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Wagner A, Reifegerste D. Desirable and Adverse Effects of Communicative Suicide Prevention Interventions Among Men. CRISIS 2024; 45:365-375. [PMID: 39136159 DOI: 10.1027/0227-5910/a000965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2024]
Abstract
Background: Despite men's high suicide risk, gender perspectives in suicide prevention research are scarce. Aims: The goal of this systematic review was to describe the desirable and adverse effects of distribution channels and message strategies of communicative suicide prevention interventions among men. Methods: Databases PubMed and Web of Science were searched for quantitative randomized controlled trials (RCTs) and nonrandomized studies examining the effectiveness of male-specific or general communicative interventions among men. Narrative synthesis was used to summarize findings. Results: Fifty-five studies published in peer-reviewed articles until October 15, 2021, were included. Findings demonstrate that interpersonal, mass media, and digital media interventions impact suicide-related outcomes preventively. Mass media interventions are not suitable to impact men's emotions in a prevention-desirable way. Message strategies interactivity, emotional appeals, and clear calls to action demonstrated high effectiveness, while expert exemplars, visualizations, and personalization were rather ineffective. Limitations: However, the review was not able to prove causality, could not distinguish between multichannel interventions and single-channel interventions, or between specific combinations of channels and message strategies. Discussion: The systematic review provides some guidance on which channels and message strategies to apply in communicative suicide prevention for men.
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Affiliation(s)
- Anna Wagner
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
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Ren Y, Cui S, Cui T, Tang C, Song J, Jackson T, He J. Relations of body dissatisfaction with self-injurious thoughts and behaviours in clinical and non-clinical samples: a meta-analysis of studies published between 1995 and 2022. Health Psychol Rev 2024; 18:599-618. [PMID: 38290735 DOI: 10.1080/17437199.2024.2310140] [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: 04/01/2023] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
Body dissatisfaction is a global public health concern. Self-injurious thoughts and behaviours (SITB), including suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI), have been documented as potentially significant correlates of body dissatisfaction. However, prior findings regarding associations between body dissatisfaction and SITB have been somewhat inconsistent. Therefore, this meta-analysis was conducted to determine the nature and strength of such associations in both clinical and non-clinical samples. A literature search identified 83 relevant articles and extracted 234 effect sizes. Using a three-level random-effects model, mean effect sizes (r values) for relationships between body dissatisfaction and suicidal ideation, suicide attempts, and NSSI in clinical samples were 0.29 (95% CI, 0.22-0.37), 0.16 (95% CI, 0.13-0.20) and 0.26 (95% CI, 0.19-0.34), respectively. In non-clinical samples, these values were 0.22 (95% CI, 0.16-0.28), 0.24 (95% CI, 0.17-0.30) and 0.22 (95% CI, 0.15-0.29), respectively. Several study features (e.g., participant age, geographic region and instrument validity) emerged as significant moderators. This meta-analysis provides robust support for body dissatisfaction as a significant correlate of SITB across clinical and non-clinical samples in addition to identifying study characteristics that contribute to effect size variability. Implications are discussed for SITB research, prevention and intervention.
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Affiliation(s)
- Yaoxiang Ren
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, People's Republic of China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, People's Republic of China
| | - Tianxiang Cui
- Department of Psychology, University of Macau, Macau, Taipa S.A.R., People's Republic of China
| | - Chanyuan Tang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, People's Republic of China
| | - Jianwen Song
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, People's Republic of China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macau, Taipa S.A.R., People's Republic of China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, People's Republic of China
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Grosselli L, Knappe S, Baumgärtel J, Lewitzka U, Hoyer J. Addressing help-seeking, stigma and risk factors for suicidality in secondary schools: short-term and mid-term effects of the HEYLiFE suicide prevention program in a randomized controlled trial. BMC Public Health 2024; 24:113. [PMID: 38191336 PMCID: PMC10773084 DOI: 10.1186/s12889-023-17557-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Suicidal ideation and suicide attempts present a serious public health concern among adolescents and young adults. School-based suicide prevention programs are a key tool for addressing this problem. However, more research is necessary to assess their effectiveness, acceptability, and safety. In response, the HEYLiFE suicide prevention program was developed to enhance help-seeking, reduce stigma towards suicidal peers and diminish risk factors for suicidality. This article presents the evaluation findings of the HEYLiFE program in German secondary schools. METHODS We conducted a randomized-controlled trial measuring short-term pre-post within-group effects in the intervention group only and mid-term effects at 6-months-follow-up compared to a waitlist-control group. Schools were assigned randomly to the intervention or control group (no blinding). We recruited students ≥12 years of age. Primary outcomes were knowledge about suicidality, attitudes towards suicidality, stigma towards a suicidal peer, help-seeking intentions and behaviours, risk factors for suicidality. The data was analysed with linear mixed models and generalized linear mixed models. RESULTS A total of N = 745 students participated (n = 353 intervention group, n = 392 control group). We observed favourable short-term effects on knowledge, attitudes towards suicidality and fear towards a suicidal peer. Unexpectedly, the program also led to an increase in desire for social distance and a decrease in prosocial emotions towards a suicidal peer. The mid-term effects of the program were exclusively favourable, resulting in enhanced attitudes towards help-seeking while protecting from a sharper rise in risk-factors for suicidality and from an increase in social distance. The program had more favourable effects on females and on students aged >13 years. The program was well-received by the students, and no serious adverse events were reported. CONCLUSIONS These findings demonstrate the effectiveness of the HEYLiFE universal suicide prevention program in addressing variables associated with suicidal ideation and suicide attempts among adolescents on the mid-term. The short-term negative effects on stigma and more negative effects on males should be addressed in the future. Future evaluation studies should examine its effects on suicidality and its effectiveness within populations at high risk. TRIAL REGISTRATION The study was preregistered in the German Clinical Trials Register (registration number: DRKS00017045; registration date: 02/04/2019).
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Affiliation(s)
- Luna Grosselli
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany.
