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Hofmann L, Wagner B. Understanding the complexity of suicide loss: PTSD, complex PTSD and prolonged grief disorder following suicide bereavement. DEATH STUDIES 2024:1-10. [PMID: 38913771 DOI: 10.1080/07481187.2024.2369858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Suicide-bereaved individuals are often confronted with profound grief reactions and have an increased risk for mental health disorders. Little is known about the development of complex post-traumatic stress disorder (CPTSD) following a loss by suicide. This paper aims to assess the prevalence of CPTSD, PTSD, prolonged grief disorder (PGD), and depression as well as to identify sociodemographic and loss-related factors regarding their development. A total of 161 suicide loss survivors (91.3% female) completed a questionnaire, which collected symptoms of grief (TGI-SR+), PTSD, CPTSD (ITQ), and depression (PHQ-D). In total, 12.4% met the diagnosis for CPTSD, 5.0% for PTSD. A total of 22.0% fulfilled the diagnosis for PGD. 41.6% showed at least moderate symptoms of depression. Pearson's correlation showed that time since loss was negatively associated with PG and PTSD symptoms, kinship to the deceased was associated with PG severity. The sample scored high on all disturbances in self-organization (DSO) symptom clusters typical for CPTSD. A focus on symptoms of CPTSD may be a necessary component in the care of survivors of suicide loss.
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Affiliation(s)
- Laura Hofmann
- Department of Clinical Psychology, Medical School Berlin, Berlin, Germany
| | - Birgit Wagner
- Department of Clinical Psychology, Medical School Berlin, Berlin, Germany
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2
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Gupta S, Fischer J, Roy S, Bhattacharyya A. Emotional regulation and suicidal ideation-Mediating roles of perceived social support and avoidant coping. Front Psychol 2024; 15:1377355. [PMID: 38629033 PMCID: PMC11018903 DOI: 10.3389/fpsyg.2024.1377355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Recent research has uncovered a wide prevalence variation of suicidal ideation in university students ranging from 9.7% to 58.3%. India has witnessed a 4.5% increase in suicide rates in the year 2021. The interplay between cognitive reappraisal of a stressful situation, suppression of emotional expression, and coping strategies for suicidal ideation of Indian University students is yet to be explored. We aim to determine whether suicidal ideation would differ across different types of family units, and to predict the extent to which perceived social support and avoidant coping could mediate the relation between emotion regulation processes and suicidal ideation. Methods Two hundred randomly selected University students (Mean age = 19.9, SD = 1.43) participated. Kruskal-Wallis, Pearson's product-moment correlation, and GLM mediation model were computed. Results and discussion Lifetime suicidal ideation significantly differed between those who stay alone and those who live in a nuclear family (p < 0.01), and also those who stay in a joint family (p < 0.05). Cognitive reappraisal predicted a reduction in suicidal ideation mediated by perceived social support (B = -0.06, p < 0.05) and avoidant coping (B = -0.07, p < 0.05). Whereas, expressive suppression predicted induced levels of suicidal ideation through perceived social support (B = 0.05, p < 0.05), and avoidant coping (B = 0.06, p < 0.05) as mediators. Conclusion Though our sample size restricts the generalization, our findings implied the importance of regular psychological consultation regarding the efficacy of the said coping processes in dealing with suicidal ideation.
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Affiliation(s)
- Soham Gupta
- Amity Institute of Psychology and Allied Sciences, Amity University Kolkata, Kolkata, West Bengal, India
| | - Jonathan Fischer
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - Sakhi Roy
- Amity School of Economics, Amity University Kolkata, Kolkata, India
| | - Atreyee Bhattacharyya
- Amity Institute of Psychology and Allied Sciences, Amity University Kolkata, Kolkata, West Bengal, India
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Kawashima D, Kawamoto S, Shiraga K, Kheibari A, Cerel J, Kawano K. Suicide Attitudes Among Suicide Loss Survivors and Their Adaptation to Loss: A Cross-Cultural Study in Japan and the United States. OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:1258-1274. [PMID: 35345933 DOI: 10.1177/00302228211051512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Survivors' adaptation to a suicide loss is likely influenced by their attitudes toward suicide and their respective sociocultural contexts. Our study aimed to compare suicide attitudes and their association with depressive symptoms and sense of community safety in Japanese and American suicide loss survivors. A total of 193 Japanese survivors and 232 American survivors completed online surveys. The results show that Japanese survivors tended not to consider suicide as an illness or to recognize that others understood their experience but were more likely than American survivors to consider suicide as justifiable. Regression analyses indicated that taking suicide as a right was associated with depressive symptoms. Further, their sense of being understood by others was positively correlated with perceived community safety in both samples, but justifying suicide and considering it to be an illness was positively related to perceived community safety only among Japanese survivors.
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Affiliation(s)
| | | | - Keisuke Shiraga
- School of Education, Joetsu University of Education, Joetsu, Japan
| | - Athena Kheibari
- School of Social Work, Wayne State University, Detroit, MI, USA
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Kenji Kawano
- College of Comprehensive Psychology, Ritsumeikan University, Ibaraki, Japan
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O'Connell S, Troya MI, Arensman E, Griffin E. "That feeling of solidarity and not being alone is incredibly, incredibly healing": A qualitative study of participating in suicide bereavement peer support groups. DEATH STUDIES 2024; 48:176-186. [PMID: 37092540 DOI: 10.1080/07481187.2023.2201922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Suicide can have a significant impact on the bereaved. Peer support groups for suicide bereavement have been shown to enhance the wellbeing of those attending. However, research is lacking on the mechanisms that underlie these benefits. Semi-structured interviews were conducted with 12 adults attending peer-facilitated support groups in Ireland and thematic analysis was used. The findings highlighted the enduring emotional impact including guilt and questioning, loss of identity, as well as wider impacts. Mechanisms of the groups included the opportunity to share experiences and feel validated, connection and belongingness and collective processing of grief. Groups were found to have a unique role alongside other informal and formal supports. This study highlights the important role of peer support groups in lessening this burden and adds to the literature through identifying potential mechanisms by which peer support groups contribute to improved wellbeing for the suicide-bereaved and practical steps to facilitate these mechanisms.
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Affiliation(s)
| | - M Isabela Troya
- School of Public Health, University College Cork, Cork, Ireland
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Eve Griffin
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
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Diab P, Andrews K. Supports for university counselors impacted by student suicide: A systematic review and thematic synthesis. DEATH STUDIES 2024; 48:609-620. [PMID: 38258427 DOI: 10.1080/07481187.2024.2304780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
The purpose of this systematic review and thematic synthesis was to identify and consolidate research on the support needs of impacted Higher Education (HE) counselors that have experienced a student suicide death. When exposed to a student suicide death, counselors are often extensively involved in a postvention response. This systematic review synthesized four qualitative papers that explored the experiences of staff impacted by student suicide. Thematic synthesis revealed three core themes: The unknown, responding, and the known, and six subthemes: Gaps in knowledge of individual experience, gaps in knowledge of organizational impact, extrospective responding, introspective responding, the needs of impacted counselors, the degree of impact, and the support processes that arise from needs. The results provide a summary of the current supports available to impacted HE counselors and considerations relevant to their postvention needs.
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Affiliation(s)
- Paula Diab
- School of Law and Society, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Katrina Andrews
- School of Law and Society, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Levi-Belz Y, Blank C. The longitudinal contribution of prolonged grief to depression and suicide risk in the aftermath of suicide loss: The moderating role of self-criticism. J Affect Disord 2023; 340:658-666. [PMID: 37586648 DOI: 10.1016/j.jad.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Suicide-loss survivors (SLSs)-individuals who lost family member to suicide, have been recognized as at risk for several mental health complications, including depression and suicide. Recent studies have emphasized the contribution of prolonged grief (PG) symptoms and suicide-related shame as facilitators of depression and suicide risk in the aftermath of suicide loss. In this six-year longitudinal design study, we examined self-criticism as a moderator of the link between PG and depression and suicide risk, with suicide-related shame mediating these links. METHOD Participants were 152 SLSs (130 females) aged 18-70 who completed questionnaires assessing prolonged grief, depression, and suicide risk as well as trauma-related shame and self-criticism. RESULTS A moderated mediation model shows that high self-criticism intensified the relations between PG and shame and between shame and depression and suicide risk, above and beyond the contribution of the longitudinal PG trajectory. Importantly, the indirect effects of PG on both depression and suicide risk via shame levels were found only among SLSs with high levels of self-criticism. CONCLUSION The findings highlight the critical longitudinal role of self-criticism in facilitating depression and suicide risk among SLSs with higher levels of PG. Theoretical implications relating to healing processes and focused clinical recommendations are discussed, including interventions for addressing self-criticism and suicide-related shame in the aftermath of suicide loss.
