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Sela Y, Levi-Belz Y. Nurses' Attitudes and Perceptions Regarding Suicidal Patients: A Quasi-Experimental Study of Depression Management Training. Healthcare (Basel) 2024; 12:284. [PMID: 38338169 PMCID: PMC10855615 DOI: 10.3390/healthcare12030284] [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: 12/06/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
Suicide prevention is a priority globally. Community nurses are on the frontline of healthcare, and thus well placed to identify those at risk of suicide and act to prevent it. However, they are often ill-equipped to do so. This study examines whether depression management training for nurses may also help them manage suicide-risk patients. METHOD This quasi-experimental study used a questionnaire that included a randomly assigned textual case vignette, measures related to patient descriptions portrayed in the vignette, and demographic and clinical/training information. The participants were 139 Israeli nurses who were mostly Jewish, Israeli-born, and married women working as community nurses. Almost half had completed depression management training (DMT) in their routine work. RESULTS Nurses who completed depression management training were more likely than non-trainees to query the patient regarding mental status and suicide plans and were more likely to refer them to appropriate further treatment. The graduate nurses also reported higher self-competence and more positive attitudes regarding their ability to assess depression and suicide risk than nurses who had not received depression management training. DISCUSSION The results highlight the importance of depression management training, as suicide assessment and referral are among the major steps to suicide prevention.
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Affiliation(s)
- Yael Sela
- Ruppin Academic Center, Emek Hefer 4025000, Israel;
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2
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Ng R, O'Reilly CL, Collins JC, Roennfeldt H, McMillan SS, Wheeler AJ, El-Den S. Mental Health First Aid crisis role-plays between pharmacists and simulated patients with lived experience: a thematic analysis of debrief. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1365-1373. [PMID: 36928545 PMCID: PMC10423112 DOI: 10.1007/s00127-023-02443-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Healthcare professionals, including pharmacists, can recognise and assist people experiencing mental health crises. Despite this, little is known about how pharmacists assist and engage with people presenting with signs and symptoms of mental health crises. This study aimed to (i) examine pharmacists' mental health crisis assessment language during simulated patient role-plays (SPRPs) and (ii) explore participants' experiences of participating in SPRPs of Mental Health First Aid (MHFA) scenarios. METHODS Fifty-nine MHFA-trained pharmacy staff participated in audio-recorded SPRPs of three crisis scenarios enacted by a mental health consumer educator (MHCE). Post-SPRP, pharmacy staff members (including role-playing and observing participants), engaged in reflective debrief discussions with the facilitator and MHCEs. Debrief discussions were transcribed verbatim and analysed using inductive thematic analysis and suicide assessment language was explored. RESULTS The majority of role-playing pharmacists asked about suicidal ideation using appropriate, direct language (n = 8). Qualitative analyses of debrief discussions yielded four themes: (i) Relationship with the consumer, (ii) Verbal and non-verbal communication, (iii) Challenges with crisis assessment, which included difficulties associated with initiating conversations about suicide and mania, and (iv) Reflective learning. CONCLUSION While pharmacists demonstrated the appropriate suicide assessment language post-MHFA training, pharmacists felt uncomfortable initiating conversations around suicide and lacked confidence during crisis assessments. SPRPs provided pharmacists with opportunities to reflect on and practice MHFA skills in a safe learning environment. Future research exploring how MHFA training and SPRPs impact pharmacists' ability to provide MHFA in real-world settings is warranted.
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Affiliation(s)
- Ricki Ng
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia.