- Werner-Felber-Institut e. V, Dresden, Germany.
| | - Susanne Knappe
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
- Werner-Felber-Institut e. V, Dresden, Germany
- Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Julia Baumgärtel
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
| | - Ute Lewitzka
- Werner-Felber-Institut e. V, Dresden, Germany
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Hoyer
- Fakultät Psychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
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Ropaj E, Haddock G, Pratt D. Developing a consensus of recovery from suicidal ideations and behaviours: A Delphi study with experts by experience. PLoS One 2023; 18:e0291377. [PMID: 37729121 PMCID: PMC10511083 DOI: 10.1371/journal.pone.0291377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Understanding recovery in mental health has received significant attention and consequently, recovery has been incorporated into health policy across many countries in the Global North. In comparison, the concept of 'recovery' from suicidal thoughts and behaviours has received little attention. However, the few studies in this area appear to suggest that recovery is a complex and an idiosyncratic process with many contributing factors. This can present a challenge for clinicians and services seeking to become more recovery focused. Thus, it seems of importance to develop a consensus on how recovery from suicidal thoughts and behaviours is conceptualised. AIM The study aimed to use the Delphi design to establish a consensus of how recovery is defined by those with lived experience of suicidal thoughts and behaviours. The Delphi method draws on the expertise of a panel, often involving clinicians, researchers and lived experience experts to develop consensus over a topic by inviting them to rate the importance of, often a series of statements to a given topic area. METHOD Lived experience experts were asked to complete two rounds of questionnaires distributed online to capture their views on recovery. RESULTS A total of 196 individuals gave their views on the first round of the study and 97 gave their views on the second round. A final list of 110 statements was developed that 80% or more of participants defined as essential or important. Statements covered items that were important in defining, facilitation and hindering the process of recovery. CONCLUSION Findings are consistent with the wider literature that suggests that recovery is an idiosyncratic process, but with many commonly shared features. Here we also show that a comprehensive definition of recovery must include factors that hinder the process of recovery. Implications and recommendations for practice, policy development and future research are discussed.
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Affiliation(s)
- Esmira Ropaj
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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Markowski KL, White L, Harcey SR, Schmidt T, McEachern D, Habecker P, Wexler L. What Kinds of Support are Alaska Native Youth and Young Adults Reporting? An Examination of Types, Quantities, Sources, and Frequencies of Support. Health Promot Pract 2023; 24:863-872. [PMID: 36047453 PMCID: PMC10729876 DOI: 10.1177/15248399221115065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
American Indian and Alaska Native (AI/AN) youth, particularly males, experience disproportionately high rates of suicide compared to other young people in the United States. Therefore, enacting suicide prevention efforts for AI/AN youth is especially important. Since research shows that strengthening social, cultural, and emotional support can reduce suicide risk, many recent prevention efforts focus on these strategies. Yet, to reinforce and to extend the positive impact of these strategies for suicide risk reduction, we argue it is useful to identify baseline levels and other features of already-existing support. Toward this end, we describe the types (i.e., category), quantities (i.e., distribution and average number), sources (i.e., from whom), and frequencies (i.e., how often) of social support that AN young people report receiving, and we examine if these "support profiles" differ by age and sex. We use survey data from 165 ANs under age 30, collected as part of a participatory intervention study focused on Promoting Community Conversations About Research to End Suicide (PC CARES). We find that: 1) most ANs reported receiving nearly all supports, 2) compared with females, males reported receiving fewer supports on average, 3) family was the most selected support source, followed by close friends and service providers, and 4) family (e.g., parents, siblings, and grandparents) provided support regularly (i.e., monthly or more). Though our findings may suggest fruitful avenues for interventions targeted toward AN males, we discuss these findings in relation to the gendered nature of suicide prevention and assessment.
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Choi WS, Han J, Hong HJ. Association Between Internet Searches Related to Suicide/Self-Harm and Adolescent Suicide Death in South Korea, 2016–2020: Data Analysis Study (Preprint). J Med Internet Res 2023; 25:e46254. [PMID: 37079349 PMCID: PMC10160929 DOI: 10.2196/46254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Previous studies have investigated the association between suicide and internet search volumes of terms related to suicide or self-harm. However, the results varied by people's age, period, and country, and no study has exclusively investigated suicide or self-harm rates among adolescents. OBJECTIVE This study aims to determine the association between the internet search volumes of terms related to suicide/self-harm and the number of suicides among South Korean adolescents. We investigated gender differences in this association and the time lag between the internet search volumes of the terms and the connected suicide deaths. METHODS We selected 26 search terms related to suicide and self-harm among South Korean adolescents, and the search volumes of these terms for adolescents aged 13-18 years were obtained from the leading internet search engine in South Korea (Naver Datalab). A data set was constructed by combining data from Naver Datalab and the number of suicide deaths of adolescents on a daily basis from January 1, 2016, to December 31, 2020. Spearman rank correlation and multivariate Poisson regression analyses were performed to identify the association between the search volumes of the terms and the suicide deaths during that period. The time lag between suicide death and the increasing trend in the search volumes of the related terms was estimated from the cross-correlation coefficients. RESULTS Significant correlations were observed within the search volumes of the 26 terms related to suicide/self-harm. The internet search volumes of several terms were associated with the number of suicide deaths among South Korean adolescents, and this association differed by gender. The search volume for "dropout" showed a statistically significant correlation with the number of suicides in all adolescent population groups. The correlation between the internet search volume for "dropout" and the connected suicide deaths was the strongest for a time lag of 0 days. In females, self-harm and academic score showed significant associations with suicide deaths, but academic score showed a negative correlation, and the time lags with the strongest correlations were 0 and -11 days, respectively. In the total population, self-harm and suicide method were associated with the number of suicides, and the time lags with the strongest correlations were +7 and 0 days, respectively. CONCLUSIONS This study identifies a correlation between suicides and internet search volumes related to suicide/self-harm among South Korean adolescents, but the relatively weak correlation (incidence rate ratio 0.990-1.068) should be interpreted with caution.
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Affiliation(s)
- Won-Seok Choi
- Department of Psychiatry, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Junhee Han
- Department of Statistics, Hallym University, Chunchon, Republic of Korea
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, College of Medicine, Hallym Univerisity, Anyang, Republic of Korea
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Rice T, Sher L. Identifying and Managing Suicidality in Children and Adolescents with Chronic Pain: Evidence-Based Treatment Strategies. Psychol Res Behav Manag 2022; 15:3561-3574. [PMID: 36505667 PMCID: PMC9733630 DOI: 10.2147/prbm.s371832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/22/2022] [Indexed: 12/07/2022] Open
Abstract
Children and adolescents with chronic pain are at an increased risk of suicidality. This narrative review article aims to inform clinical practice in the assessment and management of suicidality in youth with chronic pain. The article begins with a survey of the background and prevalence of youth with chronic pain. A review of the current evidence behind the increased risk of suicidality in youth with chronic pain follows. Contextualization of this data with general tenets of child and adolescent suicide risk and risk assessment is provided. Suicidology theory including the interpersonal theory of suicide is overviewed to help clinicians to conceptualize the reviewed data. Guiding parameters for the suicide risk assessment and management planning is presented. Concluding recommendations are made to guide clinical practice in the assessment and management of suicidality in youth with chronic pain.
