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Vatne ME, Lohne V, Nåden D. "You get tired of remaining in a state of fear"- professionals' experiences of self-care facing suicidality in psychiatric wards. Int J Qual Stud Health Well-being 2024; 19:2292184. [PMID: 38112269 DOI: 10.1080/17482631.2023.2292184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
AIM The aim of this study is to explore mental healthcare professionals (MHCPs) experiences related to own emotions when encountering patients at risk of suicide in psychiatric wards and their family members. METHODOLOGY AND METHODS, PARTICIPANTS AND RESEARCH CONTEXT This study has a qualitative explorative design. Data consist of texts from twelve in-depth interviews with MHCPs belonging to six units in two psychiatric wards. Data were interpreted using a hermeneutical approach based on Gadamer's philosophical hermeneutics. FINDINGS Through an interpretation process, three themes emerged: Enduring own emotions, Balancing emotional engagement and the need to rest, and Being together in the community of colleagues. CONCLUSION This study shows the importance of being aware of own anxiety facing suicidality. MHCPs have to work emotionally and cognitively so that care is not guided by anxiety but by collaboration with the patient and his family members. The study highlights the need for a culture in the mental health service in which the MHCP can reflect on own emotional reactions and thoughts in a collegial environment characterized by openness, generosity and collaboration.
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Affiliation(s)
- May Elise Vatne
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
| | - Vibeke Lohne
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
| | - Dagfinn Nåden
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
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2
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Lascelles KM, Davey Z, Jackson D, Aveyard H. Experiences and needs of adult informal carers of adults at risk of suicide: A systematic review with mixed methods analysis. J Adv Nurs 2024; 80:1686-1718. [PMID: 38010822 DOI: 10.1111/jan.15940] [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: 03/24/2023] [Revised: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]
Abstract
AIM To systematically review and synthesize primary research on experiences and needs of adult informal caregivers of adults at risk of suicide. DESIGN Systematic review with a data-based convergent synthesis. DATA SOURCES MEDLINE, PsychINFO and CINAHL were searched in April 2022 and February 2023. English language research focusing on experiences of adult carers of adults was included. METHODS Articles were screened by title (n = 9077) and abstract (n = 132) with additional articles (n = 6) obtained via citation and hand searching. Thirty-one included studies were quality assessed using the Mixed Methods Appraisal Tool and study data were systematically extracted prior to thematic synthesis. RESULTS Five interconnected themes resulted: transitions; living with fear and uncertainty; changing relationships; interface with healthcare professionals and services; what carers need and want. Caring impacts mental, physical and social wellbeing. Relationships are affected in ways which might not be evident when caring for a minor. Repeated suicidal behaviour is particularly challenging with ongoing hypervigilance contributing to burden, burnout and interpersonal strain. Poor carer support exacerbates negative effects; carers need to feel informed, educated, involved and holistically supported. CONCLUSION Timely support for carers is essential. Interventions should address emotional responses, relational changes and effective care recipient support. Longitudinal research is required to understand effects of ongoing caring where there are multiple suicide attempts. IMPLICATIONS Nurses can provide carers with early support and information and longer term psychosocial interventions. If carers are adequately equipped and supported patient safety and wellbeing will be improved. IMPACT Findings of this systematic review include relational changes due to carer hypervigilance reducing autonomy and living with the possibility of suicide. Clinician awareness of the potential for relational shifts will help them prepare and support carers. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
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Affiliation(s)
| | - Zoe Davey
- Oxford Institute of Nursing Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Debra Jackson
- University of Sydney, Sydney, New South Wales, Australia
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3
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Hennipman-Herweijer C, Amerongen-Meeuse JVN, Schaap-Jonker H, Boonstra N. The experiences of living with a suicidal family member, and the impact on daily life: A systematic review and meta-aggregation. J Psychiatr Ment Health Nurs 2024. [PMID: 38470095 DOI: 10.1111/jpm.13045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/22/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Because of the pivotal role that family members play in caring for their suicidal relative, insight into their experiences is necessary to develop good support for them. AIM This systematic review aimed to aggregate qualitative research examining the experiences of family members living with their suicidal relative, and their impact on daily life. METHODS Systematic searches, covering the period 2000-2022, were conducted in Medline, Embase, PsycINFO, Ovid Nursing database and CINAHL. The JBI-QARI meta-aggregation approach and the PRISMA guidelines were followed. RESULTS Eleven studies met the inclusion criteria. Six themes were identified: The hard job of managing the risk of suicide; contributing to the relative's survival; struggling with professional care; being in a lonely position; pressure on relationships; and disruption of well-being. DISCUSSION The constant worry of losing their relative and ever-present vigilance dominates their lives in such a way that their well-being may be decreased. Professionals often overlook family members, which leads to feelings of powerlessness and loneliness. IMPLICATIONS FOR PRACTICE Collaborating with families in treatment, allowing them to share information and supporting them in the care at home may lead to better outcomes for both the family and their suicidal relative.