| | - Claire L O'Reilly
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Jack C Collins
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Helena Roennfeldt
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sarira El-Den
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
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3
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Whitaker-Brown C, Cornelius JB, Smoot J, Khadka A, Patil A. Statewide Assessment of North Carolina Nurse Practitioners' Knowledge of and Attitudes Toward Suicide Awareness and Prevention: Protocol for a Statewide Mixed Methods Study. JMIR Res Protoc 2023; 12:e39675. [PMID: 36881461 PMCID: PMC10031437 DOI: 10.2196/39675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Suicide is a major public health problem, which affects people of all ages and ethnicities. Despite being preventable, the rates of suicide have steadily climbed (more than a third) over the past 2 decades. OBJECTIVE Nurse practitioners (NPs) must be responsible for recognizing suicide risk and providing appropriate treatment referrals in addition to having an important role in suicide prevention. The reasons why NPs may not pursue suicide prevention training are their lack of suicide awareness and prevention, limited experiences with suicidal patients, and the stigma associated with mental illness. Before we begin to address the gaps within suicide awareness and prevention skills, we need to first examine NPs' knowledge of and attitudes (stigma) toward suicide prevention. METHODS This study will comprise a mixed methods approach. First, quantitative data will be collected using the Suicide Knowledge and Skills Questionnaireand the Suicide Stigma Scale (Brief version) questionnaire. An email will be sent to the NPs explaining the purpose of the study. If they consent, they will click on a link to access the surveys on a secure site. In our previous research with this sample, email reminders to nonresponders after 2 and 4 weeks were sent. The quantitative component will be used to inform the qualitative interviews of this study. The Suicide Knowledge and Skills Questionnaire is a 13-item questionnaire comprising 2 subscales: suicide knowledge and suicide skills. All questions are rated on a 5-point Likert scale (1=completely disagree to 5=completely agree). The survey has been shown to differentiate between those with suicide training and those without and has a Cronbach α score of .84. The Suicide Stigma Scale (Brief version) is a 16-item survey that assesses stigma regarding suicide. The items are measured on a 5-point Likert scale (1: strongly disagree to 5: strongly agree) and have a Cronbach α of .98. RESULTS This study was funded by the Faculty Research Grants program through the Office of the Vice Chancellor for Research and Economic Development at the University of North Carolina at Charlotte. Institutional review board approval was obtained in April 2022. Recruitment occurred between summer and winter 2022. Interview conduction began in December 2022 and will conclude in March 2023. Data will be analyzed during spring and summer 2023. CONCLUSIONS The study results will add to the literature on NPs' knowledge of and attitudes (stigma) toward suicide prevention. It represents a first step in addressing gaps within suicide awareness and prevention skills, among NPs in their respective practice settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/39675.
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Affiliation(s)
- Charlene Whitaker-Brown
- School of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Judith Bacchus Cornelius
- School of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Jaleesa Smoot
- Department of Public Health, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Anjala Khadka
- Department of Public Health, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Arundhati Patil
- William States Lee College of Engineering, University of North Carolina at Charlotte, Charlotte, NC, United States
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4
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Muehlenkamp JJ, Grande N, Talbott M. Evidence-Based vs Informal Suicide Training: Nurse Confidence and Comfort With Suicidal Patient Care. J Emerg Nurs 2023; 49:266-274. [PMID: 36599734 DOI: 10.1016/j.jen.2022.12.003] [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: 08/11/2022] [Revised: 11/08/2022] [Accepted: 12/04/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Emergency nurses are on the front line of patient care for suicidal persons, yet many nurses report feeling unprepared to effectively manage suicidal patients owing to a lack of suicide-specific training. The purpose of this study was to examine the suicide-specific training experiences of emergency nurses and evaluate how training relates to burnout, confidence, and comfort working with suicidal patients. METHODS Emergency nurses at critical access and community hospitals completed an anonymous online survey during work hours. The survey included questions about training experiences, burnout, confidence, and comfort working with suicidal patients, perceptions of the quality and interactive nature of training, and desires for future suicide-specific intervention training. RESULTS Group comparisons among the 117 emergency nurses revealed that those who received evidence-based/expert-delivered training reported greater confidence, comfort, and perceived ability to treat suicidal patients and lower burnout than those who received informal or no training. Those with informal training reported greater confidence and ability to treat suicidal patients, but similar levels of comfort and burnout as those with no training. Mediation analyses showed that training was associated with greater comfort working with suicidal patients through its effect on increased confidence. A majority desired additional suicide-specific training. DISCUSSION Evidence-based/expert-delivered professional training in suicide intervention is associated with improved confidence, comfort, and perceived ability to care for suicidal patients and lower burnout. Providing evidence-based suicide intervention training may improve quality of care for suicidal patients by improving emergency nurse confidence and comfort for treating these high-risk patients.