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Affiliation(s)
- Timothy Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Correspondence: Timothy Rice, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1090 Amsterdam Avenue, 13th Floor, Suite A, Office 5, New York, NY, 10025, USA, Tel +1 212 523 5635, Fax +1 212 523 5650, Email
| | - Leo Sher
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Weitzman ER, Wisk LE, Minegishi M, Cox R, Lunstead J, Brogna M, Levy S. Effects of a Patient-Centered Intervention to Reduce Alcohol Use Among Youth With Chronic Medical Conditions. J Adolesc Health 2022; 71:S24-S33. [PMID: 36122966 DOI: 10.1016/j.jadohealth.2021.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Alcohol poses unique risks for youth with chronic medical conditions (YCMC) yet many drink. Preventive interventions targeting YCMC are scarce. METHODS YCMC with type 1 diabetes, juvenile idiopathic arthritis, systemic lupus erythematosus, or inflammatory bowel disease were recruited and randomized to trial the effects of a self-administered condition-tailored psychoeducational intervention on frequency in days of past 3-month alcohol use, alcohol-related risk perceptions, and knowledge. Changes in outcomes over time were measured and compared by treatment arm using multivariate mixed effects models. RESULTS Among N = 418 participants (average age 16.0 years, 52.2% female, 84.7% white, 90.7% non-Hispanic), 24.2% reported past-year alcohol use at baseline. Alcohol-related knowledge increased overall and was greater for the intervention group (adjusted improvement in knowledge score +7.70, 95% confidence interval [CI] 2.92-12.48). By 6-month follow-up, the percentage of youth reporting any alcohol use is risky/dangerous increased among intervention arm participants from 41.5% to 45.4% at baseline and decreased from 38.9% to 37.4% among controls (adjusted intervention effect odds ratio 1.79, 95% confidence interval 1.02-3.13). Overall, frequency of drinking increased over time from 3.72 to 4.52 days on average, with no differences by treatment group. Among female drinkers, the predicted mean frequency of drinking days declined in the intervention group (4.11-3.33) and increased among controls (2.82-4.55) (adjusted intervention effect rate ratio .50, 95% confidence interval .25-.99). CONCLUSIONS Exposure to a chronic illness-tailored psychoeducational intervention targeting alcohol use increased knowledge and perceived risk and, among females, reduced alcohol use. Promising results merit future work to optimize the model for both males and females.
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Affiliation(s)
- Elissa R Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
| | - Lauren E Wisk
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Division of General Internal Medicine and Health Services Research, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Machiko Minegishi
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Rachele Cox
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Julie Lunstead
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts
| | - Melissa Brogna
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts
| | - Sharon Levy
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts
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Depression, suicidal ideation and suicide risk in German veterinary medical students compared to the German general population. PLoS One 2022; 17:e0270912. [PMID: 35976912 PMCID: PMC9384977 DOI: 10.1371/journal.pone.0270912] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Various studies from different countries indicated that veterinarians have a significantly increased risk of depression, suicidal ideation and of death by suicide. For German veterinarians a recent study has demonstrated a three times higher rate for depression, two times higher rate for suicidal ideation and a five times higher suicide risk compared to the German general population. For veterinary students, recent studies in the US and UK indicated higher mental distress. To date, empirical studies on depression, suicidal ideation and suicide risk among veterinary students in Germany were lacking so far. This study investigates depression, suicidal ideation and suicide risk of veterinary students in Germany.
Methods
913 German veterinary students (14.3% response rate, 90.7% women, mean age 23.6 years) between 18 and 46 years were included and compared with representative German general population samples from 2007 (N = 1097, 55.4% women, mean age 33.9) and 2015 (N = 1033, 56.1% women, mean age 32.8) of the same age range using the depression module of the Patient Health Questionnaire (PHQ-9) and Suicide Behaviors questionnaire-Revised (SBQ-R). The general population samples were collected with the assistance of a demographic consulting company.
Results
The prevalence of depression among German veterinary students was 45.9% (compared to 3.2% in the general population), suicidal ideation was 19.9% (compared to 4.5% in the general population) and suicide risk was 24.0% (compared to 6.6% in the general population).
Conclusion
In this study, German veterinary students have a 22.1 times higher risk to be screened positive for depression, a 4 times higher risk for reporting current suicidal ideation and they are 4.2 times more likely to have an increased suicide risk compared with the general population in Germany of the same age range.
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Cecchin HFG, Murta SG, de Macedo EOS, Moore RA. Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness. PSICOLOGIA-REFLEXAO E CRITICA 2022; 35:22. [PMID: 35856124 PMCID: PMC9294115 DOI: 10.1186/s41155-022-00227-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 06/28/2022] [Indexed: 11/10/2022] Open
Abstract
A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and cost-effectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation.
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Affiliation(s)
- Hareli Fernanda Garcia Cecchin
- Universidade Federal do Tocantins, Pró-reitoria de Assuntos Estudantis – PROEST, Quadra 109 Norte, Avenida NS-15, Prédio da Reitoria, Plano Diretor Norte, 77001-090 Palmas, Tocantins Brazil
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Spark TL, Cogan CM, Monteith LL, Simonetti JA. Firearm Lethal Means Counseling Among Women: Clinical and Research Considerations and a Call to Action. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2022; 9:301-311. [PMID: 35791313 PMCID: PMC9247955 DOI: 10.1007/s40501-022-00273-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
Purpose of review Firearm injury is the leading mechanism of suicide among US women, and lethal means counseling (LMC) is an evidence-based suicide prevention intervention. We describe current knowledge and research gaps in tailoring LMC to meet the needs of US women. Recent findings Available LMC and firearm suicide prevention literature has not fully considered how LMC interventions should be tailored for women. This is especially important as firearm ownership and firearm-related suicides among women are increasing. Additional research is needed to better understand firearm characteristics, behaviors, and beliefs of US women, particularly related to perceptions of personal safety and history of trauma. Research is also needed to identify optimal components of LMC interventions (e.g., messengers, messages, settings) and how best to facilitate safety practices among women with firearm access who are not themselves firearm owners but who reside in households with firearms. Finally, it will be important to examine contextual and individual factors (e.g., rurality, veteran status, intimate partner violence) which may impact LMC preferences and recommendations. Summary This commentary offers considerations for applying existing knowledge in LMC and firearm suicide prevention to clinical practice and research among US women, among whom the burden of firearm suicide is increasing.