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Affiliation(s)
- Christina Hennipman-Herweijer
- Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop, Hoevelaken, The Netherlands
- Eleos Mental Health Care, Bosch en Duin, The Netherlands
- Nursing Sciences, Program in Clinical Health Sciences, Utrecht University, Utrecht, The Netherlands
| | - Joke van Nieuw Amerongen-Meeuse
- Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop, Hoevelaken, The Netherlands
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Hanneke Schaap-Jonker
- Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop, Hoevelaken, The Netherlands
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Nynke Boonstra
- Nursing Science in Mental Health Care, UMC Utrecht, Utrecht, The Netherlands
- NHL Stenden University of Applied Science, Leeuwarden, The Netherlands
- KieN Early Intervention Service, Leeuwarden, The Netherlands
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4
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Maple M, Wayland S, Sanford RL, Bhullar N. Predictors of Caregiver Burden Among Carers of Suicide Attempt Survivors. CRISIS 2023; 44:41-48. [PMID: 34915733 PMCID: PMC9909369 DOI: 10.1027/0227-5910/a000836] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Family members often provide informal care following a suicide attempt. Carers may be vulnerable to caregiver burden. Yet, little is known about what contributes to this. Aims: To determine the predictors of caregiver burden in those carers who support people who have attempted suicide. Method: An online survey of 435 participants assessed exposure to suicide, caring behaviors, and psychological variables and caregiver burden. Results: A multivariate model explained 52% of variance in caregiver burden. Being female, closeness to the person, impact of suicide attempt, frequency of contact pre-attempt, and psychological distress were positively associated with caregiver burden. Confidence in supporting the person after suicide attempt, perceived adequacy of healthcare the person received and the support the carer received, and suicidal ideation of the carer were negatively associated with caregiver burden. Moderation analysis suggested that carers with high levels of distress reported negative association between suicidal ideation and caregiver burden. Limitations: The cross-sectional online survey design of self-identified carers is a limitation of the study. Conclusion: Carers are highly distressed, and if unsupported report increased suicide ideation. In their caring roles they may have contact with support services, thus attending to their needs may ameliorate caregiver burden and associated negative outcomes.
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Affiliation(s)
- Myfanwy Maple
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia,Myfanwy Maple, School of Health, Faculty of Medicine and Health, University of New England, Armidale 2351 NSW, Australia,
| | - Sarah Wayland
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Rebecca L. Sanford
- School of Social Work and Human Service, Thompson Rivers University, Kamloops, BC, Canada
| | - Navjot Bhullar
- School of Psychology, Faculty of Medicine and Health, University of New England, NSW, Armidale, Australia
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5
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Li C, Wei Z, Wang Y, Sun L. Associations between Suicidal Ideation and Relatives' Physical and Mental Health among Community Residents: Differences between Family Members and Lineal Consanguinity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15997. [PMID: 36498070 PMCID: PMC9737015 DOI: 10.3390/ijerph192315997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Despite the verified relationship between relatives’ characteristics and individual suicidal ideation, few studies have discussed the role of family members and lineal consanguinity independently according to whether they live together with the individuals or not. (2) Methods: The data in this study were collected in November 2019 and identified rural adults over 18 years old in Shandong as the survey objects, with a total of 879 valid cases included in this survey. Logistic regression analysis was employed to examine the risk factors affecting adults’ suicidal ideation and differentiate the effects of a family member and lineal consanguinity’s physical and mental health. Relatives’ physical and mental health were estimated by three aspects: whether they were suffering from chronic diseases, mental illness, or alcoholism. (3) Results: The study showed that a family member’s physical (OR = 2.303, p < 0.01) and mental health (OR = 5.877, p < 0.05) was related to suicidal ideation, but the association between lineal consanguinities’ physical and mental health and suicidal ideation were not supported. People over 40 years old (OR = 6.528, p < 0.05), from only-child families (OR = 4.335, p < 0.01), with household indebtedness (OR = 2.992, p < 0.001), or difficulty falling asleep (OR = 3.165, p < 0.001) had risk factors of suicidal ideation. (4) Conclusions: The physical and mental health of individuals’ family members are related to their suicidal ideation, and their lineal consanguinities’ physical and mental health are not related to suicidal ideation. These findings imply the different associations between family environment, genetic factors, and suicidal ideation. Family members’ health should be considered as a factor to prevent and control suicidal behaviors, including suicidal ideation.
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Affiliation(s)
- Caifeng Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Yifan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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6
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Marshall P, Jones S, Gooding P, Robinson H, Lobban F. Caring for a Family Member with Psychosis or Bipolar Disorder Who Has Experienced Suicidal Behaviour: An Exploratory Qualitative Study of an Online Peer-Support Forum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15192. [PMID: 36429907 PMCID: PMC9690796 DOI: 10.3390/ijerph192215192] [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: 09/28/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The likelihood of suicidal behaviour is elevated amongst people with psychosis or bipolar disorder. This study aimed to understand how carers experience supporting family members with psychosis or bipolar disorder who have also experienced suicidal behaviour. METHODS A qualitative thematic analysis of online peer forum posts was carried out on the Relatives Education and Coping Toolkit (REACT) website, an online intervention for carers of people with psychosis and bipolar disorder. Analysis was based on 178 posts by 29 forum users. Posts were selected based on their relevance to suicidal behaviour. RESULTS Three themes were generated. "Suicide as the ultimate threat" highlights fears emerging from carers' difficulties with understanding and managing suicidal behaviour. "Bouncing from one crisis to another" reflects carers' experiences of recurring crises and the challenges of relying on emergency healthcare support. "It definitely needs to be easier to get help" emphasises carers' desires to be acknowledged by healthcare professionals and included in support offered to service users. CONCLUSIONS Digital platforms, including online forums, brief interventions such as safety planning, and interagency crisis models, hold the potential to meet carers' needs in this context. However, further research is required to investigate the effectiveness and implementation of these approaches.
