intentions. Unexpectedly, amount of training in suicide risk assessments was not related to theory of planned behavior variables including behavioral competency. CONCLUSION These findings have implications regarding the effectiveness of current suicide risk assessment training practices and ways to improve trainings to help increase the number of clinical psychologists competent in suicide risk assessment and management.
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Affiliation(s)
- Maureen F Monahan
- New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Marc S Karver
- Department of Psychology, University of South Florida, Tampa, Florida, USA
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22
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Hager NM, Cramer RJ, Kaniuka AR, Vandecar-Burdin T, Badger N, Holley AM, Foss J, Glenn CR, Judd S, South G, Judah MR. An Evaluation of the Core Competency Suicide Prevention Training Program for University Health Service Providers. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2021. [DOI: 10.1080/87568225.2021.1911726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Nathan M. Hager
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Robert J. Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Andrea R. Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | | | - Nancy Badger
- Office of Counseling Services, Old Dominion University, Norfolk, Virginia, USA
| | - Angela M. Holley
- Office of Counseling Services, Old Dominion University, Norfolk, Virginia, USA
| | - Jennifer Foss
- Student Health Center, Old Dominion University, Norfolk, Virginia, USA
| | - Catherine R. Glenn
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Sarah Judd
- Office of Counseling Services, Old Dominion University, Norfolk, Virginia, USA
| | - Gabrielle South
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Matt R. Judah
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
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23
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Harris BR, Tracy M, Comber KG, Pechenik S, Carruthers JW. Suicide safer care in behavioral health settings: A comparative analysis of perceptions, training completion, and practice between mental health and substance use disorder treatment providers. J Subst Abuse Treat 2021; 126:108330. [PMID: 34116821 DOI: 10.1016/j.jsat.2021.108330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/02/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Despite prevention and treatment efforts, opioid overdose deaths continue to rise in the United States and totaled 46,802 in 2018. This public health crisis is closely linked with suicide, with those who misuse opioids at six times the risk of death by suicide. Suicide prevention in substance use disorder (SUD) treatment may be a critical step in saving lives and promoting recovery among those at risk for opioid overdose. METHODS We distributed an electronic survey to clinicians in mental health and SUD treatment in nine health systems across New York State from November 2018 to January 2019. The goal of the survey was to assess attitudes, perceptions, practice, and training needs among SUD treatment providers and how they differ from those of mental health providers. RESULTS A total of 633 clinicians responded to the survey (62.4% response rate). Seventy-one percent of SUD providers reported working with a client who attempted suicide. Even so, less than half of SUD providers reported routinely screening new (48.9%) or existing patients (25.6%) for suicidal thoughts/behaviors; overall, 28.4% of SUD providers reported low levels of action to address suicide risk, compared to 9.0% of mental health providers (p < 0.001). Perceived self-efficacy and effectiveness at reducing a patient's risk of suicide and training completion were strongly associated with routine delivery of suicide safer care in adjusted logistic regression models. CONCLUSIONS The results of this study identify key areas for targeted training and technical assistance to increase the provision of quality suicide safer care in SUD treatment.
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Affiliation(s)
- Brett R Harris
- University at Albany School of Public Health, One University Place, Rensselaer, NY 12144, USA.
| | - Melissa Tracy
- University at Albany School of Public Health, One University Place, Rensselaer, NY 12144, USA.
| | - Katharine G Comber
- New York State Office of Mental Health, 44 Holland Avenue, Albany, NY 12229, USA.
| | - Sigrid Pechenik
- New York State Office of Mental Health, 44 Holland Avenue, Albany, NY 12229, USA.
| | - Jay W Carruthers
- New York State Office of Mental Health, 44 Holland Avenue, Albany, NY 12229, USA.
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Wand APF, Draper B, Brodaty H, Hunt GE, Peisah C. Evaluation of an Educational Intervention for Clinicians on Self-Harm in Older Adults. Arch Suicide Res 2021; 25:156-176. [PMID: 31941427 DOI: 10.1080/13811118.2019.1706678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Clinicians may lack knowledge and confidence regarding self-harm in older adults and hold attitudes that interfere with delivering effective care. A 1-hour educational intervention for hospital-based clinicians and general practitioners (GPs) was developed, delivered, and evaluated. Of 119 multidisciplinary clinicians working in aged care and mental health at two hospitals, 100 completed pre/post-evaluation questions. There were significant improvements in knowledge, confidence in managing, and attitudes regarding self-harm in late life, and the education was rated as likely to change clinical practice. No GP education sessions could be conducted. A brief educational intervention had immediate positive impacts for hospital-based clinicians albeit with high baseline knowledge. The sustainability of these effects and effectiveness of the intervention for GPs warrant examination.
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Elliott GM, Henninger J. Online Teaching and Self‐Efficacy to Work With Suicidal Clients. COUNSELOR EDUCATION AND SUPERVISION 2020. [DOI: 10.1002/ceas.12189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Gregory M. Elliott
- Department of Counselor Education Adams State University
- Now at Department of Clinical Mental Health Counseling Colorado Christian University
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An Assessment of the Utility of the Youth Mental Health First Aid Training: Effectiveness, Satisfaction, and Universality. Community Ment Health J 2020; 56:1581-1591. [PMID: 32285372 DOI: 10.1007/s10597-020-00612-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
Youth Mental Health First Aid (YMHFA) is a training program developed to educate child-serving professionals on how to properly identify and respond to mental health needs among children and adolescents. The current study tested the utility of the training by examining the effectiveness, satisfaction, and universality across child-serving occupations. Data collected from 893 child-serving professionals was used to compare training effectiveness and training experiences across four different occupational settings (child welfare, education, support services, and the justice system). Using a pretest/posttest survey design, strong support for the effectiveness of YMHFA (i.e. knowledge, confidence, preparedness, and intentions to intervene), satisfaction with the training program, and universality of effectiveness and satisfaction across the occupational groups was found. Results highlight the utility of YMHFA across different sectors of child-serving agencies and support its sustainability.