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Affiliation(s)
- Talia L. Spark
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, CO Aurora, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora, USA
- VA Rocky Mountain MIRECC for Suicide Prevention, Rocky Mountain Regional VA Medical Center, 1700 North Wheeling St., CO 80045 Aurora, USA
| | - Chelsea M. Cogan
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, CO Aurora, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Lindsey L. Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, CO Aurora, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Joseph A. Simonetti
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, CO Aurora, USA
- Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Health Administration, Aurora, USA
- Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
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Yeung CY, Morgan PR, Lai CCS, Wong PWC, Yip PSF. Short- and long-term effects of a community-based suicide prevention program: A Hong Kong experience. Suicide Life Threat Behav 2022; 52:515-524. [PMID: 35142390 DOI: 10.1111/sltb.12842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/11/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND A multidisciplinary, multilayer, community-based suicide prevention program (2008-2012) was implemented in the Eastern District, Hong Kong. This article documents the program and reports on short- and longer-term program evaluation. METHODS Characteristics and rates of self-harm/suicidal behaviors and suicide deaths by age group and gender in the Eastern District before, during, and after the intervention were calculated and compared with the rest of Hong Kong, using Kruskal-Wallis and chi-squared tests, and Jonckheere-Terpstra and Cochran-Mantel-Haenszel tests for trend analyses. RESULTS The program impacts varied by age and gender subgroups. Suicide rates in the Eastern District were lower compared to the rest of Hong Kong during the intervention period. They slowly rebounded after the intervention ceased; nevertheless, they remained lower than the rest of Hong Kong until 2016. The rates of self-harm continuously dropped and remained lower than the rest of Hong Kong. During the intervention period in the Eastern District, the age of people who died by suicide increased; more deaths occurred from jumping and fewer by charcoal burning. CONCLUSIONS The program coincided with the lowered self-harm and suicide rates after the implementation. Some of the strategies need to be rebooted or routinely and continuously implemented to ensure the sustainability.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Peter R Morgan
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Carmen Chui Shan Lai
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Paul Wai Ching Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China.,The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China
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13
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Quimby EG, Brogan L, Atte T, Diamond G, Fein JA. Evaluating Adolescent Substance Use and Suicide in the Pediatric Emergency Department. Pediatr Emerg Care 2022; 38:e595-e599. [PMID: 35100762 DOI: 10.1097/pec.0000000000002453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study evaluates the relationship between substance use and impairment and current suicidal thoughts or behaviors in adolescent patients screened in a pediatric emergency department (ED). METHODS Data were collected between June 2013 and February 2018 from adolescent patients who presented to a single, urban, pediatric ED. Adolescents completed a computerized, self-administered assessment that evaluates depression, suicide, posttraumatic stress, violence, traumatic exposure, bullying, and substance use. Assessments are administered as standard care to all ED patients aged 14 to 18 years. We used binary logistic regression to estimate the odds of reporting current suicidal thoughts or behaviors associated with patient demographics (ie, age, sex, and race), substance use in the past month, and substance-related impairment. RESULTS A total of 11,623 adolescent patients (65.4% female and 52.9% African American) completed the assessment. Participants were, on average, 15.7 years old (SD = 1.27). Younger age (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.74-0.84) and substance use impairment (OR, 0.44; 95% CI, 0.33-0.58) decreased the odds of reporting current suicidal thoughts or behaviors, whereas male sex (OR, 1.51; 95% CI, 1.28-1.79) and those with past-month substance use (OR, 1.85; 95% CI, 1.51-2.26) increased the odds. CONCLUSIONS Recent substance use and male sex are associated with a higher likelihood of adolescents reporting current suicidal thoughts or behaviors during an ED visit. Standardized screening during pediatric ED visits may allow for more efficient evaluation of patients in higher-risk groups.
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Affiliation(s)
- Ernika G Quimby
- From the Division of Emergency Medicine, Cooper University Hospital, Camden, NJ
| | | | - Tita Atte
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University
| | - Guy Diamond
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University
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14
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Balcombe L, De Leo D. The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review. Front Psychol 2022; 12:796371. [PMID: 35058855 PMCID: PMC8765720 DOI: 10.3389/fpsyg.2021.796371] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022] Open
Abstract
Suicidal men feel the need to be self-reliant and that they cannot find another way out of relationship or socioeconomic issues. Suicide prevention is of crucial importance worldwide. The much higher rate of suicide in men engenders action. The prelude is a subjective experience that can be very isolating and severely distressing. Men may not realize a change in their thinking and behaviors, which makes it more difficult to seek and get help, thereby interrupting a "downward spiral". Stoicism often prevents men from admitting to their personal struggle. The lack of "quality" connections and "non-tailored" therapies has led to a high number of men "walking out" on traditional clinical approaches. But there are complicated relationships in motivations and formative behaviors of suicide with regards to emotional state, psychiatric disorders, interpersonal life events and suicidal behavior method selection. Middle-aged and older men have alternated as the most at-risk of suicide. There is no one solution that applies to all men, but digital tools may be of assistance (e.g., video conferences, social networks, telephone calls, and emails). Digital interventions require higher levels of effectiveness for distress and suicidality but self-guided approaches may be the most suitable for men especially where linked with an integrated online suicide prevention platform (e.g., quick response with online chats, phone calls, and emails). Furthermore, technology-enabled models of care offer promise to advance appropriate linking to mental health services through better and faster understanding of the specific needs of individuals (e.g., socio-cultural) and the type and level of suicidality experienced. Long-term evidence for suicidality and its evaluation may benefit from progressing human computer-interaction and providing impetus for an eminent integrated digital platform.