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Affiliation(s)
- Paul Marshall
- Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YT, UK
| | - Steven Jones
- Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YT, UK
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Heather Robinson
- Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YT, UK
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YT, UK
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7
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Lavers G, Andriessen K, Krysinska K. A Systematic Review of the Experiences and Support Needs of Informal Caregivers for People Who Have Attempted Suicide or Experienced Suicidal Ideation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095181. [PMID: 35564578 PMCID: PMC9102006 DOI: 10.3390/ijerph19095181] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 02/04/2023]
Abstract
Informal caregivers include family, friends, and significant others who provide important support for people who have attempted suicide or experienced suicidal ideation. Despite the prevalence of suicidal behaviour worldwide, they remain an understudied population. This review aimed to synthesise the literature on the experiences and support needs of informal caregivers of people who have attempted suicide or experienced suicidal ideation. We conducted a systematic review according to PRISMA guidelines. Searches of peer-reviewed literature in Medline, Emcare, Embase, EBM Reviews, and PsycINFO identified 21 studies (4 quantitative and 17 qualitative), published between 1986 and 2021. Informal carers commonly reported symptoms of depression and anxiety, for which they receive little assistance. They also expressed a desire for more involvement and education in the professional care of suicidality. Together, the studies indicated a need to improve the way informal caregiving is managed in professional healthcare settings. This review identified potential avenues for future research, as well as broad areas which require attention in seeking to improve the care of suicidal people and their caregivers.
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Affiliation(s)
- George Lavers
- Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia;
- Correspondence:
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8
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Harding KD, Turner K, Howe SJ, Bagshawe MJ, Flannigan K, Mela M, McMorris CA, Badry D. Caregivers' experiences and perceptions of suicidality among their children and youth with fetal alcohol spectrum disorder. Front Psychiatry 2022; 13:931528. [PMID: 36117649 PMCID: PMC9471421 DOI: 10.3389/fpsyt.2022.931528] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with Fetal Alcohol Spectrum Disorder (FASD) experience a range of biopsychosocial vulnerabilities that can increase the possibility of adverse life outcomes, including a heightened risk of suicidality. In this study, we explored the lived experiences of caregivers of children and youth with FASD and suicidality, including their perceptions of their child and youth's suicidal experiences. Between March and June 2021, six comprehensive, semi-structured interviews were conducted with five caregivers of children and youth with FASD (Mage = 14.5 years, range 11-22) who were currently experiencing suicidality or had a history of suicidality. Data were analyzed using interpretative phenomenological analysis and then developed into a composite vignette informed and organized by the social-ecological suicide prevention model (SESPM). The composite vignette revealed the narratives of families living with and caring for children and youth with FASD who experience suicidality in relation to the complex and intersectional individual, relational, community, and societal level contextual and protective factors. Findings from this study highlight the critical need for comprehensive FASD-informed suicide prevention and intervention approaches to promote the mental health and wellbeing of children and youth with FASD and their caregivers.
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Affiliation(s)
- Kelly D Harding
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada.,Department of Psychology, Laurentian University, Sudbury, ON, Canada
| | - Kailyn Turner
- Werklund School of Education, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Stephanie J Howe
- Werklund School of Education, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Mercedes Jayne Bagshawe
- Werklund School of Education, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Katherine Flannigan
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
| | - Mansfield Mela
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada.,Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Dorothy Badry
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada.,Faculty of Social Work, University of Calgary, Calgary, AB, Canada
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9
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Vatne M, Lohne V, Nåden D. "Embracing is the most important thing we can do" - Caring for the family members of patients at risk of suicide. Int J Qual Stud Health Well-being 2021; 16:1996682. [PMID: 34806566 PMCID: PMC8635556 DOI: 10.1080/17482631.2021.1996682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aim This study explores mental health personnel’s experiences in the encounter with family members of patients at risk of suicide so as to develop a deeper understanding of the content of caring. Methodology Data were collected using semi-structured interviews with 12 participants and were analysed and interpreted using a model inspired by the philosophical hermeneutics of Gadamer. The context was psychiatric wards. Findings Through a thematic analysis, four themes emerged: Acknowledgement as a premise for involving family members. Embracing with the family members’ feelings and reactions. Strengthening hope in a situation entailing a serious risk of suicide. Providing reassurance to family members in transitional situations. Conclusion Witnessing the family members’ suffering and needs is understood as arousing a sense of responsibility in the participants and triggering various care strategies such as listening, embracing, strengthening hope and providing reassurance.