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Brown S, Iqbal Z, Burbidge F, Sajjad A, Reeve M, Ayres V, Melling R, Jobes D. Embedding an Evidence-Based Model for Suicide Prevention in the National Health Service: A Service Improvement Initiative. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144920. [PMID: 32650466 PMCID: PMC7399800 DOI: 10.3390/ijerph17144920] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022]
Abstract
Despite the improved understanding of the determinants of suicide over recent decades, the mean suicide rate within the United Kingdom (UK) has remained at 10 per 100,000 per annum, with about 28% accessing mental health services in the 12 months prior to death. In this paper, we outlined a novel systems-level approach to tackling this problem through objectively differentiating the level of severity for each suicide risk presentation and providing fast-track pathways to care for all, including life-threatening cases. An additional operational challenge addressed within the proposed model was the saturation of local crisis mental health services with approximately 150 suicidality referrals per month, including non-mental health cases. This paper discussed a service improvement initiative undertaken within a National Health Service (NHS) secondary care mental health provider's open-access 24/7 crisis and home treatment service. An organisation-wide bespoke "suicide risk triage" system utilising the Collaborative Assessment and Management of Suicidality (CAMS) was implemented across all services. The preliminary impacts on suicidality, suicide rates and service user outcomes were described.
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Affiliation(s)
- Sophie Brown
- Department of Psychology, Faculty of Health Sciences, University of Hull, Hull HU6 7RX, UK; (S.B.); (F.B.)
- NAViGO Health and Social Care Community Interest Company, Grimsby DN32 0QE, UK; (A.S.); (M.R.); (V.A.); (R.M.)
| | - Zaffer Iqbal
- Department of Psychology, Faculty of Health Sciences, University of Hull, Hull HU6 7RX, UK; (S.B.); (F.B.)
- NAViGO Health and Social Care Community Interest Company, Grimsby DN32 0QE, UK; (A.S.); (M.R.); (V.A.); (R.M.)
- Correspondence: ; Tel.: +44-1472-806800
| | - Frances Burbidge
- Department of Psychology, Faculty of Health Sciences, University of Hull, Hull HU6 7RX, UK; (S.B.); (F.B.)
- NAViGO Health and Social Care Community Interest Company, Grimsby DN32 0QE, UK; (A.S.); (M.R.); (V.A.); (R.M.)
| | - Aamer Sajjad
- NAViGO Health and Social Care Community Interest Company, Grimsby DN32 0QE, UK; (A.S.); (M.R.); (V.A.); (R.M.)
| | - Mike Reeve
- NAViGO Health and Social Care Community Interest Company, Grimsby DN32 0QE, UK; (A.S.); (M.R.); (V.A.); (R.M.)
| | - Victoria Ayres
- NAViGO Health and Social Care Community Interest Company, Grimsby DN32 0QE, UK; (A.S.); (M.R.); (V.A.); (R.M.)
| | - Richard Melling
- NAViGO Health and Social Care Community Interest Company, Grimsby DN32 0QE, UK; (A.S.); (M.R.); (V.A.); (R.M.)
| | - David Jobes
- Department of Psychology, School of Arts and Sciences, Clinical Psychology Faculty, The Catholic University of America, Washington, DC 20064, USA;
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Snyder DJ, Jordan BA, Aizvera J, Innis M, Mayberry H, Raju M, Lawrence D, Dufek A, Pao M, Horowitz LM. From Pilot to Practice: Implementation of a Suicide Risk Screening Program in Hospitalized Medical Patients. Jt Comm J Qual Patient Saf 2020; 46:417-426. [PMID: 32473966 PMCID: PMC11173372 DOI: 10.1016/j.jcjq.2020.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Hospitals have become an important venue for identifying medical patients with occult suicidality. This article describes the implementation of a quality improvement project at the National Institutes of Health Clinical Center (NIHCC) to systematically screen medical/surgical inpatients for suicide risk. METHODS Using the Plan-Do-Study-Act method, questions from the Ask Suicide-Screening Questions (ASQ) tool were deployed with medical inpatients aged 10 years and older between April 2018 and April 2019. Goals included the development of a training program, policy and procedure review, electronic medical record integration and data collection, and ongoing management and troubleshooting. RESULTS A total of 4,284 patients were screened for suicide risk with a nurse screening compliance rate of 94.3%. Prevalence data on patients aged 10 years and older revealed an overall screen positive rate of 2.3% (97/4,284), with 3.1% of youth aged 10 to 24 years and 2.2% of adults screening positive. Of the 97 patients who screened positive, 96 were non-acute positive screens. Of the full sample, only 1 patient (0.02%) was deemed acute positive, requiring a 1:1 observer and full safety precautions. CONCLUSION Universal suicide risk screening was successfully implemented in the NIHCC without incurring a need for additional resources. The intermediate step of a brief suicide safety assessment is a critical part of the workflow, providing guidance for determining appropriate follow-up in a safe and efficient manner that spares limited mental health and hospital resources. Given the increasing suicide rates in the general population, medical venues offer important opportunities for early detection, assessment, and referral.