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Affiliation(s)
- Luke Balcombe
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
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15
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Collins M, Higgs P. Improving suicide awareness in rural service providers: Some considerations arising from stakeholder consultations. Aust J Rural Health 2021; 29:999-1001. [PMID: 34757646 DOI: 10.1111/ajr.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/04/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Michael Collins
- Department of Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Peter Higgs
- Department of Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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Effects of Financial Expenditure of Prefectures/Municipalities on Regional Suicide Mortality in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168639. [PMID: 34444387 PMCID: PMC8394344 DOI: 10.3390/ijerph18168639] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/08/2021] [Accepted: 08/13/2021] [Indexed: 12/16/2022]
Abstract
In Japan, suicide mortality has been improving from 2009; however, suicide remains one of the leading causes of death. Although previous studies identified solid relationships between governmental financial support for social welfare systems and suicide mortality, little attention is paid to how specific regional policies, designed according to regional cultural, economic, and social welfare situations, affect suicide mortality. Therefore, the present study analyses the relationships between the regional governmental expenditure of six major divisions and suicide mortality across the 47 prefectures in Japan from 2009 to 2018 using fixed-effect analysis of hierarchal linear regression with robust standard error. The expenditure in “public health”, “police”, “ambulance/fire services”, “welfare” and “education” is associated with reduction in suicide mortality, at least in some statistical indicators, whereas expenditure of “public works” indicated the influence of increasing suicide mortality or had no effect. Welfare expenditure was the most predominantly effective among the six major divisions of regional governmental expenditure. In the welfare subdivisions, expenditure of “child welfare” and “social welfare” was effective in a reduction in suicide mortality, but expenditure of “elderly welfare” surprisingly contributed to increasing suicide mortality. Child welfare expenditure negatively impacted suicide mortality in wide-ranging generations of both males and females; the positive effects of elderly welfare expenditure reached were limited as working-age populations increased, but unexpectedly did not affect the suicide mortality of elderly populations. The relatively increasing expenditure of elderly welfare with the relatively decreasing child welfare are unavoidable due to the Japanese social issues associated with a declining birth rate and ageing population. Furthermore, the budget of that regional government that can modify its expenditure structure by making its own policies is limited since most regional governmental expenditure is composed of essential expenditure for maintaining and operating regional social welfare systems. Although severe social situations in Japan are still unoptimised, the present results suggest that scientific-evidence-based redistributions of welfare expenditure in regional governments can at least partially improve Japanese society and welfare systems.
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Cilovic-Lagarija S, Hasanica N, Musa S, Peek-Asa C. Trends in Suicide Mortality in the Federation of Bosnia and Herzegovina - 2010-2020. Med Arch 2021; 75:302-306. [PMID: 34759452 PMCID: PMC8563048 DOI: 10.5455/medarh.2021.75.302-306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Suicide is a major public health problem, with far-reaching social, emotional and economic consequences. Suicide rates are high in all age groups are particularly high in all age groups but are one of the major causes of death among younger age groups, yeilding substantial years of premature life lost. Preventing suicide is one of the major mental health challenges in the world. OBJECTIVE The aim of this study was to estimate the number and rates of suicide deaths in the Federation of Bosnia and Herzegovina (FB&H), and describe suicide characteristics by sex, age, method of suicide over the period of 2010 to 2020. METHODS This is a retrospective population-based study from the period 2010 - 2020. Data were from the FB&H mortality register, Institute for Statistics FB&H. Data on deaths by cause of death are given according to the 10th edition of the International Statistical Classification of Diseases, Injuries and Causes of Death. Suicide data were presented rates by three age group, total number, male and female, crude rates, age-specific death rates and suicide mechanism by age and gender. RESULTS The total number of suicides increased until 2017 to a peak of 201, then decreased to 157 for 2020. Males comprised over 70% of the suicide deaths. Over half of suicides were among those aged 30 - 64 and nearly one third among those 65 and above. However, the greatest increases were among youth aged 15 to 29, which grew from 2% to 9% of suicides over teh study period. The most common mechanisms for suicide were for hanging and firearms, both most common amond males. Poisoning was the most common mechanism among females. CONCLUSION Understanding age and mechanism trends over time will help prioritize prevention strategies. Focus on mental health systems needs to ensure equal access to high-quality services in community based settings. For responses to this challenge to be effective, a comprehensive multisectoral suicide prevention strategy is needed.
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Affiliation(s)
| | - Nino Hasanica
- Institute for Public Health of FB&H, Sarajevo, Bosnia and Herzegovina
| | - Sanjin Musa
- Institute for Public Health of FB&H, Sarajevo, Bosnia and Herzegovina
| | - Corinne Peek-Asa
- Institute for Public Health of FB&H, Sarajevo, Bosnia and Herzegovina
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18
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Forte A, Vichi M, Ghirini S, Orri M, Pompili M. Trends and ecological results in suicides among Italian youth aged 10-25 years: A nationwide register study. J Affect Disord 2021; 282:165-172. [PMID: 33418363 DOI: 10.1016/j.jad.2020.12.142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/15/2020] [Accepted: 12/24/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Documenting current trends and sources of variation in youth suicide rates is critical to inform prevention strategies. We aimed to document suicide mortality trends among Italian youth from 1981 to 2016 and to describe age-, gender- and urbanization-specific suicide rates. METHODS We used official mortality data for the period 1981-2016 for adolescents and young adults aged 10-25 years. We estimated standardized all-cause and suicide mortality rates per 100,000 individuals and used joinpoint regression analyses to determine annual mortality trends and significant changes in rate trends. Analyses were reported according to gender, age group (10-17 and 18-25 years), urbanization and suicide method. RESULTS From 1981 to 2016, 1,752 suicides were identified among youth aged 10-17 years (boy/girl ratio of 5.80 in 2016) and 9,897 suicides among youth aged 18-25 years (boy/girl ratio of 3.97 in 2016). Overall suicide rates remained stable for boys and showed a small decrease for girls. Suicide was most common in rural areas for boys and in metropolitan areas for girls. We observed a significant decrease in the use of firearms and poisoning; the most common suicide method was hanging for boys and falls for girls. LIMITATIONS We did not control for regional-level sociodemographic, economic and health care system characteristics. CONCLUSIONS Youth suicides were either stable (for boys) or slightly declining (for girls). We found differences according to urban versus rural areas, suggesting the need for a broader view of the phenomenon. Factors influencing these trends and gender differences in the geographical areas are important in delivering suicide prevention strategies.
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Affiliation(s)
- Alberto Forte
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy; Department of Psychiatry and Substance Abuse, ASL Roma 5, Rome, Italy
| | - Monica Vichi
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy, Via Giano della Bella 34, 00161 Rome, Italy, National Institute of Health (ISS).
| | - Silvia Ghirini
- National Center on Addictions and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Canada; Bordeaux Population Health Research Centre, Inserm U1219, Université de Bordeaux, Bordeaux, France
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Lund L, Lauemøller SG, Kjeld SG, Andersen A, Bast LS. Gender differences in attitudes towards a school-based smoking prevention intervention. Scand J Public Health 2020; 49:511-518. [PMID: 32883175 DOI: 10.1177/1403494820953325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS There are well-known gender differences in smoking, including the pattern of use and the effectiveness of smoking prevention programs. However, little is known about the differences between boys and girls in their attitudes towards smoking prevention interventions. This study explores gender differences in attitudes towards a school-based intervention to prevent smoking. METHODS We used data from the X:IT II intervention study conducted in 46 Danish elementary schools. RESULTS Compared to boys, girls were more positive towards smoke-free school time, both concerning rules for teachers smoking (odds ratio (OR) = 1.69, 95% confidence interval (CI): 1.35-2.12) and for students smoking (OR = 1.41, 95% CI: 1.13-1.76). No difference was observed in students signing the smoke-free agreement. However, a larger proportion of girls reported that the agreement was a good occasion to talk about smoking with their parents (OR = 1.36, 95% CI: 1.13-1.76). Girls were also more positive towards the smoke-free curriculum (OR = 1.52, 95% CI: 1.19-1.94). CONCLUSIONS This study showed that girls were, overall, more positive towards the components of the smoking preventive intervention. Our findings highlight the importance of considering differences in intervention preferences for boys and girls in future health prevention initiatives.