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Affiliation(s)
- May Vatne
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Vibeke Lohne
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Dagfinn Nåden
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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10
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Vandewalle J, Debyser B, Deproost E, Verhaeghe S. Family expectations of inpatient mental health services for adults with suicidal ideation: a qualitative study. Int J Ment Health Nurs 2021; 30:1136-1148. [PMID: 33817944 DOI: 10.1111/inm.12864] [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] [Accepted: 03/14/2021] [Indexed: 12/15/2022]
Abstract
Involvement of family members of adults with suicidal ideation is a key area of improvement in inpatient mental health services. To support family involvement in this context, it is crucial to understand what care and treatment family members expect for their relative. This qualitative study based on grounded theory involved interviews with 14 family members, including partners, parents, adult children and siblings. The family members' expectations of care and treatment in inpatient mental health services were captured by the core element 'Struggling to remain hopeful while looking through the lens of uncertainty'. This core element interacted with four sub-elements: assuming safety as a priority, looking for a healing approach and environment, counting on continuity of care and wanting to be involved and supported. The family members fluctuated between hope and uncertainty depending on whether their expectations were met or unmet. Unmet expectations were common and underpinned by a sense of being marginalized during the admission of their relative with suicidal ideation. Mental health professionals, including nurses, can be more empathetic towards the family members and attuned to their expectations. This can underpin partnerships that help families to deal with their feelings of uncertainty and disempowerment. Such partnerships can flourish in recovery-oriented mental health services that allow meaningful family involvement.
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Affiliation(s)
- Joeri Vandewalle
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Centre Sint-Amandus, Beernem, Belgium
| | - Bart Debyser
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy, Clinic Sint-Jozef, Pittem, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
| | - Eddy Deproost
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy, Clinic Sint-Jozef, Pittem, Belgium
| | - Sofie Verhaeghe
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
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11
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Rheinberger D, Macdonald D, McGillivray L, Maple M, Torok M, Nicolopoulos A, Shand F. "A Sustained, Productive, Constructive Relationship with Someone Who Can Help"-A Qualitative Exploration of the Experiences of Help Seekers and Support Persons Using the Emergency Department during a Suicide Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910262. [PMID: 34639571 PMCID: PMC8508062 DOI: 10.3390/ijerph181910262] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 12/14/2022]
Abstract
For Australians experiencing a suicide crisis, the emergency department (ED) is the recommended point of contact for intervention and to ensure personal safety. However, negative ED experiences can deter individuals from returning, thus impacting future suicide risk. In order to improve the ED environment for individuals in suicidal crisis, an in-depth understanding of this experience is needed. In-depth semi-structured interviews with 17 help seekers and 16 support persons were conducted. A grounded theory approach uncovered a core organising concept—all participants wanted a “a sustained, productive, constructive relationship with someone who can help” during the ED visit—which guided analysis. Thematic analysis resulted in two themes and four subthemes exploring the systemic and interpersonal aspects of the ED visit and the roadblocks and pathways to development of the relationship. Interpersonal factors included aspects of staff interaction and presence of a support person. Systemic factors related to aspects controlled by the physical space and internal policies and procedures and included aspects such as the chaotic environment, long waiting times, and access to staff. Overwhelmingly, there were more roadblocks than pathways reported by participants. Improving the ED environment, increasing staff training and encouraging the presence of support persons may help mitigate some of these roadblocks.
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Affiliation(s)
- Demee Rheinberger
- Black Dog Institute, University of New South Wales, Randwick, NSW 2031, Australia; (D.M.); (L.M.); (M.T.); (A.N.); (F.S.)
- Correspondence:
| | - Diane Macdonald
- Black Dog Institute, University of New South Wales, Randwick, NSW 2031, Australia; (D.M.); (L.M.); (M.T.); (A.N.); (F.S.)
| | - Lauren McGillivray
- Black Dog Institute, University of New South Wales, Randwick, NSW 2031, Australia; (D.M.); (L.M.); (M.T.); (A.N.); (F.S.)
| | - Myfanwy Maple
- Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia;
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Randwick, NSW 2031, Australia; (D.M.); (L.M.); (M.T.); (A.N.); (F.S.)
| | - Alexandra Nicolopoulos
- Black Dog Institute, University of New South Wales, Randwick, NSW 2031, Australia; (D.M.); (L.M.); (M.T.); (A.N.); (F.S.)
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Randwick, NSW 2031, Australia; (D.M.); (L.M.); (M.T.); (A.N.); (F.S.)
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12
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Morton M, Wang S, Tse K, Chung C, Bergmans Y, Ceniti A, Flam S, Johannes R, Schade K, Terah F, Rizvi S. Gatekeeper training for friends and family of individuals at risk of suicide: A systematic review. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:1838-1871. [PMID: 34125969 DOI: 10.1002/jcop.22624] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
AIMS Gatekeeper training (GKT) is an important suicide prevention strategy. Studies have evaluated the effectiveness of GKT in different populations, often neglecting family and friends who play a vital role in caring for people with suicide risk. This review evaluated GKT programs targeting family and friends to determine their effectiveness in this specific population. METHODS Academic databases were searched for studies on GKT programs. Programs involving family and friends caring for people with suicide risk were assessed for any impact on knowledge, self-efficacy, attitudes, and suicide prevention skills. RESULTS Seventeen studies were reviewed. GKT showed significant gains on outcomes of interest. Three studies targeted family and friends, with one involving them in program creation and conduction and another adjusting the program after their input. CONCLUSIONS GKT programs have potentially positive effects on family and friends caring for people with suicide risk. Few programs address the specific needs of this group, and programs adapted specifically for them are scarce. Future program development recommendations are discussed.