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Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel; Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel.
| | - Carmel Blank
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
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Fukuchi N, Shigemura J, Obara A. The Support to Mitigate the Impact of Suicide for Disaster Aid Workers of the 2011 Great East Japan Earthquake. Disaster Med Public Health Prep 2023; 17:e517. [PMID: 37872708 DOI: 10.1017/dmp.2023.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Suicide substantially impacts disaster-affected communities due to pre-existing psychosocial effects caused by the disaster. Following the Great East Japan Earthquake of 2011, local disaster aid workers had overworked for months, and many workers eventually died by suicide. Although many workplaces suffered this dual damage, there is limited literature on psychosocial postvention in this context. This study reports the activities of individual/group postventions provided to these aid workers. The bereaved person expressed grief for the loss of their colleagues and anger for not being protected. The postvention observed unusual and distinctive group dynamics. It was essential for mental health professionals to address 2 types of traumatic exposures in the group programs -trauma from the disaster and their colleagues' deaths due to suicide. These postvention programs might be beneficial in maintaining aid workers' mental health and helping them cope with the loss of their colleagues.
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Affiliation(s)
- Naru Fukuchi
- Department of Psychiatry, Tohoku Medical and Pharmaceutical University, Miyagi, Japan
- Miyagi Disaster Mental Health Care Center, Miyagi, Japan
| | - Jun Shigemura
- Faculty of Health Sciences, Mejiro University, Saitama, Japan
| | - Akiko Obara
- Miyagi Mental Health and Welfare Center, Miyagi, Japan
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Aluri J, Haddad JM, Parke S, Schwartz V, Joshi SV, Menon M, Conrad RC. Responding to Suicide in School Communities: An Examination of Postvention Guidance from Expert Recommendations and Empirical Studies. Curr Psychiatry Rep 2023; 25:345-356. [PMID: 37470928 DOI: 10.1007/s11920-023-01431-x] [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] [Accepted: 06/13/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE OF REVIEW We review the published literature on a school's response after a student dies by suicide ("postvention"). We examine published recommendations based on expert guidance and empirical studies that have evaluated postvention measures. RECENT FINDINGS Experts recommend careful communication with family, staff, and students that adheres to published suicide reporting guidelines. Experts also emphasize the importance of identifying and supporting high-risk students. Few robust, controlled studies have identified effective postvention measures. Effective measures tended to occur in group settings (e.g., group therapy), focus on improving grief symptoms, and involve mental health professionals. Postvention has not been robustly studied in the school context. Expert recommendations and a few evidence-backed studies provide the frame for a coherent, school-based postvention response. Further research is needed to strengthen and expand our collective understanding of effective postvention measures in the school context as youth suicide attempts continue to rise.
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Affiliation(s)
- James Aluri
- Johns Hopkins University, School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 N. Wolfe St., Meyer 3-181c, 21287, Baltimore, MD, USA.
| | - Jessi M Haddad
- Child and Adolescent Psychiatry, New York-Presbyterian Hospital Columbia and Cornell, New York City, NY, USA
| | - Susan Parke
- Div. of Law & Psychiatry, Yale School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA
- Medical Director, Community Forensic Services, Connecticut Mental Health Center, New Haven, USA
| | - Victor Schwartz
- Wellness and Student Life, CUNY School of Medicine, New York, USA
| | - Shashank V Joshi
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, USA
| | - Meera Menon
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, USA
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Ali IM, Chan LF, Daud TIM, Othman AR, Ng YP, Pheh KS, Panirselvam RR. The Advanced C.A.R.E. Suicide Prevention Gatekeeper Training Questionnaire for medical lecturers and specialists: A psychometric evaluation in a Malaysian sample. Glob Ment Health (Camb) 2023; 10:e37. [PMID: 37854427 PMCID: PMC10579687 DOI: 10.1017/gmh.2023.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/02/2023] [Accepted: 06/27/2023] [Indexed: 10/20/2023] Open
Abstract
Given the high prevalence rate of suicidal ideation amongst medical students, medical lecturers and specialists as gatekeepers should be well-trained in suicide prevention. There is a need for validated measures to assess gatekeeper training gains for suicide prevention. The psychometric properties of the Advanced C.A.R.E. Suicide Prevention Gatekeeper Training Questionnaire (AdCARE-Q) were evaluated for a sample of medical lecturers and specialists in Malaysia. A total of 120 participants completed 24 items in the AdCARE-Q. Analysis of variance of perceived knowledge scores was performed. Exploratory factor analysis (EFA) was conducted. Reliability was calculated. The AdCARE-Q was reduced to 15 items that fit into two factors, "self-efficacy" and "declarative knowledge." Overall internal consistency was good with Cronbach's alpha = 0.84. The intraclass correlation coefficient between groups from the psychiatry department and non-psychiatry departments was good at 0.80. The oldest age group and participants from the Psychiatry department scored significantly higher than other groups in perceived knowledge of suicide prevention. This study found that the AdCARE-Q has adequate psychometric properties to assess suicide prevention gatekeeper training gains amongst medical lecturers and specialists. Confirmatory factor analysis is recommended for future studies.
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Affiliation(s)
- Iman Mohamed Ali
- Department of Psychiatry, Sarawak General Hospital, Kuching, Malaysia
| | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Abdul Razak Othman
- Department of Psychiatry, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Yin Ping Ng
- Psychiatry Specialty, Pantai Hospital Penang, Bayan Baru, Malaysia
| | - Kai Shuen Pheh
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Tunku Abdul Rahman University, Kampar, Malaysia
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Allie SLN, Bantjes J, Andriessen K. Suicide postvention for staff and students on university campuses: a scoping review. BMJ Open 2023; 13:e068730. [PMID: 37328183 PMCID: PMC10277115 DOI: 10.1136/bmjopen-2022-068730] [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: 10/05/2022] [Accepted: 05/22/2023] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVE To examine current knowledge about suicide bereavement and postvention interventions for university staff and students. DESIGN Scoping review. DATA SOURCES AND ELIGIBILITY We conducted systematic searches in 12 electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, Africa-Wide Information, PsycARTICLES, Health Source: Nursing/Academic Edition, Academic Search Premier, SocINDEX through the EBSCOHOST platform; Cochrane Library, Web of Science, SCOPUS), hand searched lists of references of included articles and consulted with library experts during September 2021 and June 2022. Eligible studies were screened against the inclusion criteria independently by two reviewers. Only studies published in English were included. DATA EXTRACTION AND SYNTHESIS Screening was conducted by two independent reviewers following a three-step article screening process. Biographical data and study characteristics were extracted using a data extraction form and synthesised. RESULTS Our search strategy identified 7691 records from which 3170 abstracts were screened. We assessed 29 full texts and included 17 articles for the scoping review. All studies were from high-income countries (USA, Canada, UK). The review identified no postvention intervention studies on university campuses. Study designs were mostly descriptive quantitative or mixed methods. Data collection and sampling were heterogeneous. CONCLUSION Staff and students require support measures due to the impact of suicide bereavement and the unique nature of the university context. There is a need for further research to move from descriptive studies to focus on intervention studies, particularly at universities in low-income and middle-income countries.
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Affiliation(s)
| | - Jason Bantjes
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit (MASTRU), South African Medical Research Council, Tygerberg, Western Cape, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Levi-Belz Y, Krysinska K, Andriessen K. What Do We Know about Suicide Bereavement, and What We Can Do to Help Suicide-Loss Survivors? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085577. [PMID: 37107858 PMCID: PMC10138333 DOI: 10.3390/ijerph20085577] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/18/2023] [Indexed: 05/11/2023]
Abstract
"Suicide is not only the end of life for the deceased but also the beginning of a highly challenging life for those left behind" [...].