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Affiliation(s)
- Lisbeth Lund
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Stine G Lauemøller
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Simone G Kjeld
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Lotus S Bast
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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20
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Okada M, Hasegawa T, Kato R, Shiroyama T. Analysing regional unemployment rates, GDP per capita and financial support for regional suicide prevention programme on suicide mortality in Japan using governmental statistical data. BMJ Open 2020; 10:e037537. [PMID: 32859665 PMCID: PMC7454243 DOI: 10.1136/bmjopen-2020-037537] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To explore the mechanisms of reduced suicide mortality in Japan, which decreased from 25.7 to 16.5 per 100 000 people following the comprehensive suicide prevention programme from 2009 to 2018, the present study determined the relationship between regional suicide mortality, socioeconomic data (GDP per capita, unemployment rates) and financial support for regional suicide prevention programmes. DESIGN AND SETTING Stepwise multiple regression analysis was used to determine the effects of regional GDP per capita, unemployment rates and implementation amount of financial support for regional suicide prevention programmes (Emergency Fund to Enhance Community-Based Suicide Countermeasures-EFECBSC) on age and gender disaggregated suicide mortalities in Japan between 2009 and 2018. Data on each prefecture's complete unemployment rates, GDP per capita and implementation amount of EFECBSC sub-divisions were derived from an official Japanese governmental database. RESULTS Both prefectural enlightenment and intervention model programmes were found to lead to a decrease in male suicide mortality, but were less effective in reducing female suicide mortality. Municipal enlightenment and intervention model programmes were also less effective in reducing suicide mortality. Municipal development programmes for listener and leader led to a greater decrease in suicide mortality for both men and women compared with such programmes at the prefectural level. Contrary to our expectations, reduced complete unemployment rate only reduced suicide mortality in the older male population without affecting female suicide mortality. CONCLUSION The study findings suggest an inverse relationship between financial support and suicide mortality in Japan. Furthermore, independent factors in the reduction of suicide mortality rates provide important information for planning evidence-based and cost-effective regional suicide prevention programmes.
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Affiliation(s)
- Motohiro Okada
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Toshiki Hasegawa
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Ryo Kato
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Takashi Shiroyama
- Neuropsychiatry, Graduate School of Medicine, Mie University, Tsu, Mie, Japan
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21
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Coleman D, Black N, Ng J, Blumenthal E. Kognito's Avatar-Based Suicide Prevention Training for College Students: Results of a Randomized Controlled Trial and a Naturalistic Evaluation. Suicide Life Threat Behav 2019; 49:1735-1745. [PMID: 30957909 DOI: 10.1111/sltb.12550] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/12/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the efficacy and effectiveness of Kognito At Risk for College Students, an online, interactive suicide prevention gatekeeper training. METHODS In Study 1, a randomized controlled trial was conducted to test the efficacy of Kognito. Retention of participants at follow-up was strong. In Study 2, administrative records were used to follow the help-seeking behavior of Kognito trainees for one academic year, contrasted with untrained students. RESULTS In Study 1, between-group changes in gatekeeper attitudes were large at time-two, but attenuated modestly by 2-month follow-up. Kognito trainees referred more peers at 2-month follow-up (Cohen's d = .56, p < .05) - training 4 students in Kognito produces 1 more peer referred. In Study 2, the help-seeking rate of Kognito trainees (14.4%) was two-times the rate (6.8%) of untrained students (p < .001). Training 14 students in Kognito leads to 1 more self-referral to the Counseling Center. CONCLUSIONS This first randomized controlled trial of the college student version of Kognito validates the findings of less rigorous studies. Few brief suicide prevention trainings have shown changes in trainee behaviors such as referrals of at-risk peers and trainees actual help-seeking behavior. These results are promising that Kognito may outperform other similar suicide prevention trainings.
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Affiliation(s)
- Daniel Coleman
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Natasha Black
- Counseling and Psychological Services, Fordham University, New York, NY, USA
| | - Jeffrey Ng
- Counseling and Psychological Services, Fordham University, New York, NY, USA
| | - Emily Blumenthal
- Counseling and Psychological Services, Fordham University, New York, NY, USA
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22
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Werbinski JL, Rojek MK, Cabral MDI. The Need to Integrate Sex and Gender Differences into Pediatric Pedagogy. Adv Pediatr 2019; 66:15-35. [PMID: 31230691 DOI: 10.1016/j.yapd.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Janice L Werbinski
- Department of Obstetrics and Gynecology, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA.
| | - Mary K Rojek
- Sex and Gender Health Collaborative, American Medical Women's Association, 1100 Woodfield Rd. #350, Schaumburg, IL 60173, USA
| | - Maria Demma I Cabral
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
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Rawat S, Rajkumari S, Joshi PC, Khan MA, Saraswathy KN. Who dies and who survives? Investigating the difference between suicide decedents and suicide attempters. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2019. [DOI: 10.1186/s41935-019-0115-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Izadi N, Mirtorabi SD, Najafi F, Nazparvar B, Nazari Kangavari H, Hashemi Nazari SS. Trend of years of life lost due to suicide in Iran (2006-2015). Int J Public Health 2018; 63:993-1000. [PMID: 30074055 DOI: 10.1007/s00038-018-1151-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 07/05/2018] [Accepted: 07/19/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Suicide is a major global public health problem and much burden in the societies. This study aims to calculate the years of life lost (YLL) due to suicide and investigate its trend in Iran. METHODS Information on deaths due to suicide in Iran was extracted from Iran Legal Medicine Organization. The years of life lost was calculated in each year according to gender and age-groups. To examine the trend for different years, joinpoint regression was used. RESULTS The 35,297 deaths due to suicide were recorded in 2006-2015. The total YLL in the 10-year period was 34.52 per 1000 persons in males, 13.61 per 1000 persons in females and 23.35 per 1000 persons in both sexes. Hanging comprised the largest YLL of suicide. The annual percent change of YLL rate was 3.3%. CONCLUSIONS The results revealed that male shows an increasing trend in YLL specifically among youth and adult, while there is no improvement in females. There is a national need to implement an effective health policy intervention in Iran.