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Stuber J, Massey A, Payn B, Porter S, Ratzliff A. Training Health Care Professionals in Suicide Assessment, Management, and Treatment. Psychiatr Serv 2023; 74:88-91. [PMID: 35734862 DOI: 10.1176/appi.ps.202100571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Washington was the first state to require all licensed general medical and behavioral health care professionals (HCPs) to complete training in suicide assessment, management, and treatment. Results from pretest and posttest surveys of 873 HCPs participating in All Patients Safe, a 6-hour online training course, are presented. Improvements in knowledge and attitudes about suicide and confidence in treating at-risk individuals were observed, demonstrating the effectiveness of delivering large-scale training to HCPs to fulfill state requirements. Future work should examine the impact of training on clinical practices and the role of training in improving patient care.
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Affiliation(s)
- Jennifer Stuber
- School of Social Work (Stuber, Porter) and School of Public Health (Massey), University of Washington, Seattle; Advancing Integrated Mental Health Solutions Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Payn, Ratzliff)
| | - Anne Massey
- School of Social Work (Stuber, Porter) and School of Public Health (Massey), University of Washington, Seattle; Advancing Integrated Mental Health Solutions Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Payn, Ratzliff)
| | - Betsy Payn
- School of Social Work (Stuber, Porter) and School of Public Health (Massey), University of Washington, Seattle; Advancing Integrated Mental Health Solutions Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Payn, Ratzliff)
| | - Sarah Porter
- School of Social Work (Stuber, Porter) and School of Public Health (Massey), University of Washington, Seattle; Advancing Integrated Mental Health Solutions Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Payn, Ratzliff)
| | - Anna Ratzliff
- School of Social Work (Stuber, Porter) and School of Public Health (Massey), University of Washington, Seattle; Advancing Integrated Mental Health Solutions Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Payn, Ratzliff)
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Hill NTM, Woolard A, Perry Y, Lin A. The role of health professionals in suicide prevention in young people. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:513-515. [PMID: 35597244 DOI: 10.1016/s2352-4642(22)00156-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Nicole T M Hill
- Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, Nedlands, WA 6005, Australia.
| | - Alix Woolard
- Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, Nedlands, WA 6005, Australia
| | - Yael Perry
- Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, Nedlands, WA 6005, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, Nedlands, WA 6005, Australia
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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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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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Laliberte AZ, Roth B, Edwards B, Chen JI. Suicide Screening and Risk Assessment in the Emergency Department: Case Review of a Suicide Attempt Survivor. J Emerg Nurs 2021; 47:846-851. [PMID: 34479740 DOI: 10.1016/j.jen.2021.07.010] [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: 04/21/2021] [Revised: 06/17/2021] [Accepted: 07/23/2021] [Indexed: 11/25/2022]
Abstract
One in 10 of those who die by suicide are seen in an emergency department within the 2 months before their death. Despite national guidelines and resources (including from the Joint Commission and Emergency Nurses Association) for suicide screening, risk assessment, and follow-up care, suicidal ideation and behavior continue to go undetected in emergency departments, leading to gaps in care. This case review was conducted as part of a larger electronic medical record review of emergency department practices and aims to highlight potential gaps in care and identify missed opportunities for suicide screening and risk assessment. In addition to highlighting these missed opportunities, this case review provides recommendations for suicide screening and risk assessment resources with options for evidence-based follow-up care for suicidal patients.