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Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 40250, Israel
- Correspondence:
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, 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
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12
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Marek F, Oexle N. [The Significance of Social Support after Loss by Suicide]. PSYCHIATRISCHE PRAXIS 2023; 50:119-121. [PMID: 37044104 DOI: 10.1055/a-2024-5659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
- Franziska Marek
- Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg
| | - Nathalie Oexle
- Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg
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Roslan AF, Pheh KS, Mahadevan R, Bujang SM, Subramaniam P, Yahya HF, Chan LF. Effectiveness of online advanced C.A.R.E suicide prevention gatekeeper training program among healthcare lecturers and workers in national university of Malaysia: A pilot study. Front Psychiatry 2023; 14:1009754. [PMID: 36741120 PMCID: PMC9892857 DOI: 10.3389/fpsyt.2023.1009754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Suicide is a major cause of death among adolescents and young adults, especially students. This is particularly true for healthcare students with a higher risk and more access to lethal means. Thus, it is vital for healthcare educators who have regular contact with these healthcare students to be trained as gatekeepers in preventing suicide. Evidence of the effectiveness of such gatekeeper training, mainly using an online module, is lacking predominantly in Malaysia. This study aims to investigate the effectiveness of an online gatekeeper suicide prevention training program that is conducted for healthcare lecturers. METHODS A single-arm interventional pre-and post-pilot study was conducted on a sample of healthcare lecturers and workers who are involved in supervising healthcare students. A purposive sampling technique was used to recruit 50 healthcare educators in Malaysia. The program was conducted by trained facilitators and 31 participants completed a locally validated self-rated questionnaire to measure their self-efficacy and declarative knowledge in preventing suicide; immediately before and after the intervention. RESULTS Significant improvement was seen in the overall outcome following the intervention, mostly in the self-efficacy domain. No significant improvement was seen in the domain of declarative knowledge possibly due to ceiling effects; an already high baseline knowledge about suicide among healthcare workers. This is an exception in a single item that assesses a common misperception in assessing suicide risk where significant improvement was seen following the program. CONCLUSION The online Advanced C.A.R.E. Suicide Prevention Gatekeeper Training Program is promising in the short-term overall improvement in suicide prevention, primarily in self-efficacy.
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Affiliation(s)
- Amran Fadzrul Roslan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Kai Shuen Pheh
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Tunku Abdul Rahman University, Kampar, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Hospital Canselor Tuanku Muhriz, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Siti Mariam Bujang
- Department of Medical Education, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Unit of Health Psychology, Faculty of Health Sciences, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Hanieza Fadzlina Yahya
- Department of Psychiatry, Hospital Canselor Tuanku Muhriz, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
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Hill NTM, Walker R, Andriessen K, Bouras H, Tan SR, Amaratia P, Woolard A, Strauss P, Perry Y, Lin A. Reach and perceived effectiveness of a community-led active outreach postvention intervention for people bereaved by suicide. Front Public Health 2022; 10:1040323. [PMID: 36620290 PMCID: PMC9815599 DOI: 10.3389/fpubh.2022.1040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Postvention is a core component of suicide prevention strategies, internationally. However, the types of supports provided to people impacted by suicide vary widely. This study examines the perceived effectiveness of the Primary Care Navigator (PCN) model for people bereaved by suicide. The PCN model was implemented in response to a suicide cluster. It is an active outreach postvention intervention, initiated by police in response to a suspected suicide and links individuals to support in the immediate aftermath of their loss. Methods A retrospective cross-sectional mixed methods approach was used to (1) identify the reach of the PCN model, (2) describe the type of support provided to people bereaved by a suspected suicide and (3) identify the perceived effectiveness of the PCN model from the perspective of WA police, postvention stakeholders and individuals bereaved by suicide. Quantitative data was used to examine the characteristics of suicide in the region, the characteristics of people who received bereavement support, and the types of support that were provided. Interviews with police, postvention stakeholders, and people bereaved by a suspected suicide were conducted to identify the perceived effectiveness of the intervention. Results Between 1 January 2019 and 31 March 2021 there were 80 suspected suicides. Active outreach was provided to 347 bereaved individuals via the PCN model. Just under half of those who were offered outreach accepted further support (N = 164) in the form of suicide bereavement information (98%), mental health or clinical support (49.6%), specialized postvention counseling (38.4%), financial assistance (16%) and assistance with meals (16%), followed by housing assistance (14%) and referral to community services (11%). Police, stakeholders, and people with lived experience of a suspected suicide perceived the PCN model to be effective at connecting them to the community, linking people to support, and preventing suicide. Conclusion The results provide evidence supporting the perceived effectiveness of an active outreach approach to postvention that provides acute support to people bereaved by suicide. Findings highlight important practical areas of support such as providing referral pathways and information on grief and suicide loss in the immediate aftermath of a suicide loss.
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Affiliation(s)
- Nicole T. M. Hill
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,*Correspondence: Nicole T. M. Hill
| | - Roz Walker
- School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia,School of Indigenous Studies, University of Western Australia, Perth, WA, Australia
| | - Karl Andriessen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Hamza Bouras
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Shawn R. Tan
- Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Alix Woolard
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Penelope Strauss
- Telethon Kids Institute, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia
| | - Yael Perry
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
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Clements A, Nicholas A, Martin KE, Young S. Towards an Evidence-Based Model of Workplace Postvention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:142. [PMID: 36612460 PMCID: PMC9819713 DOI: 10.3390/ijerph20010142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
This instrumental case study explored what suicide postvention might offer workplaces using the example of a large metropolitan funeral company. A mixed methods approach was utilized to examine staff experiences with suicide bereavement funerals and responses to a bespoke postvention training package. Staff found funerals due to suicide difficult in terms of communication, engagement and emotionality. These challenges were commonly characterized by increased tension and concern. In the absence of a postvention informed approach, staff had developed individual ways to negotiate the identified challenges of this work. The introduction of a staff-informed postvention training package delivered improvements in staff confidence with communication, understanding and management of the impact of suicide bereavement, and increased willingness to share information about postvention services with families and mourners. The findings indicated that benefits of the training could be extended through organizational governance and integration of supports. The findings are used to inform a model of workplace postvention together with a methodology incorporating staff experience and organizational context.
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Affiliation(s)
- Alison Clements
- School of Allied Health, University of Western Australia, Crawley, WA 6009, Australia
| | - Angela Nicholas
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Karen E Martin
- School of Education, University of Tasmania, Hobart, TAS 7005, Australia
| | - Susan Young
- Social Work and Social Policy, University of Western Australia, Crawley, WA 6009, Australia
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16
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Schlichthorst M, Reifels L, Spittal M, Clapperton A, Scurrah K, Kolves K, Platt S, Pirkis J, Krysinska K. Evaluating the Effectiveness of Components of National Suicide Prevention Strategies. CRISIS 2022. [PMID: 36537610 DOI: 10.1027/0227-5910/a000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: National suicide prevention strategies support development of suicide prevention activities and their evaluation. Aims: To describe components included in national suicide prevention strategies and analyze the potential contribution of individual components to reduce suicide rates. Method: We conducted a narrative review and statistical analysis of national suicide prevention strategies. The narrative review was based on a framework of 12 components and included 29 countries (14 lower middle-income countries [LMICs] and 15 high-income countries [HICs]) with a national suicide prevention strategy. The statistical analyses covered suicide mortality data for 24 countries with a national strategy (9 LMICs and 15 HICs). Results: The number of components adopted in national strategies ranged from 4 to 11, and training and education were included in 96.5% of strategies. Estimated period effects for total suicide rates in individual countries ranged from a significant decrease in the yearly suicide rate (RR = 0.80; 95% CI 0.69-0.93) to a significant increase (RR = 1.12; 95% CI 1.05-1.19). There were no changes in suicide mortality associated with individual components of national strategies. Limitations: The limitations of existing suicide mortality data apply to our study. Conclusion: Further detailed evaluations will help identify the specific contribution of individual components to the impact national strategies. Until then, countries should be encouraged to implement and evaluate comprehensive national suicide prevention strategies.
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Affiliation(s)
- Marisa Schlichthorst
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Matthew Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Angela Clapperton
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Katrina Scurrah
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Kairi Kolves
- 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
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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17
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Tanaka K, Ikeuchi S. Difficulties in suicide prevention facing primary healthcare workers based on the characteristics of people with suicide risk and healthcare systems. J Adv Nurs 2022. [DOI: 10.1111/jan.15522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 11/03/2022] [Accepted: 11/23/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Koji Tanaka
- Faculty of Health Sciences Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University Kanazawa Japan
| | - Satomi Ikeuchi
- Faculty of Health Sciences Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University Kanazawa Japan
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18
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Oexle N, Puschner N, Votruba N, Rüsch N, Mayer L. Perceived Determinants of Disclosing Suicide Loss. CRISIS 2022; 44:470-476. [PMID: 36444885 PMCID: PMC10658637 DOI: 10.1027/0227-5910/a000891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/22/2023]
Abstract
Background: People who lost a loved one to suicide (i.e., suicide loss survivors, SLS) often struggle to talk about their experiences. However, previous studies suggest beneficial effects of disclosure among this group. Aims: This study aimed to identify determinants of disclosing suicide loss. Method: We conducted qualitative interviews with 22 female SLS focusing on determinants of disclosing suicide loss. Interviews were transcribed and analyzed using qualitative content analysis. Results: We identified contextual factors, perceived risks, and perceived benefits as determinants of disclosing suicide loss. Contextual factors included social settings and characteristics of conversation partners. Perceived risks included emotional distress among oneself and others as well as stigma-related risks of disclosing. Perceived benefits included participants' desire for authenticity and social support, as well as positive effects for grieving and fighting suicide stigma. Limitations: Findings are limited to the current female sample. Conclusion: SLS need support in identifying safe places for disclosure and in developing coping strategies to deal with suicide stigma and emotional distress experienced by themselves and others. Future research should investigate the general public's ability and attitudes to provide support after suicide loss and investigate disclosure decisions among male SLS.