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Affiliation(s)
- Michael Morton
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Shijing Wang
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Kristen Tse
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Carolyn Chung
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Yvonne Bergmans
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Amanda Ceniti
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Shelley Flam
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Robb Johannes
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Health Promotions Program, Fred Victor, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Kathryn Schade
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Flora Terah
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Sakina Rizvi
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Wayland S, Coker S, Maple M. The human approach to supportive interventions: The lived experience of people who care for others who suicide attempt. Int J Ment Health Nurs 2021; 30:667-682. [PMID: 33355984 DOI: 10.1111/inm.12829] [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] [Received: 08/05/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 01/29/2023]
Abstract
There is currently limited information about the impact and experiences of a suicide attempt on the well-being of a person providing care before, during, or after the attempt. Scant evidence available suggests that providing care has a profound impact on the support person or carers' own physical and psychological health; they may experience adverse health, financial, and functional outcomes, collectively described as 'caregiver burden'. This project sought to understand insights into the experience of providing care for someone who has previously attempted suicide. The larger study was designed in three phases consisting of an online survey, semi-structured interviews, and a follow-up survey. This paper reports the qualitative findings of the interviews which were thematically analysed. Two symbiotic themes emerged: the lived experience of caring and the impact of engagement and support from the healthcare system. The authors concluded that that the carer position is a multidimensional role involving informal agreements and situational or time-based support. Further, awareness of this shifting relationship needs to be embedded in the provision of care by health professionals following a suicide attempt. Recommendations for enhanced health system response are proposed.
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Affiliation(s)
- Sarah Wayland
- School of Social Work, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Sarah Coker
- SANE Australia, South Melbourne, Vic., Australia
| | - Myfanwy Maple
- School of Social Work, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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Krysinska K, Andriessen K, Ozols I, Reifels L, Robinson J, Pirkis J. Effectiveness of Psychosocial Interventions for Family Members and Other Informal Support Persons of Individuals Who Have Made a Suicide Attempt. CRISIS 2021; 43:245-260. [PMID: 33944608 DOI: 10.1027/0227-5910/a000776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Individuals recovering from a suicide attempt may benefit from support provided by informal carers, that is, family members and other support persons, who may require support themselves. Aims: This systematic review aims to identify and synthesize available literature on the effectiveness of psychosocial interventions for this carer population. Method: A search of peer-reviewed literature in five databases was carried out. Studies using any design were eligible and results were synthesized using a narrative review. Results: Eight articles reporting on seven quantitative studies met the eligibility criteria. This included three studies on interventions designed specifically for informal carers and four studies on interventions designed for persons who have made a suicide attempt, and which involved their informal carers. Overall, informal carers were satisfied with support and psychosocial interventions they received. Interventions were related to some improvements in carers' mental health outcomes, lowered burden, and improved ability to provide care. There were mixed results regarding family functioning and quality of life. Limitations: No studies from lower- and middle-income countries were identified and the small number of heterogeneous studies precluded conducting a meta-analysis. Conclusion: Given the low number of studies and their overall poor quality, this review can only draw preliminary conclusions. More high-quality intervention studies are needed to formulate recommendations for effective psychosocial support for family members and other informal support persons after a suicide attempt.
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Affiliation(s)
- Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ingrid Ozols
- Mental Health at Work, Melbourne, VIC, Australia
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | | | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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15
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Lascelles KM. Might Informal Carers of Adults With Enduring Suicidality Experience Anticipatory Loss? CRISIS 2021; 43:215-219. [PMID: 33860678 DOI: 10.1027/0227-5910/a000771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Carers of loved ones who repeatedly express suicidal intent and/or engage in suicidal behavior may experience a sense of anticipation of eventual suicide due to the potential of a fatal act of self-harm. An understanding of John Rolland's concept of anticipatory loss may help clinicians understand and attend to the experiences of carers of adults who engage in repeated suicidal behavior. Indeed, there appear to be some similarities between this model of anticipatory loss and experiences of informal carers, indicating that the phenomenon, which is hitherto under-explored in the suicidology field, may merit further consideration.
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Affiliation(s)
- Karen Moya Lascelles
- Mental Health Directorate, Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.,Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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16
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Characteristics associated with later self-harm hospitalization and/or suicide: A follow-up study of the HUNT-2 cohort, Norway. J Affect Disord 2020; 276:369-379. [PMID: 32871667 DOI: 10.1016/j.jad.2020.03.163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/20/2020] [Accepted: 03/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND To improve suicide and self-harm prevention in adults, better knowledge on preexisting characteristics and risk factors is of great importance. METHODS This is a population-based case-control study; baseline measures were collected in the second wave of the North-Trøndelag Health Study (HUNT-2, 1995-1997) in Norway, and outcomes were observed for up to 19 years. Average follow up time was 4.9 years for self-harm and 6.8 years for suicides. Out of 93,898 eligible adult inhabitants aged 20 and above, a total of 65,229 (70%) participated in the study. The data were linked to the National Mortality Registry and hospital patient records in the three hospitals covering the HUNT-2 catchment area. RESULTS Among the participants, 332 patients (68% women) were hospitalized because of self-harm (HSH), and 91 patients (32% women) were died by suicide (SU). A total of 10% of those who died by SU had previously been HSH. People in the HSH and SU groups were younger, reported more depression and anxiety symptoms, sleeping problems, higher use of alcohol and tobacco, poorer social network and more economic problems, compared to the rest of the HUNT-2 population. In addition, the HSH group reported more somatic health problems, higher use of health services, higher sick leave, and lower work participation than the SU group. LIMITATIONS Younger adults (20-40 years) were under-represented in HUNT-2. Younger adults (20-40 years) were constituted 31.7% in HUNT-2, 50% in HSH and 33% in SU. Further, we did not identify less severe self-harm, not requiring hospitalization. Life changes, adverse events, and other possible triggers to self-harming behavior were not recorded. CONCLUSION Psychological problems were long-term predictors of both HSH and SU. Somatic health problems and lower functional performance were more present in HSH-group compared to the SU-group.