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Mughal F, Gorton HC, Michail M, Robinson J, Saini P. Suicide Prevention in Primary Care. CRISIS 2021; 42:241-246. [PMID: 34184574 DOI: 10.1027/0227-5910/a000817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Faraz Mughal
- School of Medicine, Keele University, Staffordshire, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, UK.,Unit of Academic Primary Care, University of Warwick, Coventry, UK
| | | | - Maria Michail
- Institute for Mental Health, School of Psychology, University of Birmingham, UK
| | - Jo Robinson
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Pooja Saini
- Faculty of Health, School of Psychology, Liverpool John Moores University, UK
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Labouliere CD, Green K, Vasan P, Cummings A, Layman D, Kammer J, Rahman M, Brown G, Finnerty M, Stanley B. Is the outpatient mental health workforce ready to save lives? Suicide prevention training, knowledge, self-efficacy, and clinical practices prior to the implementation of a statewide suicide prevention initiative. Suicide Life Threat Behav 2021; 51:325-333. [PMID: 33876486 PMCID: PMC9362777 DOI: 10.1111/sltb.12708] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Many public health approaches to suicide prevention emphasize connecting at-risk individuals to professional treatment. However, it is unclear to what degree the outpatient mental health workforce has the requisite knowledge and skills to provide the evidence-based care needed to help those at risk. In this project, prior to the implementation of a statewide suicide prevention initiative, we assessed the baseline suicide prevention training and clinical practices of the New York State outpatient mental health workforce, a group likely representative of the broader U.S. clinical workforce. METHOD A workforce survey of suicide prevention training and clinical practices was administered to 2,257 outpatient clinicians, representing 169 clinics serving approximately 90,000 clients. Clinicians were asked to complete the survey online, and all responses were confidential. RESULTS Clinicians reported substantial gaps in their suicide prevention knowledge and training. The vast majority reported moderate self-efficacy working with suicidal clients and endorsed using evidence-based assessment procedures, but varied in utilization of recommended intervention practices. CONCLUSIONS This study highlights gaps in clinicians' training and clinical practices that need to be overcome to provide evidence-based suicide care. Promisingly, positive associations were found between training and clinician knowledge, self-efficacy, and use of evidence-based practices.
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Affiliation(s)
- Christa D. Labouliere
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons;,New York State Psychiatric Institute
| | - Kelly Green
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Prabu Vasan
- New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science
| | - Anni Cummings
- New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science
| | - Deborah Layman
- New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science
| | - Jamie Kammer
- New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science
| | - Mahfuza Rahman
- New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science
| | - Gregory Brown
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Molly Finnerty
- New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science;,Department of Child & Adolescent Psychiatry, New York University Langone Medical Center
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons;,New York State Psychiatric Institute
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Carpenter DM, Roberts CA, Lavigne JE, Cross WF. Gatekeeper training needs of community pharmacy staff. Suicide Life Threat Behav 2021; 51:220-228. [PMID: 33876495 DOI: 10.1111/sltb.12697] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To develop an online suicide prevention gatekeeper training program to prepare community pharmacy staff to communicate with patients who exhibit warning signs of suicide. METHOD A convenience sample of 17 community pharmacy staff members completed a 1-hr semi-structured interview during which they viewed content from an existing gatekeeper training program and provided suggestions for improvement. Once thematic saturation was achieved, interviews were digitally recorded, transcribed, and analyzed by two independent coders who reached consensus on the themes present in each transcript. RESULTS Participants noted barriers to communicating about suicide, including lack of time and privacy, discomfort with using the word "suicide" and limited referral options. Participants wanted gatekeeper training to include local suicide prevention referral resources, take less than 30 min to complete, and incorporate 3-4 realistic role play scenarios, including a phone interaction. CONCLUSIONS Many environmental, interpersonal, and individual-level barriers complicate pharmacy staff members' ability to act as gatekeepers and communicate about suicide with at-risk patients. To maximize the public health impact of pharmacy staff, skills-based training on how to identify, communicate with, and refer at-risk patients is needed. Gatekeeper training should model brief, realistic interactions with patients and provide pharmacy staff with local referral resources.