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Affiliation(s)
- Nathalie Oexle
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - Nadja Puschner
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - Nicole Votruba
- Nuffield Department of Women's & Reproductive Health, University of Oxford, UK
- Centre for Implementation Science and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Nicolas Rüsch
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - Lea Mayer
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
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19
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Mathieu S, Todor R, De Leo D, Kõlves K. Coping Styles Utilized during Suicide and Sudden Death Bereavement in the First Six Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214709. [PMID: 36429427 PMCID: PMC9690721 DOI: 10.3390/ijerph192214709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 05/13/2023]
Abstract
Individuals bereaved by suicide experience substantial emotional distress and are at risk for poorer mental health, substance use concerns, and suicidal behaviors. This study aimed to explore whether those bereaved by suicide reported different coping styles compared to those bereaved by sudden death in the first six months. It also aimed to determine whether a previous mental health diagnosis (PMHD) and experiencing stigma and/or shame impacted the utilization of adaptive and maladaptive coping. The sample was constituted by individuals bereaved by suicide (n = 142) compared to those bereaved by sudden death (n = 63), six months after loss. The study included immediate family members who were 18 years or older and understood the English language. After controlling for demographics there were no significant differences in coping styles between bereavement types. Regardless of bereavement type, having a PMHD was associated with increased avoidant and problem-focused coping, and stigma and shame were each associated with increased avoidant coping. Women were also more likely to report using adaptive coping. Findings demonstrate no difference by bereavement type and have implications for the tailoring of grief/postvention supports that are sensitive to perceived stigma/shame to better facilitate utilization of adaptive emotion-focused coping, particularly for men and those with pre-existing mental health problems.
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Affiliation(s)
- Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
| | - Racquel Todor
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
- Slovene Centre for Suicide Research, Primorska University, 6000 Koper, Slovenia
- De Leo Fund, 35137 Padua, Italy
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
- Correspondence:
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20
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Pedrollo LFS, Silva AC, Zanetti ACG, Vedana KGG. Creation and validation of a high-fidelity simulation scenario for suicide postvention. Rev Lat Am Enfermagem 2022; 30:e3699. [PMID: 36287402 PMCID: PMC9580988 DOI: 10.1590/1518-8345.6034.3699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE to create and validate a high-fidelity simulation scenario about the initial support to suicide bereaved people. METHOD a methodological research study to create and validate a simulation scenario about postvention. Its creation was based on scientific recommendations, the validation process was carried out by experts, based on an instrument developed by the authors; the data were statistically analyzed using the Content Validity Index and Gwet concordance coefficient. RESULTS the scenario was created to provide initial support to suicide bereaved people in the Primary Health Care context. As learning objectives, welcoming, health care and organization monitoring were proposed according to technical-scientific recommendations. The scenario was validated by 10 specialists in the themes of postvention (5 judges) and high-fidelity simulation (5 judges). The scenario items met the acceptance and reliability criteria (Content Validity Index = 0.80) and satisfactory concordance (Gwet coefficient = 0.640). CONCLUSION the study presented in full a scenario on postvention with innovative potential that can be used free of charge in clinical simulation development during training of different categories of health professionals, to act in support of suicide bereaved people.
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Affiliation(s)
- Laysa Fernanda Silva Pedrollo
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Aline Conceição Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Ana Carolina Guidorizzi Zanetti
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Kelly Graziani Giacchero Vedana
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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21
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McDonnell S, Flynn S, Shaw J, Smith S, McGale B, Hunt I. Suicide bereavement in the UK: Descriptive findings from a national survey. Suicide Life Threat Behav 2022; 52:887-897. [PMID: 35611626 PMCID: PMC9790485 DOI: 10.1111/sltb.12874] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/12/2022] [Accepted: 05/05/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Those bereaved by suicide are a high-risk group of adverse health outcomes and suicidal behavior, yet little is known about the experiences and support needs of these individuals in the UK. METHODS We conducted a national cross-sectional study using an online survey and analyzed the experiences of 7158 participants who had been bereaved or affected by suicide. RESULTS Suicide had a major impact on 77% of participants, including those who had lost a friend and those exposed to suicide at a professional level. Mental and physical health problems linked to the suicide were reported in half. Adverse social outcomes and engaging in high-risk behaviors following the suicide were common. Over a third reported suicidal ideation and 8% had attempted suicide as a direct result of the suicide loss. Most had not accessed support services, with the majority viewing provision of local suicide bereavement support as inadequate. CONCLUSIONS Our results highlight the need for a multi-disciplinary approach in postvention and the provision of proactive outreach to support those bereaved by suicide. Postvention efforts need to acknowledge the death of a friend by suicide as a significant loss.
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Affiliation(s)
- Sharon McDonnell
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK,Suicide BereavementRamsbottomUK
| | - Sandra Flynn
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK
| | - Jenny Shaw
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK,Independent Advisory Panel on Deaths in CustodyLondonUK
| | - Shirley Smith
- If U Care Share FoundationChesterUK,Support After Suicide PartnershipLondonUK
| | - Barry McGale
- Suicide BereavementRamsbottomUK,Support After Suicide PartnershipLondonUK
| | - Isabelle M. Hunt
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK
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22
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McGill K, Bhullar N, Batterham PJ, Carrandi A, Wayland S, Maple M. Key issues, challenges, and preferred supports for those bereaved by suicide: Insights from postvention experts. DEATH STUDIES 2022; 47:624-629. [PMID: 35984768 DOI: 10.1080/07481187.2022.2112318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
For many, suicide bereavement is challenging. Postvention responses are few and evidence to inform them is lacking. Eighteen postvention experts completed an online survey regarding the key issues, challenges, and supports available to people bereaved by suicide. Participants were asked to identify the issues, then rank them in terms of importance at key times during the first 2 years after death, with navigating grief, managing relationships, and dealing with practical challenges identified. Access to information, practical assistance and non-judgmental support were most important early in the bereavement period. These findings provide a foundation for recommendations for postvention interventions.
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Affiliation(s)
- Katie McGill
- Faculty of Medicine and Health, University of New England, Armidale, Australia
- MH-READ, Hunter New England Local Health District, Newcastle, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, Australia
| | - Navjot Bhullar
- Faculty of Medicine and Health, University of New England, Armidale, Australia
- Discipline of Psychology, Edith Cowan University, Perth, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alayna Carrandi
- Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Sarah Wayland
- Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Myfanwy Maple
- Faculty of Medicine and Health, University of New England, Armidale, Australia
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23
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Kaspersen SL, Kalseth J, Stene-Larsen K, Reneflot A. Use of Health Services and Support Resources by Immediate Family Members Bereaved by Suicide: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10016. [PMID: 36011651 PMCID: PMC9408753 DOI: 10.3390/ijerph191610016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
The knowledge on health service use, systematic follow-up, and support for families bereaved by suicide remains scarce. This scoping review includes studies from 2010 to March 2022 that investigate the follow-up and support offered by health services, peer support services, and other resources available (e.g., internet-based resources) for families bereaved by suicide. We followed the scoping review framework provided by the Johanna Briggs Institute and performed a double-blinded screening process using Covidence. Data were extracted by four researchers and a thematic analysis was performed to summarize the results. The PRISMA Extension for Scoping reviews was used for reporting results. Of 2385 studies screened by title, 190 by abstract, and 93 by full-text reading, we included 63 original articles of which 24, 29 and 10 were quantitative, qualitative, or mixed-methods studies, respectively. The review shows that we have some knowledge about the need for, and experiences with, health services and support resources for immediate family members bereaved by suicide, but a lack of knowledge about their help-seeking behaviour, patient pathways, systematic follow-up, coordination between services, and long-term outcomes. We need more longitudinal observational studies of health service use and patient trajectories for people bereaved by suicide.