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Affiliation(s)
- Neda Izadi
- Student Research Committee, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Davood Mirtorabi
- Department of Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Department of Epidemiology, Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bashir Nazparvar
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | | | - Seyed Saeed Hashemi Nazari
- Department of Epidemiology, Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kerr S, Martin C, Fleming M. Preventing suicide; nurse education and the occluded issue of gender. Nurse Educ Pract 2018; 32:58-63. [PMID: 30031273 DOI: 10.1016/j.nepr.2018.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 06/20/2018] [Accepted: 07/06/2018] [Indexed: 12/11/2022]
Abstract
Suicide prevention training recommended as part of national suicidal strategies across the UK has contributed to a reduction in suicide. Previous studies have found suicide prevention training changes attitude and increases confidence in ability to utilise suicide prevention strategies. There is limited evidence relating to the different responses to suicide prevention training by females and males. As the majority of nurses are female it is important to know if they report the same increases in confidence after suicide prevention training. An exploratory study utilising a survey design and repeated measures was used to investigate the effect of SafeTALK training on the level of general perceived self-efficacy (GPSE) in student nurses and to observe for any gender-related differences. A sample (N = 128) of first year student nurses were asked to complete a GPSE assessment pre and post SafeTALK training. Males reported higher scores on both total pre and post-training scores of GPSE and on mean scores per question compared to females. An effect of time (F (1, 118) = 20.07, p = .001) but no effect of gender (F (1, 118) = 3.53, p = .06) was found. A post-hoc sample size calculation revealed that a replication of the current investigation with a sample size of N = 15 (males), N = 155 (females), would be likely to find a statistically significant difference between genders in GPSE scores. It may be prudent to consider joint facilitation, with both male and female facilitators of SafeTALK training sessions. Specific pedagogical strategies can also be used to promote an increase in self-efficacy in those people undertaking SafeTALK training.
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Affiliation(s)
- Stewart Kerr
- School of Health, Nursing and Midwifery, University of the West of Scotland, University Avenue, Ayr, KA80SX, United Kingdom.
| | - Colin Martin
- Faculty of Society and Health, Buckinghamshire New University, Uxbridge Campus, Uxbridge Middlesex, UB8 1NA, United Kingdom.
| | - Mick Fleming
- Learning and Development Team, Cabinet Office, Keyll Darree, Nobles Hospital, Strang, IM4 4RH, Isle of Man.
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Bluth K, Roberson PNE, Girdler SS. Adolescent Sex Differences in Response to a Mindfulness Intervention: A Call for Research. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 26:1900-1914. [PMID: 29051700 PMCID: PMC5642304 DOI: 10.1007/s10826-017-0696-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Research on mindfulness interventions with adolescents has burgeoned over the last ten years, and findings have demonstrated increases in overall emotional wellbeing post-intervention. However, little is known about the differences between males and females in response to mindfulness interventions in this age group. In the present study we examine sex differences in outcomes of physiological stress markers during the Trier Social Stress Test (TSST) and emotional wellbeing measures before and after a mindfulness intervention (N = 15) with 10 female and 5 male adolescents. Additionally, we examine sex differences in course engagement and post-intervention use of mindfulness skills during the TSST. Overall, we found some evidence that females were more engaged than males in the class and also reported less stress post-intervention. We conclude by strongly encouraging future research in this area to more clearly elucidate the different ways in which adolescent males and females engage and respond to mindfulness interventions.
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Affiliation(s)
- Karen Bluth
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of North, Carolina-Chapel Hill, Chapel Hill, NC
| | | | - Susan S. Girdler
- Department of Psychiatry, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC
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Krysinska K, Batterham PJ, Christensen H. Differences in the Effectiveness of Psychosocial Interventions for Suicidal Ideation and Behaviour in Women and Men: A Systematic Review of Randomised Controlled Trials. Arch Suicide Res 2017; 21:12-32. [PMID: 26983580 DOI: 10.1080/13811118.2016.1162246] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The objective of this study was to explore outcomes of preventive programs and psychosocial treatments for suicidal ideation and behaviour in gender sub-groups in mixed gender studies and in studies limited to one gender. The method used was a systematic review of randomized controlled trials (RCTs) which included women or men only, or reported and/or examined outcomes of psychosocial interventions in mixed gender samples. A total of 27 (18%) of RCTs reported or examined differences in intervention outcomes. Of the mixed gender RCTs, 5 (33%) reported greater effectiveness for females than males. The review identified promising interventions in female-only samples. None of the trials reported greater effectiveness of the intervention in men. The majority of reviewed studies looking at treatment outcomes in gender sub-groups showed no differences between women and men or indicated that some psychosocial interventions are effective for women. There is a need for studies which look at gender effects and development of interventions more effective and appealing for men at risk of suicide.
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Lamis DA, Underwood M, D'Amore N. Outcomes of a Suicide Prevention Gatekeeper Training Program Among School Personnel. CRISIS 2016; 38:89-99. [PMID: 27561223 DOI: 10.1027/0227-5910/a000414] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Gatekeeper suicide prevention programs train staff to increase the identification and referral of suicidal individuals to the appropriate resources. AIMS We evaluated Act on FACTS: Making Educators Partners in Youth Suicide Prevention (MEP), which is an online training program designed to enhance the knowledge of suicide risk factors and warning signs as well as improve participants' attitudes and self-efficacy/confidence. METHOD School personnel (N = 700) completed a survey administered before and immediately after the training to assess gains in training outcomes and to evaluate participants' satisfaction with the training. RESULTS Results indicated that MEP participants demonstrated significant increases in suicide knowledge, attitudes, and self-efficacy. Moreover, exploratory analyses revealed moderating effects of professional role on pre-/posttest changes in self-efficacy, but not suicide knowledge or attitudes. Specifically, guidance counselors demonstrated significantly smaller increases in self-efficacy/confidence compared with teachers and classroom aids, whereas teachers demonstrated significantly larger increases in self-efficacy/confidence compared with administrators. The majority of school personnel who completed the MEP program were satisfied with the training content and experience. CONCLUSION Although the current findings are promising, more rigorous evaluations employing randomized controlled research designs are warranted to adequately determine the effectiveness of the MEP program.