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Affiliation(s)
- Delesha M Carpenter
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Asheville, NC, USA
| | - Courtney A Roberts
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Asheville, NC, USA
| | - Jill E Lavigne
- Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, US Department of Veterans Health Affairs, Canandaigua, NY, USA.,Wegmans School of Pharmacy, St John Fisher College, Rochester, NY, USA
| | - Wendi F Cross
- Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, US Department of Veterans Health Affairs, Canandaigua, NY, USA.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
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13
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Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals: A scoping review. Int J Nurs Sci 2020; 7:477-483. [PMID: 33195761 PMCID: PMC7644556 DOI: 10.1016/j.ijnss.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/03/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background Inpatient suicide is an important part of patient safety management in general hospitals. Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy. To enhance health personnel’s inpatient suicide prevention strategy, education intervention is a common method. Educational interventions in the researches varied in contents, duration and outcome measurements. However, there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention. Objective Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals. Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions. Educational interventions in researches varied in contents, duration and outcome measurements. We aimed to review education interventions targeting health personnel on inpatient suicide prevention. Methods A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals. Cochrane Library, PubMed, Embase, CINAHL, China National Knowledge Infrastructure, WanFang, and Chinese Scientific Journal Database were searched in Oct 2019. According to the inclusion and exclusion criteria, the searched studies were screened by two reviewers. And then, two researchers conducted the data extraction independently by using a table format, including the first author, year of publication, study design, participants, education intervention, etc. Results Twelve studies were included in this scoping review. The contents of education interventions on inpatient suicide prevention included three aspects: suicide knowledge, suicide assessment, and skills for coping with suicide. The duration of education interventions ranged from 1.5-h to 32.0-h. The effects of education interventions were mainly focused on participants’ knowledge, attitudes and skills of suicide prevention. Conclusion The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge, attitude and skills about inpatient suicide prevention in general hospitals. However, the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined. In the future, it is necessary to combine evidence in this review and the actual condition in clinical practice.
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14
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Gabilondo A. [Suicide prevention, review of the WHO model and reflection on its development in Spain. SESPAS Report 2020]. GACETA SANITARIA 2020; 34 Suppl 1:27-33. [PMID: 32674862 DOI: 10.1016/j.gaceta.2020.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 10/23/2022]
Abstract
In recent years, awareness of the impact of suicidal behavior on our society has been increasing, as well as the interest in measures aimed at preventing it or reducing the damage caused. Having the multidisciplinary suicide prevention model promoted by the World Health Organization as a road map, this article makes a non-exhaustive review of the evidence behind the different types of intervention within the model, reviews some outstanding initiatives and reflect on the development of this model in our country. Websites of biomedical databases, institutions and reference documentation centers in suicide prevention have been consulted, identifying and reviewing technical reports and systematic review articles published since 2010. Numerous knowledge gaps have been identified. The evidence seems to be more solid and contrasted in favor of health-type interventions with patients at risk (indicated prevention), although this approach would be insufficient to face the phenomenon. Relatively recent and promising evidence shows the potential of other forms of prevention, particularly multidisciplinary models that incorporate action on vulnerable groups in the community and throughout society (selective and universal prevention), and that would be more in line with the complex and multifactorial nature of suicide. The application of these models is still very scarce in our country, in which the healthcare-health model has predominated. It would be convenient to give greater prominence to public health professionals in order to promote the development of these approaches, with which they are more used to working.
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Affiliation(s)
- Andrea Gabilondo
- Red de Salud Mental de Gipuzkoa, Osakidetza; Centro de Investigación Biomédica Biodonostia, San Sebastián, España.
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McDevitt D, McDevitt MF. Behind the shield: Promoting mental health for law enforcement personnel. Nursing 2020; 50:62-65. [PMID: 32453157 DOI: 10.1097/01.nurse.0000662332.48712.6d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Diane McDevitt
- Diane McDevitt is an associate professor at Kingsborough Community College in Brooklyn, N.Y., and assistant director of nursing at Richmond University Medical Center in Staten Island, N.Y. Meaghan Fiona McDevitt is an RN in the ED at Richmond University Medical Center
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DeCou CR, Stuber J, Payn B, Ratzliff A. Clinicians' knowledge of suicide-specific practices in two large healthcare systems in Washington. Gen Hosp Psychiatry 2020; 64:121-122. [PMID: 31744634 DOI: 10.1016/j.genhosppsych.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Christopher R DeCou
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, United States of America; Department of Social Work, University of Washington School of Social Work, United States of America; Forefront Suicide Prevention, University of Washington, United States of America.