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Affiliation(s)
- Silje L. Kaspersen
- Department of Health Research, SINTEF Digital, Pb. 4760 Torgarden, 7465 Trondheim, Norway
| | - Jorid Kalseth
- Department of Health Research, SINTEF Digital, Pb. 4760 Torgarden, 7465 Trondheim, Norway
| | - Kim Stene-Larsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, 0456 Oslo, Norway
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24
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Hybholt L, Higgins A, Buus N, Berring LL, Connolly T, Erlangsen A, Morrissey J. The Spaces of Peer-Led Support Groups for Suicide Bereaved in Denmark and the Republic of Ireland: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169898. [PMID: 36011534 PMCID: PMC9407788 DOI: 10.3390/ijerph19169898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 05/13/2023]
Abstract
Research has shown that people bereaved by suicide have an increased risk of mental health problems, suicidality and associated stigma, as well as higher rates of sick leave and increased rates of receiving disability pensions. Peer-led suicide bereavement support groups are perceived to enhance people's recovery by enabling shared experiences with others who are bereaved in similar circumstances. The aim of the research was to explore the viewpoints of participants living in Denmark and the Republic of Ireland on these peer-led support groups. This study focused on how the participants experienced being part of the peer-led support and how the participation affected them. We conducted four focus groups, two in Denmark and two in the Republic of Ireland, and two individual interviews, involving a total of 27 people bereaved by suicide. Data were analyzed thematically. The participants' experiences in the peer-led support groups were in contrast to what they had experienced in their daily lives. They felt alienated in daily living, as they believed that people could not comprehend their situation, which in turn led participants to search for people with similar experiences and join the peer-led support groups. While peer-led support groups may not be helpful for everyone, they created 'supportive spaces' that potentially affected the participants' recovery processes, from which we generated three key themes: (i) 'A transformative space', describing how the peer-led support group created a place to embrace change, learning and knowledge about suicide and suicide bereavement and the making of new connections; (ii) 'An alternative space for belonging and grieving', describing how the participants felt allowed to and could give themselves permission to grieve; and (iii) 'A conflicted space' describing how it was troublesome to belong to and participate in the peer-led support groups. In conclusion, despite the two cultural settings and different organizational approaches, the experiences were comparable. Peer-led support groups can, despite being a conflicted space for some, provide supportive spaces aiding the participants' recovery process.
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Affiliation(s)
- Lisbeth Hybholt
- Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark
- Mental Health Services East, Psychiatry Region Zealand, 4000 Roskilde, Denmark
- Correspondence:
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Niels Buus
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Lene Lauge Berring
- Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Terry Connolly
- Friends of Suicide Loss (FOSL), D06 T685 Dublin, Ireland
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, 2900 Hellerup, Denmark
- Copenhagen Research Centre for Mental Health, 2900 Hellerup, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center of Mental Health Research, Australian National University, Canberra, ACT 0200, Australia
| | - Jean Morrissey
- School of Nursing and Midwifery, Trinity College Dublin, D02 PN40 Dublin, Ireland
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25
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Espelage DL, Boyd RC, Renshaw TL, Jimerson SR. Addressing Youth Suicide Through School-Based Prevention and Postvention: Contemporary Scholarship Advancing Science, Practice, and Policy. SCHOOL PSYCHOLOGY REVIEW 2022. [DOI: 10.1080/2372966x.2022.2069958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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26
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Uphoff EP, Zamperoni V, Yap J, Simmonds R, Rodgers M, Dawson S, Seymour C, Kousoulis A, Churchill R. Mental health promotion and protection relating to key life events and transitions in adulthood: a rapid systematic review of systematic reviews. J Ment Health 2022:1-14. [PMID: 35658814 DOI: 10.1080/09638237.2022.2069724] [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: 12/06/2021] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND During the decades representing working-age adulthood, most people will experience one or several significant life events or transitions. These may present a challenge to mental health. AIM The primary aim of this rapid systematic review of systematic reviews was to summarise available evidence on the effectiveness of interventions to promote and protect mental health relating to four key life events and transitions: pregnancy and early parenthood, bereavement, unemployment, and housing problems. This review was conducted to inform UK national policy on mental health support. METHODS We searched key databases for systematic reviews of interventions for working-age adults (19 to 64 years old) who had experienced or were at risk of experiencing one of four key life events. Titles and abstracts were screened by two reviewers in duplicate, as were full-text manuscripts of relevant records. We assessed the quality of included reviews and extracted data on the characteristics of each literature review. We prioritised high quality, recent systematic reviews for more detailed data extraction and synthesis. RESULTS The search and screening of 3997 titles/abstracts and 239 full-text papers resulted in 134 relevant studies, 68 of which were included in a narrative synthesis. Evidence was strongest and of the highest quality for interventions to support women during pregnancy and after childbirth. For example, we found benefits of physical activity and psychological therapy for outcomes relating to mental health after birth. There was high quality evidence of positive effects of online bereavement interventions and psychological interventions on symptoms of grief, post-traumatic stress, and depression. Evidence was inconclusive and of lower quality for a range of other bereavement interventions, unemployment support interventions, and housing interventions. CONCLUSIONS Whilst evidence based mental health prevention and promotion is available during pregnancy and early parenthood and for bereavement, it is unclear how best to support adults experiencing job loss, unemployment, and housing problems.
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Affiliation(s)
| | | | - Jade Yap
- Mental Health Foundation, London, UK
| | | | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
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27
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Cutrer-Párraga EA, Cotton C, Heath MA, Miller EE, Young TA, Wilson SN. Three Sibling Survivors' Perspectives of their Father's Suicide: Implications for Postvention Support. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:1838-1858. [PMID: 35611068 PMCID: PMC9120346 DOI: 10.1007/s10826-022-02308-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 06/15/2023]
Abstract
This qualitative case study describes three adult siblings' experiences and their perceptions of support connected with the time before and after their father's suicide. At the time of the suicide, participants were ages 1, 5, and 8 years old. We considered commonalities and disparities among the three survivors' perceptions. We also considered how their reported experiences compared to extant literature on child survivors of parent suicide. Our findings suggest that, although the siblings experienced the same traumatic event, each had unique perceptions of the parent's suicide. Immediately prior to closing each interview, to deescalate from the intense topic of suicide, participants offered their impressions of potentially therapeutic children's books and how bibliotherapy may or may not support surviving children. Participants' perceptions of selected children's picture books offer insights about opening communication and addressing challenges specific to a parent's suicide. Implications for teachers, parents, and school-based mental health professionals are provided. We conclude that postvention must consider and monitor each child's perceptions and provide individualized interventions that encourage open communication and support adaptive coping to navigate the intense grief associated with a parent's suicide.
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Affiliation(s)
- Elizabeth A. Cutrer-Párraga
- Counseling Psychology & Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT 84602 USA
| | - Caitlin Cotton
- Spectrum Academy, 867 S 800 W, Pleasant Grove, UT 84062 USA
| | - Melissa A. Heath
- Counseling Psychology & Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT 84602 USA
| | - Erica E. Miller
- Counseling Psychology & Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT 84602 USA
| | - Terrell A. Young
- Teacher Education, McKay School of Education, 205-F MCKB, Brigham Young University, Provo, UT 84602 USA
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28
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Duval B, Guziewicz P, McCauley J, Berkowitz L, Peterson E. The first 72 hours: Suicide loss survivor experiences with early responders. DEATH STUDIES 2022; 47:354-359. [PMID: 35439109 DOI: 10.1080/07481187.2022.2063455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Exposure to a suicide carries risks for loss survivors including significant and long-standing emotional distress. Early responders play a critical role in shaping survivors' experience and trajectory for seeking support services. Yet, few prior studies explore the nuances of early responders' interactions with loss survivors. The current study explored suicide-bereaved adults' experiences with early responders in the first 72 h after their loss through four group interviews. Participants (N = 15) indicated that interactions with early responders were positive overall. Yet, the lack of resources and referrals provided, and perceived stigmatization of suicide may contribute to survivors' delay in obtaining support services.
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Affiliation(s)
- Brianna Duval
- Clinical Psychology Department, William James College, Newton, Massachusetts, USA
| | - Patrick Guziewicz
- Clinical Psychology Department, William James College, Newton, Massachusetts, USA
| | - Jim McCauley
- Riverside Trauma Center, Needham, Massachusetts, USA
- Massachusetts Suicide Postvention Taskforce, Needham, Massachusetts, USA
| | - Larry Berkowitz
- Riverside Trauma Center, Needham, Massachusetts, USA
- Massachusetts Suicide Postvention Taskforce, Needham, Massachusetts, USA
| | - Emma Peterson
- Clinical Psychology Department, William James College, Newton, Massachusetts, USA
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Williams DY, Wexler L, Mueller AS. Suicide Postvention in Schools: What Evidence Supports Our Current National Recommendations? SCHOOL SOCIAL WORK JOURNAL 2022; 46:23-69. [PMID: 38362045 PMCID: PMC10869049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Suicide is a leading cause of death for school-aged preteens and adolescents and a growing risk for younger children. Schools are the ubiquitous institutional context serving this age group. These trends suggest a need for knowledge and guidance related to school postvention efforts, yet the available research is limited. Focusing on postvention, or the period after a peer suicide occurs, is critical to youth suicide prevention because this is a time of elevated suicide risk for youth. Targeted postvention interventions in schools can mitigate youth suicide risk and limit contagion within a school's student body. This article explores the scientific literature related to school-based suicide postvention, describing the strength and limits of research supporting common recommendations for suicide postvention in schools. It identifies widespread recommendations for school postvention that have only preliminary supportive evidence and notes several areas in need of additional research. With clearer postvention best practices to guide their suicide crisis preparedness plans and postvention procedures, schools can better support students, families, and the community as a whole in order to prevent further tragedies.