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Borentain S, Nash AI, Dayal R, DiBernardo A. Patient-reported outcomes in major depressive disorder with suicidal ideation: a real-world data analysis using PatientsLikeMe platform. BMC Psychiatry 2020; 20:384. [PMID: 32703173 PMCID: PMC7376651 DOI: 10.1186/s12888-020-02758-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 06/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The current analysis utilized data collected via an online patient community platform, PatientsLikeMe (PLM) to compare patient-reported experiences in patients with major depressive disorder (MDD) with suicidal ideation (MDSI) to those with MDD but without suicidal ideation. METHODS PLM members who joined PLM between May-2007 and February-2018 and reported a diagnosis of MDD were included. The MDSI cohort included patients with MDD who reported at least one suicide-related symptom at a severity greater than "none". Demographics, comorbidities, symptoms, and side-effects were compared between MDSI and MDD cohorts. Factors correlated with suicidal ideation (SI) were determined by a random forest procedure. RESULTS Patients in the MDSI cohort (n = 266) were younger (median age, 36 vs 44 years) with an earlier disease onset (before 30 years, 83% vs 71%), and a longer diagnosis latency (median, 4 vs 2 years) vs patients in the MDD cohort (n = 11,963). Majority of patients were women in both cohorts (73% vs 83%). Median number of psychiatric comorbidities was higher in the MDSI cohort (4 vs 3). Unprompted symptoms (e.g., loneliness, feeling of hopelessness, social anxiety, impulsivity, and self-hating thoughts) were more frequent in the MDSI cohort. Hopelessness, loneliness, anhedonia, social anxiety, and younger age were highly correlated with suicidal ideation. CONCLUSIONS This analysis utilized patient-reported data to better understand symptoms, experiences, and characteristics of patients with MDSI compared to patients with MDD. The results identified various risk factors correlated with suicidal ideation that may help guide clinical judgement for patients with MDD who may not voluntarily report suicidal ideation.
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Affiliation(s)
| | - Abigail I. Nash
- grid.497530.c0000 0004 0389 4927Janssen Scientific Affairs, LLC, Titusville, NJ USA
| | - Rachna Dayal
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, Titusville, NJ USA
| | - Allitia DiBernardo
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, Titusville, NJ USA
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18
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Abstract
OBJECTIVES Previous research indicates that dialectical behaviour therapy for adolescents (DBT-A) is effective in treating emotionally dysregulated adolescents with self-harm and/or suicidal ideation. As part of the DBT-A programme, parents attend the weekly skills group with their child. However, few studies have evaluated parental outcomes in DBT-A. This multi-site study aims to explore the outcomes and experiences of parents who participated in a 16-week DBT-A programme in Ireland. METHODS This study was conducted in community-based child and adolescent mental health services (CAMHS) in the national public health system in Ireland. Participants were parent/guardians of adolescents attending a DBT-A programme in their local CAMHS. Participants attended the group skills component of the DBT-A programme. This study utilised a mixed methods approach where both quantitative and qualitative data were collected from participants. Self-report measures of burden, grief and parental stress were completed at pre-intervention, post-intervention and 16-week follow-up. Qualitative written feedback was obtained at post-intervention. The data were analysed using multi-level linear mixed-effects models and content analysis. RESULTS One hundred participants (76% female) took part in this study. Significant decreases were reported for objective burden, subjective burden, grief and parental stress from pre- to post-intervention (p < 0.01). Participants reported that the skills component of DBT-A was useful in meeting their own needs and the needs of their child. DISCUSSION DBT-A shows promise for parents as well as their adolescent child. Future studies should evaluate changes to family relationships following completion of the programme and also include controlled comparison groups.
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Finlayson-Short L, Hetrick S, Krysinska K, Harris M, Salom C, Bailey E, Robinson J. A Survey of People With Lived Experience of Suicide-Related Behavior in Queensland, Australia. CRISIS 2020; 41:39-46. [DOI: 10.1027/0227-5910/a000602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Abstract. Background: Many organizations provide support to people affected by suicide-related behavior, for example, those bereaved by suicide, those who have attempted suicide, and their informal carers. However, evidence regarding how well used, and acceptable, these resources are is lacking. Aims: To investigate the views about and experiences with support and resources of people with lived experience of suicide bereavement, suicide attempt, or caring. Method: The study was conducted in Queensland, Australia. In total, 175 people completed the survey. Data were analyzed using SPSS Statistics 22. Results: Participants found resources helpful and user-friendly, but many had never searched for support, did not know it was available, or felt no better after using it. Respondents who had attempted suicide were more likely to look for resources, but less likely to feel better after using them and endorsed more barriers to accessing support. Limitations: This study used a convenience sample of individuals living in Queensland, was biased toward help-seeking populations, and included mostly women, and therefore it was not representative. Conclusion: Support and resources that are more flexible and accessible, and are offered in a more proactive manner could improve the user experiences of people affected by suicide-related behavior.