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Wakai S, Schilling EA, Aseltine RH, Blair EW, Bourbeau J, Duarte A, Durst LS, Graham P, Hubbard N, Hughey K, Weidner D, Welsh A. Suicide prevention skills, confidence and training: Results from the Zero Suicide Workforce Survey of behavioral health care professionals. SAGE Open Med 2020; 8:2050312120933152. [PMID: 32595971 PMCID: PMC7298428 DOI: 10.1177/2050312120933152] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 05/11/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction: In behavioral health care settings, a workforce well trained in suicide
prevention is critically important for behavioral health care professionals
across different disciplines and service sectors who are likely to have
considerable exposure to patients at risk for suicidal behavior. This study
examined the types of training behavioral health care professionals
received, their self-reported skills, comfort level and confidence related
to suicide prevention, the association of types and length of training with
skills, comfort level and confidence, and areas in which participants would
like more training. Methods: The Zero Suicide Workforce Survey was administered electronically to
behavioral health care professionals at six behavioral health treatment
centers with both inpatient and ambulatory programs in Connecticut, USA.
Item numbers and percentages were calculated for 847 respondents with
behavioral health care roles. The chi-square tests were performed to
determine the statistical significance of group differences. Non-parametric
sign tests were performed to determine the statistical significance of the
collective differences in direction among items between groups. Results: Suicide prevention training is associated with increased levels of behavioral
health care professionals’ skills and confidence, but one-third of
behavioral health care professionals in the sample received no formal
training in suicide prevention/intervention. Even brief training appears to
have a positive impact on behavioral health care professionals’ assessment
of their skills and confidence. Prominent topics for additional training
include suicide-specific treatment approaches, suicide prevention and
awareness, and identification of risk factors and warning signs. Conclusion: Although behavioral health care professionals may often encounter patients at
risk for suicide, many have not obtained any relevant training. The findings
highlight the need to strengthen suicide identification, assessment and
treatment within behavioral health care treatment settings as part of an
effort to prevent suicide.
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Affiliation(s)
- Sara Wakai
- Department of Medicine, UConn Health, Farmington, CT, USA
| | | | | | | | | | - Andrea Duarte
- Connecticut Department of Mental Health and Addiction Services, Hartford, CT, USA
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Cwik MF, O’Keefe VM, Haroz EE. Suicide in the pediatric population: screening, risk assessment and treatment. Int Rev Psychiatry 2020; 32:254-264. [PMID: 31922455 PMCID: PMC7190447 DOI: 10.1080/09540261.2019.1693351] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The number of children and adolescents dying by suicide is increasing over time. Patterns for who is at risk are also changing, leading to a need to review clinical suicide prevention progress and identify limitations with existing practices and research that can help us further address this growing problem. This paper aims to synthesise the literature on paediatric suicide screening, risk assessment and treatment to inform clinical practice and suicide prevention efforts. Our review shows that universal screening is strongly recommended, feasible and acceptable, and that there are screening tools that have been validated with youth. However, screening may not accurately identify those at risk of dying due to the relative rarity of suicide death and the associated research and clinical challenges in studying such a rare event and predicting future behaviour. Similarly, while risk assessments have been developed and tested in some populations, there is limited research on their validity and challenges with their implementation. Several promising suicide-specific treatments have been developed for youth, but overall there is an insufficient number of randomised trials. Despite great need, the research evidence to support screening, risk assessment and treatment is still limited. As suicide rates increase for children and adolescents, continued research in all three domains is needed to reverse this trend.
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Affiliation(s)
- Mary F. Cwik
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Victoria M. O’Keefe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily E. Haroz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Communication about the desire to die: Development and evaluation of a first needs-oriented training concept - A pilot study. Palliat Support Care 2020; 18:528-536. [PMID: 32131932 DOI: 10.1017/s1478951520000097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patients' desire to die (DD) is rarely discussed in palliative care (PC) due to health professionals' (HPs) feeling of uncertainty. The aim of the study was to develop and evaluate a training to increase HPs' self-confidence in responding professionally to patient's DD and to assess the feasibility of this approach. METHODS The training course was developed via focus groups and relevant literature and refined with an advisory board. An evaluation design was developed to evaluate training outcomes and to examine feasibility. To assess self-confidence, knowledge, skills, and attitudes: (1) standardized surveys were applied at T1 (before training), T2 (directly after), and T3 (3 months later), and were analyzed by descriptive and non-parametric statistics; and (2) participants' open feedback was summarized by content. RESULTS A two-day multi-disciplinary training was developed to improve self-confidence via diverse teaching methods. Twenty-four HPs from general and specialized PC were participated. Via self-rating on Likert scales at three time points, improvements were seen at T1, T2, and partly remained at T3, especially in the overall item of self-confidence in communicating with patients about their DD (means: 4.3. at T1, 5.7 at T2, and 5.9 at T3; on a 7-point scale with 1 = lowest value and 7 = highest value). Fewer improvements were found in skills (using different approaches) and attitudes (feeling less helplessness). Open feedback revealed a high appreciation for the training, especially the composition of participants, the role-play, and the overall increase of awareness of the topic. SIGNIFICANCE OF RESULTS The developed training on addressing DD meets a need and was perceived by the participants to be of added value. Future research should measure training effects with a validated instrument, including more participants, diverse participant groups, and a control group. Effects on patients should be assessed.