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Affiliation(s)
| | - Lisa Wexler
- Recenter for Group Dynamics, Institute for Social Research, at the University of Michigan, Ann Arbor
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Panesar B, Soni D, Khan MI, Bdair F, Holek M, Tahir T, Woo J, Sanger N, Khumalo NP, Minuzzi L, Thabane L, Samaan Z. National suicide management guidelines recommending family-based prevention, intervention and postvention and their association with suicide mortality rates: systematic review. BJPsych Open 2022; 8:e54. [PMID: 35197148 PMCID: PMC8935913 DOI: 10.1192/bjo.2022.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Suicidal behaviour remains a major public health concern and countries have responded by authoring guidelines to help mitigate death by suicide. Guidelines can include family-based recommendations, but evidence for the level and category of family-based involvement that is needed to effectively prevent suicide is unclear. AIMS To explore the association between family-based recommendations in guidelines and countries' crude suicide rates. PROSPERO registration: CRD42019130195. METHOD MEDLINE, Embase, PsycInfo, Web of Science and WHO MiNDbank databases and grey literature were searched within the past 20 years (1 January 2000 to 22 June 2020) for national guidelines giving family-based recommendations in any of three categories (prevention, intervention and postvention). RESULTS We included 63 guidelines from 46 countries. All identified guidelines included at least one family-based recommendation. There were no statistically significant differences seen between mean World Health Organization crude suicide rates for countries that included only one, two or all three categories of family-based recommendations. However, a lower spread of crude suicide rates was seen when guideline recommendations included all three categories (mean crude suicide rates for one category: 11.09 (s.d. = 5.71); for two categories: 13.42 (s.d. = 7.76); for three categories: 10.68 (s.d. = 5.20); P = 0.478). CONCLUSIONS Countries should work towards a comprehensive national suicide guideline that includes all categories of family-based recommendations. Countries with previously established guidelines should work towards the inclusion of evidence-based recommendations that have clear implementation plans to potentially help lower suicide rates.
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Affiliation(s)
- Balpreet Panesar
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Divya Soni
- Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Mohammed I Khan
- Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Faris Bdair
- Mathematical and Computational Science Undergraduate Program, Stanford University, California, USA
| | - Matthew Holek
- Health Sciences Undergraduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Talha Tahir
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Julia Woo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Nitika Sanger
- Medical Science Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Nonhlanhla P Khumalo
- Division of Dermatology, Department of Medicine, Groote Schuur Hospital, and University of Cape Town, South Africa
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; and Centre for Evaluation of Medicines, Programs for Assessment of Technology in Health (PATH) Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Vachon M, Nicolas C, Notredame CE, Séguin M. [Investigating postvention best practices : The Delphi method]. Rev Epidemiol Sante Publique 2021; 69:367-379. [PMID: 34642047 DOI: 10.1016/j.respe.2021.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 04/23/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Postvention aims to implement services adapted to the needs of a population that may be vulnerable after suicide. While a plethora of postvention programs exist, they are generally based less on solid evidence than on the judgment of health professionals. Using the Delphi method, an Australian study obtained a consensus among experts as to which postvention actions are to be engineered in a postvention program. Since no similar study has been carried out for programs in French-speaking countries, it seemed important to reproduce the same type of study and to compare the respective results. The present study is aimed at establishing a French inventory of postvention actions and at achieving a consensus among experts as to the actions to be included in a postvention program. METHODS A systematic review of the scientific literature (PRISMA method) and the gray literature (documentation on the WEB) made it possible to identify the different actions that have been included in various postvention programs. Using the DELPHI method, experts endeavored to assess their relevance. RESULTS An inventory of 190 postvention actions was established and they were classified according to a sequential axis (pre-event, at the time of the event, and post-event), according to type of action (environment-centered or people-centered). The experts identified 128 actions to be included in a postvention program. CONCLUSION Convergence was observed among the experts, as they identified the practices to be encouraged following a suicide. When comparing the results in French-speaking countries to the 548 actions selected in the Australian study, we observe similarities between the two studies regarding types of postvention actions. This study provides an update for health professionals on the most relevant practices to be included in a postvention program.
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Affiliation(s)
- M Vachon
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada.
| | | | - C-E Notredame
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Lille, 59000Lille, France; Centre neurosciences et cognition de Lille, Subjectivité et plasticité, Inserm U1172, Université de Lille, 59000Lille, France
| | - M Séguin
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada; Groupe McGill d'études sur le suicide,; Réseau québécois de recherche sur le suicide, les troubles de l'humeur et les troubles associés,; Institut universitaire en santé mentale de l'Hôpital Douglas, Montréal, Canada
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Kim HS, Bae HJ, Kang KH. [How Should We Approach Nurse Suicide in Korea: With the Aspect of Prevention-Intervention-Postvention Management]. J Korean Acad Nurs 2021; 51:408-413. [PMID: 34497250 DOI: 10.4040/jkan.21171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/09/2022]
Abstract
Recently, nurse suicide has emerged as one of the major issues. We tried to review the status of nurse suicide and its management in Korea through inspecting related web sites, news articles, and research. However, there were no sufficient reports or statistics along with the research throughout the country. Moreover, there were no organized nurse suicide management systems or programs including suicide prevention, suicide intervention, suicide postvention management. In other countries, there were various trials and successful experiences about nurse suicide programs, and those have been managed in organized and integrated ways. It gave us a lot of implications. To effectively prevent and manage the nurse suicide in Korea, nursing workforce, nursing managers, and nursing researchers should be concerned about nurse suicide. Furthermore, discussions and the research must be made actively. Based on such efforts, appropriate programs, organized manage systems, and policies must be devised at institution and national level.
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Affiliation(s)
- Hyoung Suk Kim
- School of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Hyun Ji Bae
- Department of Nursing, College of Bioscience, Andong National University, Andong, Korea
| | - Kyeong Hwa Kang
- School of Nursing · Research Institute of Nursing Science, Hallym University, Chuncheon, Korea.
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Cupler ZA, Daniels CJ, Anderson DR, Anderson MT, Napuli JG, Tritt ME. The chiropractor's role in primary, secondary, and tertiary prevention of suicide: a clinical guide. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2021; 65:137-155. [PMID: 34658386 PMCID: PMC8480373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To provide the practicing chiropractor foundational knowledge to enhance the understanding of relevant primary, secondary, and tertiary public health measures for suicide prevention. METHODS A descriptive literature review was performed using keywords low back pain, neck pain, psychosocial, pain, public health, suicide, suicide risk factors, and suicide prevention. English language articles pertaining to suicide prevention and the chiropractic profession were retrieved and evaluated for relevance. Additional documents from the Centers for Disease Control, Veterans Health Administration, and the World Health Organization were reviewed. Key literature from the clinical social work and clinical psychology fields were provided by authorship team subject matter experts. CONCLUSION No articles reported a position statement regarding suicide prevention specific to the chiropractic profession. Risk, modifiable, and protective factors associated with self-directed violence are important clinical considerations. A proactive approach to managing patients at-risk includes developing interprofessional and collaborative relationships with mental health care professionals.
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Levi-Belz Y, Feigelman W. Pulling Together - The Protective Role of Belongingness for Depression, Suicidal Ideation and Behavior Among Suicide-Bereaved Individuals. CRISIS 2021; 43:278-288. [PMID: 34130482 DOI: 10.1027/0227-5910/a000784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: While belongingness has frequently been investigated in the general population as an antidote to experiencing depression, suicidal thoughts, and suicidal behavior, it has rarely been evaluated as a protective factor among individuals bereaved by suicide. Aims: We examined whether perceived belongingness could moderate the differences between suicide-bereaved, suicide-exposed, and nonexposed respondents regarding depression, suicide ideation, and suicide attempts. Method: We conducted an online survey of the adult Israeli population (N = 806), with 203 suicide-bereaved, 266 suicide-exposed, and 377 nonexposed respondents. Participants completed several questionnaires tapping depression and suicidality as well as perceived belongingness levels. Results: Individuals bereaved by suicide reported the highest levels of depression, suicide ideation, and suicide attempts in comparison with suicide-exposed and nonexposed individuals. However, belongingness was found to moderate these distinctions concerning suicide ideation and suicide attempts. Limitations: Belongingness was assessed by only a single question, and the online survey suffered from a relatively high nonresponse rate. Conclusion: Our results suggest that belongingness may act as a potent antidote to the adverse mental health consequences among individuals bereaved by suicide. Clinicians should accord adequate attention to fostering social connectedness among their clients bereaved by suicide.