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Affiliation(s)
- Laura Finlayson-Short
- Orygen, the National Centre of Excellence in Youth Mental Health & Centre for Youth Mental Health, University of Melbourne, VIC, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, VIC, Australia
| | - Sarah Hetrick
- Orygen, the National Centre of Excellence in Youth Mental Health & Centre for Youth Mental Health, University of Melbourne, VIC, Australia
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Karolina Krysinska
- Orygen, the National Centre of Excellence in Youth Mental Health & Centre for Youth Mental Health, University of Melbourne, VIC, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - Meredith Harris
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Caroline Salom
- Institute for Social Science Research, University of Queensland, Brisbane, QLD, Australia
| | - Eleanor Bailey
- Orygen, the National Centre of Excellence in Youth Mental Health & Centre for Youth Mental Health, University of Melbourne, VIC, Australia
| | - Jo Robinson
- Orygen, the National Centre of Excellence in Youth Mental Health & Centre for Youth Mental Health, University of Melbourne, VIC, Australia
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Abstract
Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and general population, sometimes with fatal consequences. The development of SIB seems to share developmental pathways and mechanisms similar to attachment insecurity. To date, no reviews have explored their relationship. A search of publication databases PubMed and PsychInfo from 1969 through April 2018 was conducted and 17 papers met inclusion criteria. Of the 17 articles identified, 13 reported a positive relationship and 1 reported a negative relationship between attachment insecurity and SIB. Both attachment anxiety and avoidance seem to play a role in the risk for SIB, possibly through different mechanisms and likely with different impacts on the choice for either self-harm or suicide attempts.
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21
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Nygaard L, Fleischer E, Buus N. Sense of Solidarity Among Parents of Sons or Daughters Who Have Attempted Suicide: An In-depth Interview Study. Issues Ment Health Nurs 2019; 40:133-139. [PMID: 30605365 DOI: 10.1080/01612840.2018.1519620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A suicide attempt is a significant burden on the suicidal person, the family, and the community. The psychosocial strain on parents after their offspring's suicide attempt is significant. The aim of this study was to gain insight into how a parent's relationship with a partner was affected after their son or daughter's suicide attempt or serious suicide threats. Individual in-depth interviews were made of 19 parents recruited through a Danish non-governmental organisation in 2013. Data were analysed using a generic thematic analysis. A key category "Sense of solidarity" and two sub-categories "Challenges to the relationship" and "Responding to different reactions and coping strategies" were constructed. Sense of solidarity was important for the parents' co-parenting and how they engaged with the situation as a couple. The group of participants was heterogeneous and had learned to manage the stressful situation in different ways. Interventions to support parents of sons or daughters who have attempted suicide should include a stronger focus on parents' co-parenting abilities in the family system in order to support the well-being of the whole family.
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Affiliation(s)
- Lene Nygaard
- a Department of Gynaecology and Obstetrics , Odense University Hospital , Odense , Denmark
| | | | - Niels Buus
- c Faculty of Medicine and Health , University of Sydney , Sydney , Australia.,d St. Vincent's Hospital Sydney , Sydney , Australia.,e St. Vincent's Private Hospital Sydney , Sydney , Australia.,f Department of Regional Health Research , University of Southern Denmark , Odense , Denmark
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22
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Systematic Literature Review of Attempted Suicide and Offspring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050937. [PMID: 29738447 PMCID: PMC5981976 DOI: 10.3390/ijerph15050937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care.
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Reshetukha TR, Alavi N, Prost E, Kirkpatrick RH, Sajid S, Patel C, Groll DL. Improving suicide risk assessment in the emergency department through physician education and a suicide risk assessment prompt. Gen Hosp Psychiatry 2018; 52:34-40. [PMID: 29549821 DOI: 10.1016/j.genhosppsych.2018.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To determine the efficacy of two interventions on suicide risk assessment within emergency departments (EDs) on improving the documentation of suicide risk factors by emergency medicine and psychiatric physicians during suicide risk assessment. METHOD An educational intervention on suicide was provided to all emergency medicine and psychiatry physicians and was followed by the placement of a suicide risk assessment prompt within local EDs. The medical charts of all ED patients presenting with suicidal ideation or behaviours were reviewed immediately and six months after the interventions and compared to pre-intervention. Differences in the documentation of 40 biopsychosocial suicide risk factors between specialties and after the interventions were determined. RESULTS The documentation of 34/40 (p ≤ 0.008) and 33/40 (p ≤ 0.009) suicide risk factors was significantly improved by emergency medicine and psychiatry physicians, respectively, after the interventions and maintained six months later. Immediately and six months after the interventions, the documentation of 8/40 (p ≤ 0.041) and 14/40 (p ≤ 0.048) suicide risk factors, respectively, significantly differed between specialties. CONCLUSION This suggests that providing a brief educational intervention on suicide to emergency medicine and psychiatry physicians followed by placing a prompt for important, yet commonly undocumented risk factors within the ED is a low-cost and effective intervention for improving documentation of suicide risk assessments within the ED.