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Kullberg MLJ, Mouthaan J, Schoorl M, de Beurs D, Kenter RMF, Kerkhof AJ. E-Learning to Improve Suicide Prevention Practice Skills Among Undergraduate Psychology Students: Randomized Controlled Trial. JMIR Ment Health 2020; 7:e14623. [PMID: 32012076 PMCID: PMC7003118 DOI: 10.2196/14623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/02/2019] [Accepted: 10/07/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Despite increasing evidence of the effectiveness of digital learning solutions in higher vocational education, including the training of allied health professionals, the impact of Web-based training on the development of practical skills in psychiatry and psychology, in general, and in suicide prevention, specifically, remains largely understudied. OBJECTIVE This study aimed to determine the effectiveness of an electronic learning (e-learning) module on the adherence to suicide prevention guidelines, knowledge of practical skills, and provider's confidence to have a conversation about suicidal behavior with undergraduate psychology students. METHODS The e-learning module, comprising video recordings of therapist-patient interactions, was designed with the aim of transferring knowledge about suicide prevention guideline recommendations. The program's effects on guideline adherence, self-evaluated knowledge, and provider's confidence were assessed using online questionnaires before the program (baseline and at 1 month [T1] and 3 months after baseline). The eligible third- and fourth-year undergraduate psychology students were randomly allocated to the e-learning (n=211) or to a waitlist control condition (n=187), with access to the intervention after T1. RESULTS Overall, the students evaluated e-learning in a fairly positive manner. The intention-to-treat analysis showed that the students in the intervention condition (n=211) reported higher levels of self-evaluated knowledge, provider's confidence, and guideline adherence than those in the waitlist control condition (n=187) after receiving the e-learning module (all P values<.001). When comparing the scores at the 1- and 3-month follow-up, after both groups had received access to the e-learning module, the completers-only analysis showed that the levels of knowledge, guideline adherence, and confidence remained constant (all P values>.05) within the intervention group, whereas a significant improvement was observed in the waitlist control group (all P values<.05). CONCLUSIONS An e-learning intervention on suicide prevention could be an effective first step toward improved knowledge of clinical skills. The learning outcomes of a stand-alone module were found to be similar to those of a training that combined e-learning with a face-to-face training, with the advantages of flexibility and low costs.
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Affiliation(s)
| | - Joanne Mouthaan
- Department of Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Maartje Schoorl
- Department of Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Derek de Beurs
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
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Suicide prevention in community mental health: changing systems. JOURNAL OF PUBLIC MENTAL HEALTH 2020. [DOI: 10.1108/jpmh-06-2019-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to describe a performance improvement process related to suicide assessment in a community mental health center. As suicide rates rise in the USA, it is crucial that community mental health providers are capable and comfortable to assess for suicide risk among individuals with mental illness. Support for healthcare providers is emphasized in the quadruple aim model of enhancing healthcare delivery and patient experience. The quadruple aim model is applied in the present performance improvement project in a community mental health center.
Design/methodology/approach
An interprofessional team used provider survey responses, critical incident data and other stakeholder input to implement a new assessment mechanism and education plan to support direct care staff to address suicide risk.
Findings
Although the rate of patient death by suicide at the community mental health center is low, managing risk is a frequent provider concern. Providers’ comfort assessing and managing suicide risk varied widely based on survey responses. A structured suicide assessment process was implemented to offer clarity and direction for providers. Education to address assessment and management was designed and implemented.
Research limitations/implications
Suicide data were retrospective and limited to known deaths, thus there may have been higher numbers of deaths by suicide historically. Providers’ comfort with suicide risk management was based on self-report and future work should also integrate skills-based assessment.
Originality/value
Improving the provider experience in mental health care must be explored. Focusing on provider input and voice in suicide-related efforts in community settings is a step toward integrating the quadruple aim ideals into mental health care.
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Mitchell SM, Taylor NJ, Jahn DR, Roush JF, Brown SL, Ries R, Quinnett P. Suicide-Related Training, Self-Efficacy, and Mental Health Care Providers' Reactions Toward Suicidal Individuals. CRISIS 2020; 41:359-366. [PMID: 31918586 DOI: 10.1027/0227-5910/a000647] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Mental health care providers commonly encounter suicide ideation and suicidal behaviors among their patients despite a frequent lack of adequate knowledge and competence regarding suicide risk management. Aims: This study examined the associations among self-perceived sufficiency of training, self-efficacy, anxiety, and attitudes related to working with suicidal individuals. Method: Participants were 289 mental health care providers who completed a self-report survey. Results: Path analysis results indicated that perceived sufficiency of training was indirectly associated with negative attitudes (i.e., avoidance and discomfort) and cognitive and somatic anxiety about working with suicidal individuals through assessment self-efficacy. Limitations: The current study utilized cross-sectional data, and there were occupational heterogeneity and geographical homogeneity among the mental health care providers sampled. Conclusion: These findings suggest that sufficient suicide-related training focused on risk assessment may decrease mental health professionals' negative and anxious reactions toward suicidal individuals and enhance confidence in suicide risk management.
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Affiliation(s)
- Sean M Mitchell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.,Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Nathanael J Taylor
- Denver Health Medical Center, Adult Psychiatric Inpatient Unit, Denver, CO, USA.,University of Colorado Denver, School of Medicine, Aurora, CO, USA
| | - Danielle R Jahn
- Mental Health Center for Acute Recovery Empowerment, Orlando VA Medical Center, Orlando, FL, USA
| | - Jared F Roush
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Sarah L Brown
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
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Fehling KB, Selby EA. Suicide in DSM-5: Current Evidence for the Proposed Suicide Behavior Disorder and Other Possible Improvements. Front Psychiatry 2020; 11:499980. [PMID: 33613330 PMCID: PMC7891495 DOI: 10.3389/fpsyt.2020.499980] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
Suicide continues to be one of the greatest challenges faced by mental health clinicians and researchers, an issue made worse by increasing trends in the global suicide rate. Suicide behavior disorder (SBD) was introduced in DSM-5 as a disorder for further consideration and potential acceptance into the diagnostic system. There are numerous positive developments that would arise from the addition of a suicide-related diagnosis. Utilizing the 2009 guidelines established by Kendler and colleagues, the present review examines the evidence for SBD's validity and discusses the diagnosis' potential clinical benefits and limitations. Altogether, growing evidence indicates that SBD has preliminary validity and benefit. SBD presents with several significant limitations, however, and possible alternative additions to future DSMs are highlighted.