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Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.,Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - William Feigelman
- Sociology Department, Nassau Community College, Garden City, NY, USA
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Scocco P, Idotta C, Totaro S, Preti A. Addressing psychological distress in people bereaved through suicide: From care to cure. Psychiatry Res 2021; 300:113869. [PMID: 33799198 DOI: 10.1016/j.psychres.2021.113869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/11/2021] [Indexed: 01/10/2023]
Abstract
To illustrate the main characteristics of the request for and choice of support by a population accessing a dedicated service for people bereaved through suicide.The participants were divided first according to their reason for requesting support and based on their choice of intervention, which were "caring" services (improve knowledge about suicide prevention, postvention and grief support) and "curing" services (psychotherapy, chat groups, and meditation retreats).The study was based on 539 participants, chiefly middle-aged women. Most had lost kin and the time since suicide ranged from 1day to 45 years. The main reasons for contacting the service were: seeking help for symptoms (42%), connecting with other suicide survivors (19%); 15% reported not knowing what to ask for. Among the participants, 30% participated in the "curing" interventions; they were slightly older and had more grief symptoms, some above the threshold for complicated grief. These participants had more often survived a child or partner and more frequently sought contact with other survivors or were more likely to be seeking help for symptoms.The presence on the web of a project specialized in the care of suicide survivors can provide a resource bringing them closer to curing their emotional pain.
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Affiliation(s)
- Paolo Scocco
- SOPROXI, via Vesalio10, Padova, Italy; Mental Health Center, via Buzzaccarini 1, ULSS 6 Euganea, Padova, Italy.
| | | | | | - Antonio Preti
- Genneruxi Medical Center, via Costantinopoli 42, Cagliari 09129, Italy.
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Causer H, Bradley E, Muse K, Smith J. Bearing witness: A grounded theory of the experiences of staff at two United Kingdom Higher Education Institutions following a student death by suicide. PLoS One 2021; 16:e0251369. [PMID: 33979333 PMCID: PMC8115842 DOI: 10.1371/journal.pone.0251369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/24/2021] [Indexed: 11/21/2022] Open
Abstract
Wider networks of people are affected by a suicide death than originally thought, including those whose job-role brings them into contact with a death by suicide of another person. The impact of student suicide within United Kingdom (UK) Higher Education Institutions (HEIs) is unexplored and the experiences of staff members remain unknown. It is not known whether staff members have specific postvention needs following a student death by suicide. Any postvention support currently offered to staff members within UK HEIs lacks a context-specific evidence base. This study asked 'How is a student suicide experienced by staff members within a UK HEI and what are the features of that experience?' Staff members from diverse job-roles in two UK HEIs responded to a qualitative survey (n = 19) and participated in semi-structured interviews (n = 10). Data were transcribed and subjected to a constructivist grounded theory analysis. Participants' experiences informed the development of a core category: 'Bearing witness', which encompassed six further categories: 'Responding to a student suicide'; 'Experiencing a student suicide'; 'Needs and fears'; 'Experiences of support'; 'Human stories'; and 'Cultural stories'. The resulting grounded theory demonstrates how participants' perceptions of impact are informed by their experiences of undertaking tasks following a student suicide within the community of their HEI. Processes of constructing perceptions of closeness to the student who died are evident amongst participants who did not know the student prior to their death. Tailored postvention support is required to respond to the range and complexity of HEI staff needs following a student death by suicide.
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Affiliation(s)
- Hilary Causer
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
| | - Eleanor Bradley
- College of Life, Health and Environmental Sciences, University of Worcester, Worcestershire, United Kingdom
| | - Kate Muse
- School of Psychology, University of Worcester, Worcestershire, United Kingdom
| | - Jo Smith
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
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de Almeida AS, Silva AC, Almeida de Moura A, Miasso AI, Graziani Giacchero Vedana K. Meanings of suicidal behavior from the perspective of primary care professionals. Public Health Nurs 2021; 38:564-570. [PMID: 33590484 DOI: 10.1111/phn.12880] [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: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To explore the meaning of suicidal behavior from the perspective of family health professionals. METHOD A qualitative study developed during 2017-2018 with 18 primary care professionals from a Brazilian municipality. Grounded theory was used as the methodological framework. Semi-oriented interviews were conducted, transcribed, and analyzed by open, axial, and selective coding. FINDINGS The professionals perceived themselves as unprepared, emotionally affected, and fearful to work in suicide prevention, prioritizing the referral of people to specialized services regardless of the severity of the situation. Suicide was represented as both a choice and a condition of vulnerability, being more reprehensible when associated with individual choice. CONCLUSION We identified beliefs related to suicidal behavior that could affect the care of people at risk. Our findings reinforce the need for education and training in the prevention of suicidal behavior in primary care.
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Affiliation(s)
| | - Aline Conceição Silva
- Ribeirao Preto School of Nursing, University of São Paulo-USP, Ribeirao Preto, Brasil
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"It Changes Your Orbit": The Impact of Suicide and Traumatic Death on Adolescents as Experienced by Adolescents and Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249356. [PMID: 33327577 PMCID: PMC7765017 DOI: 10.3390/ijerph17249356] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/30/2020] [Accepted: 12/11/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Having someone close die through suicide or another form of traumatic death is a distressing event in the lives of adolescents, putting them at risk of grief and mental health ramifications. As most research in this field has been focused on intrapersonal grief reactions, this study aimed to broaden the perspective by exploring the impact of the death through an interpersonal lens. METHODS The study involved individual and group interviews with bereaved adolescents (n = 20) and parents of bereaved adolescents (n = 18), and thematic analysis of the data. RESULTS The analysis yielded three themes: (i) the death is a life-changing experience, (ii) the death differentiates you from your peers, and (iii) the death impacts on the family system. CONCLUSIONS The study revealed the devastating impact of the deaths on adolescents, their relationships with peers and the family system. Adolescents' grief must be understood within the context of their agency and their immediate social environment. The findings clearly indicate that support for bereaved adolescents should incorporate the familial context.
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Pengpid S, Peltzer K. The Prevalence and Correlates of Suicidal Ideation, Plans and Suicide Attempts among 15- to 69-Year-Old Persons in Eswatini. Behav Sci (Basel) 2020; 10:bs10110172. [PMID: 33182681 PMCID: PMC7696382 DOI: 10.3390/bs10110172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 10/24/2020] [Accepted: 11/01/2020] [Indexed: 12/15/2022] Open
Abstract
The study aimed to assess the prevalence and associated factors of ever suicide attempt and past 12-month suicidal ideation, plans and/or attempts among persons aged 15–69 years in Eswatini. Cross-sectional nationally representative data from 3281 persons (33 years median age, range 15–69) of the 2014 Eswatini STEPS Survey were analysed. Results indicate that 3.6% of participants had attempted suicide, and 10.1% engaged in past 12-month suicidal ideation, plan and/or attempts. In adjusted logistic regression analysis, having family members who died from suicide and childhood sexual abuse were associated with ever suicide attempt. In addition, in unadjusted analysis, female sex, adult sexual abuse, threats and family member attempted suicide were associated with ever suicide attempt. In adjusted logistic regression, female sex, childhood sexual abuse, adult sexual abuse, threats, family alcohol problems and having family members who died from suicide were associated with past 12-month suicidal ideation, plan and/or attempts. In addition, in unadjusted analysis, 25–34-year-old participants, unemployed and other, childhood physical abuse, violent injury, family member attempted suicide and having had a heart attack, angina or stroke were associated with past 12-month suicidal ideation, plans and/or attempts. One in ten participants were engaged in suicidal ideation, plans and/or attempts in the past 12 months, and several associated factors were identified that can inform intervention programmes.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand;
- Department of Research and Innovation, University of Limpopo, Polokwane, Sovenga 0727, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein 9300, South Africa
- Correspondence:
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del Carpio L, Rasmussen S, Paul S. A Theory-Based Longitudinal Investigation Examining Predictors of Self-Harm in Adolescents With and Without Bereavement Experiences. Front Psychol 2020; 11:1153. [PMID: 32581958 PMCID: PMC7283530 DOI: 10.3389/fpsyg.2020.01153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/05/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research has demonstrated that exposure to suicide can lead to increased vulnerability for self-harm or suicide. As a result, ideation-to-action models of suicide (e.g., the Integrated Motivational-Volitional Model of Suicide; IMV) recognise exposure as a significant risk factor which may be implicated in the translation of thoughts into actions. However, few studies have tested this theoretical link explicitly within an adolescent population, and examined how it compares to other types of bereavements. METHODS A 6-month prospective questionnaire study was conducted with 185 Scottish adolescents aged 11-17 (113 adolescents also completed the questionnaire at follow-up). The questionnaire included measures on experiences with bereavement and lifetime engagement in self-harm, as well as measures of defeat, entrapment, social support, coping, and other psychological variables. RESULTS At baseline, 12% of young people reported exposure to a suicide death, and 61% to a non-suicide death. In addition, 21% of pupils reported ever engaging in self-harm, while 23% had experienced self-harm ideation without engaging in it. Cross-sectional multivariate logistic regressions showed that family social support, glorifying/normalising beliefs about suicide, and family self-harm were significantly associated with self-harm group membership (control, ideation, or enactment groups). At follow-up, 10% of pupils reported exposure to a suicide death and 16% to a non-suicide death for the first time. A total of 26% of the sample reported self-harm at T2 (11% of participants for the first time), and 24% reported self-harm ideation without engaging in it. Multivariate analyses found that self-harm ideation and family self-harm at baseline were the only variables to predict self-harm group membership prospectively, in the expected directions. Bereavement experiences, whether by suicide or non-suicide, did not predict self-harm group status at baseline nor at follow-up. CONCLUSIONS This study provides support for the validity of a theoretical model of suicide, even though predictive ability over the 6-months period was limited. Although difficulties with recruitment may have limited the statistical power, this study provides insight into the prevalence and experiences of suicide bereavement among adolescents and the factors related to the onset and maintenance of self-harm.