| | - Jennifer Stuber
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, United States of America; Department of Social Work, University of Washington School of Social Work, United States of America; Forefront Suicide Prevention, University of Washington, United States of America
| | - Betsy Payn
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, United States of America; Department of Social Work, University of Washington School of Social Work, United States of America; Forefront Suicide Prevention, University of Washington, United States of America
| | - Anna Ratzliff
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, United States of America; Department of Social Work, University of Washington School of Social Work, United States of America; Forefront Suicide Prevention, University of Washington, United States of America
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Wittink MN, Levandowski BA, Funderburk JS, Chelenza M, Wood JR, Pigeon WR. Team-based suicide prevention: lessons learned from early adopters of collaborative care. J Interprof Care 2019; 34:400-406. [PMID: 31852272 DOI: 10.1080/13561820.2019.1697213] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Suicide prevention in clinical settings requires coordination among multiple clinicians with expertise in different disciplines. We aimed to understand the benefits and challenges of a team approach to suicide prevention in primary care, with a particular focus on Veterans. The Veterans Health Administration has both a vested interest in preventing suicide and it has rapidly and systematically adopted team-based approaches for primary care interventions, including suicide prevention. We conducted eight focus groups and eight in-depth interviews with primary care providers (PCPs), behavioral health providers and nurses located in six regions within one Veterans Administration Catchment Area in the northeast of the US. Transcripts were analyzed using simultaneous deductive and inductive content analysis. Findings revealed that different clinicians were thought to have particular expertise and roles. Nurses were recognized as being well positioned to identify subtle changes in patient behavior that could put patients at risk for suicide; behavioral health providers were recognized for their skill in suicide risk assessment; and PCPs were felt to be an integral conduit between needed services and treatment. Our findings suggest that clinician role-differentiation may be an important by-product of team-based suicide prevention efforts in VHA settings. We contextualize our findings within both a processual and relational interprofessional framework and discuss implications for the implementation of team-based suicide prevention.
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Affiliation(s)
- Marsha N Wittink
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY, USA.,Department of Family Medicine, University of Rochester School of Medicine, Rochester, NY, USA
| | - Brooke A Levandowski
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine, Rochester, NY, USA
| | - Jennifer S Funderburk
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY, USA.,VA Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, Syracuse, NY, USA.,Center of Excellence for Suicide Prevention, Canandaigua Veterans Affairs Medical Center, Canandaigua, NY, USA
| | - Melanie Chelenza
- Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA
| | - Jane R Wood
- Rochester Calkins Veterans Administration Clinic, Rochester, NY, USA
| | - Wilfred R Pigeon
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY, USA.,Center of Excellence for Suicide Prevention, Canandaigua Veterans Affairs Medical Center, Canandaigua, NY, USA.,Department of Public Health Sciences, University of Rochester School of Medicine, Rochester, NY, USA
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Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide. Res Social Adm Pharm 2019; 16:349-359. [PMID: 31182418 DOI: 10.1016/j.sapharm.2019.05.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Little is known about community pharmacy staff members' interactions with patients at risk of suicide. OBJECTIVES To: 1) develop a measure to assess the frequency with which pharmacy staff encounter patients with suicide risk factors and warning signs; 2) to assess the measure's validity and reliability; and 3) describe pharmacy staff members' interactions with at-risk patients and their suicide prevention training preferences. METHODS A convenience sample of 501 community pharmacy staff members who worked in North Carolina completed an anonymous online survey. A 10-item measure (the Pharmacy Suicide Interaction Scale (PSIS)) assessed how often respondents encountered patients with suicide risk factors or warning signs, and one open-ended question elicited barriers to interacting with these patients. Psychometric analyses, including an exploratory factor analysis, were performed to examine the validity and reliability of the PSIS. Descriptive statistics were calculated, and responses to open-ended questions were analyzed thematically. RESULTS The PSIS possessed two factors (or subscales): a non-verbal suicide warning signs and risk factors subscale (Cronbach's alpha = 0.79) and a verbal warning signs subscale (Cronbach's alpha = 0.67). Respondents who knew a patient who had died by suicide had higher mean scores on the non-verbal and verbal subscales, indicating that the PSIS had construct validity. Many respondents (22.4%) knew a patient who died by suicide, and 21.6% of respondents had patients request a lethal dose of medication. Interactions occurred both face-to-face and over the phone, and respondents most commonly reacted to patients by contacting others or offering emotional support. Few respondents (8.8%) had suicide prevention training or resources, but most (89.6%) desired additional training. CONCLUSION Many community pharmacy staff members have interacted with patients who exhibited suicide warning signs or died by suicide. Suicide prevention training may help prepare pharmacy staff to recognize, communicate with, and refer at-risk patients.
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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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