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Affiliation(s)
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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36
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Boukouvalas E, El-Den S, Murphy AL, Salvador-Carulla L, O'Reilly CL. Exploring Health Care Professionals' Knowledge of, Attitudes Towards, and Confidence in Caring for People at Risk of Suicide: a Systematic Review. Arch Suicide Res 2020; 24:S1-S31. [PMID: 30856366 DOI: 10.1080/13811118.2019.1586608] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Health care professionals are paramount to the prevention and management of suicidal thoughts and behaviors. Confidence in caring for people at risk of suicidal thoughts and behaviors is influenced by knowledge of and attitudes towards suicide. This systematic review aimed to explore health care professionals' knowledge of and attitudes towards suicide, as well as, their confidence in caring for people at risk of suicidal thoughts and behaviors. A systematic search of 4 electronic databases over 10 years was conducted. Following retrieval of 1,723 abstracts, 46 primary research publications were included, involving both cross-sectional (n = 27) and intervention study designs (n = 19). Knowledge of, attitudes towards, and confidence in caring for people at risk of suicidal thoughts and behaviors were explored among primary health care professionals, specialists, and health care students. The influence of training and education, type of health care professional, country of practice, and prior experience with suicide were highlighted among included studies. Health care professionals' knowledge of, attitudes towards and confidence in caring for people at risk of suicide are complex, interrelated constructs that shape their behaviors and may impact patient outcomes. Suicide training and education is necessary within health care curricula and as part of health care professionals' continuing professional development.
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37
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Nugent AC, Ballard ED, Park LT, Zarate CA. Research on the pathophysiology, treatment, and prevention of suicide: practical and ethical issues. BMC Psychiatry 2019; 19:332. [PMID: 31675949 PMCID: PMC6824024 DOI: 10.1186/s12888-019-2301-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/20/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Despite decades of research, the rate of death from suicide is rising in the United States. Suicide is a complex and multifactorial phenomenon and, to date, no validated biomarkers that predict suicidal behavior have been identified. Only one FDA-approved drug to prevent suicide exists, and it is approved only for patients with schizophrenia. Although anti-suicide psychotherapeutic techniques exist, treatment takes time, and only preliminary data exist for rapid-acting therapies. DISCUSSION While more research into suicidal ideation and acute suicidal behavior is clearly needed, this research is fraught with both practical and ethical concerns. As a result, many investigators and bioethicists have called for restrictions on the types of research that individuals with suicidal behavior can participate in, despite the fact that the available empirical evidence suggests that this research can be done safely. This manuscript presents background information on the phenomenology of suicide, discusses the current state of treatment and prevention strategies, and reviews the practical and ethical issues surrounding suicide research in the context of available empirical data. Currently, the causes of suicide are poorly understood, in part due to the fact that very few studies have investigated the acute suicidal crisis. Although some biomarkers for predicting risk have been developed, none have been sufficiently validated. The most successful current interventions involve means restriction. However, while numerous hurdles face researchers, these are not insurmountable. The available evidence suggests that research into suicide can be conducted both safely and ethically.
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Affiliation(s)
- Allison C. Nugent
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,0000 0004 0464 0574grid.416868.5Magnetoencephalography Core Facility, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth D. Ballard
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Lawrence T. Park
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Carlos A. Zarate
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
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Niinomi K, Soejima M, Hiraga K, Kodama S, Okazaki S, Nakao S. Effectiveness of a Volunteer Training Program on the Learning Support of Children in Hospice Palliative Care. Am J Hosp Palliat Care 2019; 37:100-107. [PMID: 31272189 DOI: 10.1177/1049909119860249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Volunteers are expected to play a key role in children's hospice. However, there is a lack of information about how to cultivate effective volunteer training programs. OBJECTIVE To verify the effect of a training program on volunteers' confidence in providing learning support and sharing experiences with children with life-threatening conditions and their families in a children's hospice. METHODS In this pre-post study, participants were 48 undergraduate and graduate students from 3 universities in Japan. They received 5 lectures on children's hospice learning support. They evaluated the training program by rating their self-confidence in meeting each of the 15 program goals on a questionnaire. RESULTS An exploratory factor analysis of the questionnaire yielded 12 goals in 4 factors: understanding of one's own and others' mental state, accommodating the learning needs of children with life-threatening conditions, understanding and accommodating the physical state of children with life-threatening conditions, and understanding the significance of children's hospice. A paired t test revealed that participants' self-confidence had increased significantly in 3 of these 4 factors after the program. However, the score for accommodating the learning needs of children with life-threatening conditions decreased but not significantly. CONCLUSION Although it needs some improvements, the program was effective for improving volunteers' self-confidence in and understanding of learning support and sharing experiences with children with life-threatening conditions.