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Affiliation(s)
- Laura del Carpio
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, United Kingdom
| | - Susan Rasmussen
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, United Kingdom
| | - Sally Paul
- School of Social Work & Social Policy, University of Strathclyde, Glasgow, United Kingdom
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Leaune E, Cuvillier B, Vieux M, Pacaut-Troncin M, Chalancon B, Perez AF, Haesebaert J, Chauliac N, Poulet E, Durif-Bruckert C. The SUPPORT-S Protocol Study: A Postvention Program for Professionals After Patient or User Suicide. Front Psychol 2020; 11:805. [PMID: 32431643 PMCID: PMC7217323 DOI: 10.3389/fpsyg.2020.00805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/31/2020] [Indexed: 01/26/2023] Open
Abstract
Background Exposure to patient or user suicide (PUS) is identified as a challenging occupational hazard for mental health and social work professionals. Professionals exposed to PUS may encounter several ranges of emotional, traumatic or professional impacts in the aftermath. A high proportion of exposed professionals reports a lack of support in the aftermath of PUS. SUPPORT is a postvention program designed to provide a comprehensive, adaptative and effective support to professionals impacted by PUS. The aims of the SUPPORT-S study are to (1) improve the design of the SUPPORT program, (2) evaluate the effectiveness of the program to buffer the emotional, traumatic and professional impacts and to improve the perceived social support for professionals exposed to PUS, and (3) provide more insights into the consequences of PUS on both professionals and organizations. Method The SUPPORT-S study is a mixed method collaborative and participatory action research. The simultaneous and complementary collection and analysis of qualitative and quantitative data will offer an in-depth evaluation of the implementation and the effectiveness of the program. The qualitative evaluation includes: (a) an ethnographic observation; (b) 25 semi-directed interviews with randomized participants; (c) an activity analysis with providers of the program; and (d) collaborative sharing of the results with providers and participants. The quantitative evaluation includes pre- and post-measures in participants of: (a) emotional impact (Differential Emotions Scale IV); (b) traumatic impact (Impact of Event Scale-Revised); (c) professional impact (non-validated questionnaire); and (d) perceived social support (Perceived Social Support Scale for Professionals). The action research design will rely on: (a) the cycling process of implementation/evaluation/data sharing/adjustment and (b) the participatory approach through data sharing with providers and participants. Triangulation, saturation, randomization, and participatory design will also reduce the risk of biases and will improve the generalizability of conclusions. Expected Results We expect the SUPPORT-S study to evaluate and improve the design of the SUPPORT program to effectively help professionals to cope with PUS. Conclusion The results of the study will allow us to disseminate an effective and adaptive postvention program for professionals and institutions encountering PUS.
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Affiliation(s)
- Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France
| | - Bruno Cuvillier
- Groupe de Recherche en Psychologie Sociale, Lumière Lyon 2 University, Lyon, France
| | - Maxime Vieux
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
| | | | - Benoît Chalancon
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,CNRS, UMR 5191, Interactions, Corpus, Apprentissages, Représentations, Ecole Normale Supérieure de Lyon, Lumière Lyon University, Lyon, France
| | - Anne-Fleur Perez
- Institut Régional Jean Bergeret, Centre Hospitalier Saint-Jean de Dieu, Lyon, France
| | - Julie Haesebaert
- EA 7425 HESPER Health Services and Performance Research - Claude Bernard Lyon 1 University, Lyon, France
| | - Nicolas Chauliac
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,EA 7425 HESPER Health Services and Performance Research - Claude Bernard Lyon 1 University, Lyon, France
| | - Emmanuel Poulet
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France
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Nelson PA, Cordingley L, Kapur N, Chew-Graham CA, Shaw J, Smith S, McGale B, McDonnell S. 'We're the First Port of Call' - Perspectives of Ambulance Staff on Responding to Deaths by Suicide: A Qualitative Study. Front Psychol 2020; 11:722. [PMID: 32373035 PMCID: PMC7186388 DOI: 10.3389/fpsyg.2020.00722] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/25/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction Exposure to suicide is a known risk factor for suicide. Ambulance staff are exposed to work-related stressors including attending suicides, which may elevate their risk for mental health problems/suicide. Little is known about ambulance staff’s perspectives on how they experience these events and whether they feel equipped to respond to bereaved families at the scene of death. This study explores the perspectives of ambulance staff about responding to deaths by suicide. Materials and Methods A convenience sample of ambulance staff recruited from one ambulance service in England. In-depth, qualitative, semi-structured face-to-face interviews conducted with nine ambulance staff (six male, three female) to explore experiences of responding to suicide. Data analyzed using thematic analysis. Results Participants reported the experience of job-related strain including exposure to the suicide/suicidal ideation of colleagues; they described suppressing their distress despite significant emotional impact. All participants had been personally bereaved by suicide and responding to suicide was a common part of their job. They were often the first professionals at the scene, and undertook varied and often conflicting roles: negotiating with patients in crisis; informing individuals of the death of a loved one; preserving the body/potential crime scene; dealing with the intense emotional reactions of bereaved individuals. Participants reported long-term, salient memories of these events; however, there was a reported lack of acknowledgment in the workplace that suicides may be traumatic and no guidance for staff on how to cope. Opportunities to debrief were reportedly rare, and there was reluctance to access work-based liaison services. Training in how to respond to individuals bereaved by suicide was also lacking. Discussion The study is the first to reveal the complex challenges faced by ambulance staff in responding to suicide without adequate training and support. It demonstrates the potential impact that responding to suicide can have personally and professionally on staff, and emphasizes the need for employers to support staff wellbeing in better ways. Training and postvention support could enable better coping among staff, more effective support for bereaved individuals and reduce the risk of death by suicide both in those bereaved by suicide and in ambulance staff.
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Affiliation(s)
- Pauline A Nelson
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Lis Cordingley
- Division of Musculoskeletal & Dermatological Sciences, Manchester Biomedical Research Centre, The University of Manchester, Manchester, United Kingdom
| | - Navneet Kapur
- Centre for Mental Health and Safety, The University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, United Kingdom
| | - Carolyn A Chew-Graham
- School of Primary, Community and Social Care, Keele University, Keele, United Kingdom.,NIHR Applied Research Collaboration, West Midlands, United Kingdom
| | - Jenny Shaw
- Centre for Mental Health and Safety, The University of Manchester, Manchester, United Kingdom
| | | | - Barry McGale
- Suicide Bereavement United Kingdom, Manchester, United Kingdom
| | - Sharon McDonnell
- Centre for Mental Health and Safety, The University of Manchester, Manchester, United Kingdom.,Suicide Bereavement United Kingdom, Manchester, United Kingdom
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