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Affiliation(s)
- Dorian A Lamis
- 1 Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA, USA
| | | | - Nicole D'Amore
- 2 Society for the Prevention of Teen Suicide, Freehold, NJ, USA
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Matsuyama T, Kitamura T, Kiyohara K, Hayashida S, Nitta M, Kawamura T, Iwami T, Ohta B. Incidence and outcomes of emergency self-harm among adolescents: a descriptive epidemiological study in Osaka City, Japan. BMJ Open 2016; 6:e011419. [PMID: 27381208 PMCID: PMC4947743 DOI: 10.1136/bmjopen-2016-011419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To evaluate the incidence and outcomes of self-harm from ambulance records. DESIGN A retrospective, observational study. SETTING Osaka City, Japan. PARTICIPANTS A total of 365 adolescents aged 10-19 years with emergency self-harm such as poisoning by drugs or gas, cutting skin, jumping from heights, hanging and drowning and treated by emergency medical service personnel from January 2010 through December 2012. PRIMARY OUTCOME MEASUREMENTS Incidence per 100 000 persons and outcome at the scene or hospital arrival by age and gender. Poisson regression models for incidence evaluation were used; reporting relative risks (RRs) and their 95% CIs. RESULTS During the study period, a total of 425 self-harm events were documented in 365 adolescents. The incidence of self-harm increased significantly between the ages of 11 and 19 years, from 6.3 to 81.0 among boys and the ages of 12 and 19 years from 6.3 to 228.3 among girls, respectively (both p<0.001). Although there was no incidence difference between girls and boys in the group aged 11-14 years (RR 1.20; 95% CI 0.59 to 2.47), the incidence was significantly higher among girls than boys in the group aged 15-19 years (RR 4.18; 95% CI 3.20 to 5.45). The overall proportion of death by self-harm was 4.9%. The proportion of hospital admission and death by self-harm was higher among boys than among girls (38.6% vs 25.2%, p=0.016 and 14.8% vs 2.4%, p<0.001). CONCLUSIONS The incidence of emergency treatment for self-harm by adolescents increased with age and our findings also demonstrated the gender paradox. It would be necessary to establish active, gender-specific and comprehensive prevention strategies for adolescent self-harm, based on our findings showing the age and gender differences of self-harm among adolescents.
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Affiliation(s)
- Tasuku Matsuyama
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Masahiko Nitta
- Department of Emergency Medicine, Osaka Medical College, Takatsuki, Japan
- Department of Pediatrics, Osaka Medical College, Takatsuki, Japan
| | | | - Taku Iwami
- Kyoto University Health Services, Kyoto, Japan
| | - Bon Ohta
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Marshall A. Suicide Prevention Interventions for Sexual & Gender Minority Youth: An Unmet Need. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2016; 89:205-13. [PMID: 27354846 PMCID: PMC4918883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Suicide is currently the second leading cause of death in the U.S. among youth ages 10 to 24. Sexual and gender minority (SGM) youth face heightened risk for suicide and report greater odds of attempting suicide than their heteronormative peers. Contributing factors of experience, which are distinctly different from the experiences of heteronormative youth, place SGM youth at heightened risk for suicide. While interventions aimed at addressing suicide risk factors for all youth are being implemented and many have proven effective in the general population, no evidence-based intervention currently exists to reduce suicide risk within this special population. This perspective article discusses this need and proposes the development of an evidence-based suicide risk reduction intervention tailored to SGM youth. Creating a supportive school climate for SGM youth has been shown to reduce suicide risk and may provide protective effects for all youth while simultaneously meeting the unique needs of SGM youth.
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Shrivastava SR, Shrivastava PS, Ramasamy J. Public health strategies to ensure reduction in suicide incidence in middle and low income nations. J Neurosci Rural Pract 2016; 6:619-21. [PMID: 26752917 PMCID: PMC4692033 DOI: 10.4103/0976-3147.165431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Worldwide, the incidence of suicide has increased at an alarming rate and in the year 2012 close to 1 million people died because of suicide. Although, it is a well-acknowledged fact that suicides are completely preventable, the public health authorities have failed to halt the rising trend of the suicide because of the presence of various social and health related factors. As suicide is a complex issue, in the low and middle-income nations, the most cost-effective approach is to ensure the integration of suicide prevention program into the primary health care network. To conclude, suicide is an important public health concern which is definitively preventable. However, the need of the hour is that all the stakeholders should take collective responsibility, and work in collaboration to develop and implement a comprehensive multi-sectoral suicide prevention strategy.
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Affiliation(s)
| | - Prateek Saurabh Shrivastava
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Jegadeesh Ramasamy
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India
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Klimes-Dougan B, Wright N, Klingbeil DA. Suicide Prevention Public Service Announcements Impact Help-Seeking Attitudes: The Message Makes a Difference. Front Psychiatry 2016; 7:124. [PMID: 27471477 PMCID: PMC4945655 DOI: 10.3389/fpsyt.2016.00124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/28/2016] [Indexed: 11/13/2022] Open
Abstract
Suicide continues to be one of the most serious public health challenges. Public service announcements (PSAs) are frequently used to address this challenge, but are rarely sufficiently evaluated to determine if they meet the intended goals, or are associated with potential iatrogenic effects. Although it is challenging to assess the relative impact of different PSA modalities, our group previously noted that one billboard message failed to show the same benefits as one TV ad [e.g., Klimes-Dougan and Lee (1)]. The purpose of this study was to extend these findings to test critical aspects of suicide prevention billboard messaging. Although both simulated billboard messages presented had identical supporting messages, we predicted that the more personal billboard message, focused on saving one's life, would cause more favorable help-seeking attitudes than the message focused on suicide. Young adult university students (N = 785) were randomly assigned to one of three conditions; one of two billboard simulations or a TV ad simulation. Help-seeking attitudes, maladaptive coping, and reports of concern and distress were evaluated. The results of this study suggest some relative benefits in endorsement of favorable help-seeking attitudes for one of the billboard conditions - stop depression from taking another life. Although further research is needed to determine what methods will alter the risk for suicide in the population, the results of this study provide a useful first step showing that some billboard messaging may favorably influence help-seeking attitudes.
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Affiliation(s)
| | - Nathan Wright
- State of Minnesota: Department of Public Health , Minneapolis, MN , USA
| | - David A Klingbeil
- Department of Educational Psychology, University of Wisconsin-Milwaukee , Milwaukee, WI , USA
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