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Affiliation(s)
| | - Masakazu Soejima
- Graduate School of Health Sciences, Showa University, Tokyo, Japan
| | - Kentaro Hiraga
- Graduate School of Education, Osaka Kyoiku University, Osaka, Japan
| | - Shoko Kodama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | | | - Shigeki Nakao
- School of Education, Kansai University of International Studies, Hyogo, Japan
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39
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Audouard-Marzin Y, Kopp-Bigault C, Scouarnec P, Walter M. General practitioners training about suicide prevention and risk: A systematic review of literature. Presse Med 2019; 48:767-779. [DOI: 10.1016/j.lpm.2019.05.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/25/2018] [Accepted: 05/28/2019] [Indexed: 11/15/2022] Open
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40
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Gryglewicz K, Monahan MF, Chen JI, Bozzay M, Bender A, Gleason LL, Witmeier M, Karver MS. Examining the effects of role play practice in enhancing clinical skills to assess and manage suicide risk. J Ment Health 2019; 29:549-557. [DOI: 10.1080/09638237.2018.1521936] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kim Gryglewicz
- School of Social Work, College of Health Professions & Sciences, University of Central Florida, Orlando, FL, USA
| | | | - Jason I. Chen
- Center to Improve Veteran Involvement in Care, Portland Health Care System, U.S. Department of Veterans Affairs and Oregon Health and Science University, Portland State University School of Public Health, Portland, OR, USA
| | - Melanie Bozzay
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Ansley Bender
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - LaDonna L. Gleason
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Melissa Witmeier
- Florida Council for Community Mental Health, Tallahassee, FL, USA
| | - Marc S. Karver
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Slovak K, Pope N, Giger J, Kheibari A. An Evaluation of the Counseling on Access to Lethal Means (CALM) Training with an Area Agency on Aging. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2019; 62:48-66. [PMID: 30247989 DOI: 10.1080/01634372.2018.1522410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/07/2018] [Indexed: 06/08/2023]
Abstract
Firearms are a significant risk factor in suicide and older adults are disproportionately impacted in suicide by this means. This study investigated the impact of Counseling on Access to Lethal Means (CALM) training with geriatric case managers at an Area Agency on Aging. A concurrent mixed methods approach was used to explore 1) geriatric case managers' attitudes, beliefs, and behavioral intentions about counseling on access to lethal means following CALM training, and 2) perceived barriers to assessing for suicidality and counseling clients on access to firearms. The CALM evaluation data was collected immediately posttest at CALM training, at three-month follow up. Results indicated that 38% of respondents reported they had, since CALM training, discussed reducing access to lethal means with clients and/or families. At three-month follow up, data showed that most beliefs, attitudes, and behavioral intentions about counseling clients and families on this topic increased. Focus group findings indicated that training had a positive effect on participants' attitudes, beliefs, and behavioral intentions about counseling on access to lethal means.The findings of the present study offer additional evidence and implication for trainings of this type.
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Affiliation(s)
- Karen Slovak
- a Social Work , aMalone University , Canton , USA
- b College of Social Work , bUnviversity of Kentucky , Lexington , USA
| | - Natalie Pope
- a Social Work , aMalone University , Canton , USA
- b College of Social Work , bUnviversity of Kentucky , Lexington , USA
| | - Jarod Giger
- a Social Work , aMalone University , Canton , USA
- b College of Social Work , bUnviversity of Kentucky , Lexington , USA
| | - Athena Kheibari
- a Social Work , aMalone University , Canton , USA
- b College of Social Work , bUnviversity of Kentucky , Lexington , USA
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42
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El-Den S, O'Reilly CL, Gardner DM, Murphy AL, Chen TF. Content validation of a questionnaire measuring basic perinatal depression knowledge. Women Health 2018; 59:615-630. [PMID: 30481138 DOI: 10.1080/03630242.2018.1539431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Perinatal depression (PND) screening is encouraged in healthcare settings. We aimed to develop and content validate a basic PND knowledge questionnaire for use among pharmacists and potentially other primary healthcare professionals (HCPs). A six-item questionnaire was developed. Twenty-five perinatal mental health experts were invited to participate in content validation by completing the questionnaire and assessing its content validity. A content validity index (CVI) score above 0.8 was indicative of content validity. Expert comments may inform items' deletion or revision. Between November 2016 and February 2017, ten experts participated. For five out of six items, the CVI score was 0.9 or 1.0. Two experts selected "I think none are correct" for one item regarding the onset of postpartum depression. Comments reflected the lack of consensus in the literature surrounding onset periods and prevalence rates and informed minor modifications to three of six questions and seven of 24 response options. The CVI for the questionnaire was 0.83.Content validation of a questionnaire measuring basic PND knowledge resulted in modifications. Comments about PND onset and prevalence indicated the need for consistency when defining and measuring these constructs. This questionnaire may be used among pharmacists and other HCPs.
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Affiliation(s)
- Sarira El-Den
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
| | - Claire L O'Reilly
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
| | - David M Gardner
- b Department of Psychiatry , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Andrea L Murphy
- c College of Pharmacy, Dalhousie University , Halifax , Nova Scotia , Canada
| | - Timothy F Chen
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
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Should suicide prevention training be required for mental health practitioners? A Colorado, United States case study. J Public Health Policy 2018; 39:424-445. [PMID: 30097612 DOI: 10.1057/s41271-018-0141-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Suicide is a critical public health problem, resulting in more than 40,000 deaths a year in the United States (U.S.) and 800,000 globally. Provision of mental health services is a key component of a comprehensive population-based approach to prevention. State licensing boards in some U.S. states require mental health practitioners to be trained in suicide risk assessment and management, but such requirements are not uniform. Our case study examined mental health practitioner preparedness to engage in suicide prevention and intervention in Colorado, a state with a high suicide rate, using a survey designed to understand training experiences and perceptions of the acceptability of mandated training. Our findings support efforts to require mental health practitioners be trained to prevent suicide.