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Affiliation(s)
- Taras R Reshetukha
- Queen's University Department of Psychiatry, Providence Care Hospital, 752 King Street West, Postal Bag 603, Kingston, ON K7L 7X3, Canada.
| | - Nazanin Alavi
- Queen's University Department of Psychiatry, Providence Care Hospital, 752 King Street West, Postal Bag 603, Kingston, ON K7L 7X3, Canada; University of Toronto Department of Psychiatry, Centre for Addiction and Mental Health, Department of Psychiatry, 100 Stokes Street, Toronto, ON M6J 1H4, Canada.
| | - Eric Prost
- Queen's University Department of Psychiatry, Providence Care Hospital, 752 King Street West, Postal Bag 603, Kingston, ON K7L 7X3, Canada.
| | - Ryan H Kirkpatrick
- Queen's University Department of Psychiatry, Providence Care Hospital, 752 King Street West, Postal Bag 603, Kingston, ON K7L 7X3, Canada.
| | - Saad Sajid
- Queen's University Department of Psychiatry, Providence Care Hospital, 752 King Street West, Postal Bag 603, Kingston, ON K7L 7X3, Canada.
| | - Charmy Patel
- Queen's University Department of Psychiatry, Providence Care Hospital, 752 King Street West, Postal Bag 603, Kingston, ON K7L 7X3, Canada.
| | - Dianne L Groll
- Queen's University Department of Psychiatry, Providence Care Hospital, 752 King Street West, Postal Bag 603, Kingston, ON K7L 7X3, Canada.
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Help-Seeking in Suicidal Situations: Paramount and yet Challenging. Interactions between Significant Others of Suicidal Persons and Health Care Providers. J Clin Med 2017; 6:jcm6020017. [PMID: 28208800 PMCID: PMC5332921 DOI: 10.3390/jcm6020017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/20/2017] [Accepted: 02/06/2017] [Indexed: 11/17/2022] Open
Abstract
Significant others are often crucial for suicidal persons or suicide attempters' access to care, yet little is known about their efforts to seek help. This article presents the findings of a qualitative pilot study carried out in Switzerland on the help-seeking process of 18 significant others, their perception of the care received by their loved one, and the interactions and collaboration they experienced with professionals. Most significant others repeatedly sought out support for their loved one and themselves. The help-seeking process seemed mostly difficult, was seldom successful on the first attempt, and was filled with multiple difficulties, such as availability and continuity of care and cooperation issues with professionals. Two-thirds of participants were not satisfied with the care provided to their loved ones and half of them faced challenges in their cooperation with professionals, i.e., poor sharing of information or not being acknowledged as partners or supported by professionals. Based on their experience, providing education about suicidal crises and care programs to significant others might lighten their burden and improve their cooperation with professionals, who in turn may benefit from training in communication issues and specific methods of cooperation with significant others in suicidal situations.
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Stjernswärd S, Hansson L. Outcome of a web-based mindfulness intervention for families living with mental illness - A feasibility study. Inform Health Soc Care 2016; 42:97-108. [PMID: 27245198 DOI: 10.1080/17538157.2016.1177533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Families living with a person with mental illness can experience distress requiring therapeutic interventions. Web-based mindfulness interventions have shown beneficial health outcomes for both clinical and healthy populations, and may help families cope and overcome barriers that can otherwise hinder a help-seeking process. AIMS To develop and assess outcomes of a web-based mindfulness intervention for families living with a person with mental illness. METHODS A pilot study investigating an 8-week web-based mindfulness intervention with a pre-post design and follow-up after 3 months, with mindfulness as the primary outcome and perceived stress, caregiver burden and self-compassion as secondary outcomes. The study included a sample of 97 persons approached by advertisement in newspapers, newsletters, and online. RESULTS The study showed significant improvements in levels of mindfulness post-intervention and at follow-up as well as significant improvements in levels of perceived stress, caregiver burden, and self-compassion both post-intervention and at follow-up. DISCUSSION Acceptability and feasibility of the intervention were high, outcomes were relevant, and the intervention showed positive and significant results supporting the hypothesis that the intervention may help families cope with a stressful situation. CONCLUSION Further randomized controlled studies of the intervention are needed to investigate the intervention's effectiveness, including dose-effect studies.
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Affiliation(s)
| | - Lars Hansson
- a Lund University , Department of Health Sciences , Lund , Sweden
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26
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McLaughlin C, McGowan I, Kernohan G, O'Neill S. The unmet support needs of family members caring for a suicidal person. J Ment Health 2015; 25:212-6. [PMID: 26651233 DOI: 10.3109/09638237.2015.1101421] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The prevention of suicide is a key aim for health care authorities and society in general and family members have a principal role in caring for suicidal people. However, the support needs of these essential family carers are relatively unknown. AIM To explore the support needs of family members of suicidal people. METHOD Eighteen participants were interviewed using a short topic guide. Transcripts were analysed using thematic analysis and confirmed by discussion. FINDINGS Family members of suicidal people have unmet needs (this was the main theme). Four sub-themes emerged: having practical support, respite and advice; feeling acknowledged and included; having someone to turn-to; and consistency of support. CONCLUSIONS Family members are perceived to have an important role in suicide prevention; however some carers experience a lack of support which impinges on their ability to undertake this role. Family members need be included in care and require support from healthcare staff.
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Affiliation(s)
| | - Iain McGowan
- a School of Nursing, Ulster University , North Ireland , UK
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