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Adrian M, Lyon AR, Nicodimos S, Pullmann MD, McCauley E. Enhanced "Train and Hope" for Scalable, Cost-Effective Professional Development in Youth Suicide Prevention. CRISIS 2018; 39:235-246. [DOI: 10.1027/0227-5910/a000489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: The knowledge base surrounding how to most effectively prepare and sustain practitioner knowledge and skills for suicide risk assessment and management is limited. Aims: This study examined the impact of a 6-hr continuing education training, and the effect of a posttraining reminder system, on mental health practitioners' knowledge, attitudes, and behavior surrounding suicide assessment and intervention. Method: Data were obtained prior to the training, immediately after the training, and at the 3-month follow-up. Medical record data were abstracted for a subsample of practitioners. Participants were randomly assigned to an e-mail reminder condition or no reminder condition that provided information related to the training. Results: All practitioners demonstrated increase s in suicide assessment knowledge and attitudes for engaging in suicide risk assessments from pre- to posttest, and gains were maintained at the 3-month follow-up. There was no effect of the e-mail reminder on practitioner knowledge, attitudes, or behaviors compared with the condition without the e-mail reminder. The use of e-mail reminders was not associated with any additional changes. Limitations: Limitations include predominantly self-report and small sample. Conclusion: Strategies to effectively change practitioner knowledge, attitudes, and behaviors toward suicidal clients may include continuing education. Efficient and effective designs of reminder systems for augmenting and supporting suicide assessment management training are needed.
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Affiliation(s)
- Molly Adrian
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, Seattle, WA, USA
| | - Aaron R. Lyon
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Semret Nicodimos
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Michael D. Pullmann
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Elizabeth McCauley
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, Seattle, WA, USA
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Terpstra S, Beekman A, Abbing J, Jaken S, Steendam M, Gilissen R. Suicide prevention gatekeeper training in the Netherlands improves gatekeepers' knowledge of suicide prevention and their confidence to discuss suicidality, an observational study. BMC Public Health 2018; 18:637. [PMID: 29776415 PMCID: PMC5960185 DOI: 10.1186/s12889-018-5512-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background The gatekeeper training is designed to help identify suicidal individuals, respond to suicidal ideation and refer to help. The internationally widely used training shows promising results. This is the first study presenting its effectiveness in the Netherlands and the first study investigating the effect in different employment sectors. Methods In an observational study, 113 Suicide Prevention – the Dutch suicide prevention expertise centre and lifeline - trained 526 professionals as gatekeepers. Changes in gatekeepers’ identifying and referral behaviour, knowledge of suicide prevention and skills-confidence were studied, using a pre-post (6 weeks after training) self-report questionnaire. Outcomes were analyzed with General Linear Model (GLM) repeated measures with four employment sectors (healthcare-, educational-, socioeconomic and other sectors) as a between-subjects factor. Results Pre-post self-reports of 174 respondents showed no change in the identification of suicidal people, referrals to the general practitioner (GP) or lifeline 113, but significant improvement in professionals’ knowledge and confidence (p < .001). Results did not differ between employment sectors. Conclusions The gatekeeper training significantly increases suicide prevention knowledge and skills confidence in abilities to address suicidality. Healthcare, education, socioeconomic and other professionals (e.g. security, justice, transport, church workers) benefit similarly from the training. Increasing the number of gatekeeper training programs in all sectors is recommended. Electronic supplementary material The online version of this article (10.1186/s12889-018-5512-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sanne Terpstra
- Department of Research & Innovation, GGz InGeest, Amsterdam, The Netherlands.
| | - Aartjan Beekman
- Department of Research & Innovation, GGz InGeest, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jens Abbing
- Department of Public and Occupational Health, VU University Medical Centre, Amsterdam, The Netherlands
| | - Sabine Jaken
- 113 Suicide Prevention, Amsterdam, The Netherlands
| | - Martin Steendam
- Department of Psychology, GGz Friesland, Leeuwarden, The Netherlands
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Kene P, Yee ET, Gimmestad KD. Suicide assessment and treatment: Gaps between theory, research, and practice. DEATH STUDIES 2018; 43:164-172. [PMID: 29474113 DOI: 10.1080/07481187.2018.1440034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A considerable body of literature focuses on suicide risk assessment, treatment, and prevention. However, incorporation of these research and theoretical advances in routine care by practitioners has been largely unexamined. We examine the challenges-lack of training, fear, complexities of decision-making, practical barriers, lack of usage of assessment tools, and violations of psychometric principles by assessment tools-that confront practitioners when utilizing advances in the field. Identifying and addressing these barriers has implications to help bridge the gaps between theory, research, and practice to improve quality of care. Clinical, training, policy implications, and future research directions are reviewed.
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Affiliation(s)
- Prachi Kene
- a Rhode Island College, Department of Counseling , Educational Leadership, and School Psychology, Providence , RI , USA
| | - Elena T Yee
- a Rhode Island College, Department of Counseling , Educational Leadership, and School Psychology, Providence , RI , USA
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Fullerton M, Edbrooke-Childs J, Law D, Martin K, Whelan I, Wolpert M. Using patient-reported outcome measures to improve service effectiveness for supervisors: a mixed-methods evaluation of supervisors' attitudes and self-efficacy after training to use outcome measures in child mental health. Child Adolesc Ment Health 2018; 23:34-40. [PMID: 32677366 DOI: 10.1111/camh.12206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are recommended by healthcare systems internationally, but there are a number of barriers to implementation. The aim of this research was to examine the impact of training supervisors in using PROMs on clinical practice, given the importance of leadership when changing behaviour. METHOD Data included pre-post questionnaires from 42 supervisors, interviews after training with six supervisees and nonparticipant observations of nine video-recorded supervision sessions. RESULTS After training, supervisors had more positive attitudes to administering PROMs and using feedback from PROMs and had higher levels of self-efficacy about using PROMs in supervision. CONCLUSIONS Findings are in line with the growing body of evidence that training child mental health staff to use PROMs may be associated with changes in attitudes, self-efficacy and use of PROMs.
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Affiliation(s)
- Mary Fullerton
- East Haringey IAPT, Whittington Health NHS Trust, London, UK
| | - Julian Edbrooke-Childs
- Evidence Based Practice Unit, UCL and the Anna Freud Centre, 12 Maresfield Gardens, London, NW3 5SU, UK
| | | | | | - Isabelle Whelan
- Evidence Based Practice Unit, UCL and the Anna Freud Centre, 12 Maresfield Gardens, London, NW3 5SU, UK
| | - Miranda Wolpert
- Evidence Based Practice Unit, UCL and the Anna Freud Centre, 12 Maresfield Gardens, London, NW3 5SU, UK
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Blanco-Vieira T, Ramos FADC, Lauridsen-Ribeiro E, Ribeiro MVV, Meireles EA, Nóbrega BA, Motta Palma SM, Ratto MDF, Caetano SC, Ribeiro WS, Rosário MCD. A Guide for Planning and Implementing Successful Mental Health Educational Programs. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2018; 38:126-136. [PMID: 29851717 DOI: 10.1097/ceh.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. METHODS The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. RESULTS We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. IMPLICATIONS FOR PRACTICE These results will be helpful for planning and improving the quality of future educational programs in mental health.
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Affiliation(s)
- Thiago Blanco-Vieira
- Dr. Blanco-Vieira: Child Psychiatrist, Post Graduation Student, Department of Psychiatry, UNIFESP, and Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), Federal University of São Paulo (UNIFESP), São Paulo, Brazil. Dr. Ramos: Child Psychiatrist, Coordinator of Rio de Janeiro Mental Health School (ESAM), Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Lauridsen-Ribeiro: Pediatrician, Child Psychiatrist, Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Vieira Ribeiro: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Meireles: Psychologist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), UNIFESP, São Paulo, Brazil. Dr. Nóbrega: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Palma: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Ratto: Psychologist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Caetano: Associate Professor, Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), and Professor of the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Ribeiro: Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom. Dr. Rosário: Associate Professor, Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), and Coordinator of the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil
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Ferguson MS, Reis JA, Rabbetts L, Ashby HJ, Bayes M, McCracken T, Ross C, Procter NG. The Effectiveness of Suicide Prevention Education Programs for Nurses. CRISIS 2017; 39:96-109. [PMID: 28990823 DOI: 10.1027/0227-5910/a000479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Education to improve health professionals' responses to suicide is considered an important suicide prevention strategy. However, the effectiveness of this approach for nurses is unclear. AIM To systematically review the peer-reviewed literature regarding the effectiveness of suicide prevention education programs for nurses. METHOD Nine academic databases (CINAHL, Cochrane Reviews & Trials, Embase, Informit Health Collection, Joanna Briggs Institute, Medline, PsycINFO, Scopus, and Web of Science) were searched in November 2016, utilizing search terms related to suicide, education, and nurses, with no limits placed on publication date or study design. RESULTS The search yielded 5,456 identified articles, 11 of which met the inclusion criteria. Studies were primarily quantitative (RCTs n = 3; quasi-experimental n = 6; qualitative n = 2), and involved nurses (range = 16-561) working in a diversity of settings, particularly hospitals (n = 9). Studies revealed positive changes in nurses' competence, knowledge, and attitudes associated with training over the short term. LIMITATIONS The heterogeneity of education programs and methodological weaknesses of included studies limit the conclusions drawn. CONCLUSION There is a moderate body of evidence to support the effectiveness of suicide prevention education programs for nurses. Future research should examine longer-term changes in clinical practice and strategies for continuing education, with more rigorous study designs.
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Affiliation(s)
- Monika S Ferguson
- 1 School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
| | - Julie A Reis
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Lyn Rabbetts
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Heather-Jean Ashby
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Miriam Bayes
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Tara McCracken
- 2 School of Nursing and Midwifery, University of South Australia, Mount Gambier, SA, Australia
| | - Christine Ross
- 3 Mount Gambier and District Health Service, Mount Gambier, SA, Australia
| | - Nicholas G Procter
- 1 School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
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50
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Chu C, Van Orden KA, Ribeiro JD, Joiner TE. Does the timing of suicide risk assessments influence ratings of risk severity? PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE 2017; 48:107-114. [PMID: 28943713 DOI: 10.1037/pro0000130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Clinicians are often tasked with identifying and managing patients who are at risk for suicide. Therefore, greater understanding of factors that impact the efficacy of suicide risk assessments (SRA) are of critical importance. One potential factor that may affect assessments of risk severity is the timing of the evaluation during clinical interview. Given that some patients are reluctant to disclose suicide-related symptoms, it is possible that asking about suicide at the beginning of an interview elicits more false negatives. It is also possible that if risk assessments are conducted in a manner that is encouraging to the patient, timing does not significantly impact patient report. This study examined whether SRA timing within an initial intake interview affects risk severity ratings. Adult psychiatric outpatients (N=169) were randomly assigned to receive a SRA during the beginning or middle of a one-hour intake. We failed to find a significant difference in suicide risk ratings between those who were evaluated at the beginning as compared to the middle of intake (14% versus 15% rated at elevated risk). Findings were not moderated by age, gender, or attempt history. Our results provide preliminary evidence that the timing of SRA may not impact risk severity ratings.
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Affiliation(s)
- Carol Chu
- Department of Psychology, Florida State University, Tallahassee, Florida 32306
| | - Kimberly A Van Orden
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14652
| | - Jessica D Ribeiro
- Department of Psychology, Florida State University, Tallahassee, Florida 32306
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida 32306
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