A Case Series Study of Help-Seeking among Younger and Older Men in Suicidal Crisis

Help-Seeking Needs Related to Suicide Prevention for Individuals in Contact With Mental Health Services: A Rapid Scoping Review

INTRODUCTION

Prior mental healthcare utilisation presents an important window of opportunity for providing suicide prevention interventions. To date, no reviews have consolidated the help-seeking needs of individuals in contact with mental health services. This warrants further attention given this group may have different needs for interventions compared with the general population who have not sought help previously.

AIM

The purpose of this rapid scoping review was to summarise the available literature on help-seeking needs related to suicide prevention among individuals in contact with mental health services from healthcare settings.

METHOD

Cochrane rapid review and Joanna Briggs Institute scoping review methodologies were adapted, and databases, including MEDLINE, Scopus, CINAHL, PsycInfo and EMBASE, were searched.

RESULTS

A total of 42 primary studies were included in analysis. Reported barriers and facilitators to help-seeking behaviours identified within studies were mapped onto the socio-ecological model. Barriers and facilitators identified included knowledge and attitudes towards healthcare utilisation, family and peer support, interactions with healthcare professionals, provision of holistic care, and the creation of a supportive atmosphere and safe space to promote open discussions of suicide-related concerns.

DISCUSSION

The findings of this review offer valuable insights into areas for improvement in addressing help-seeking needs for individuals who are in contact with health services related to suicide prevention.

IMPLICATION FOR RESEARCH

The findings serve as a foundation for shaping mental health initiatives informing approaches and care delivery tailored towards individuals who are in contact with health services. The reported barriers and facilitators offer insights to inform the development of mental health support tools to enhance care and considerations for evaluations.

Psychological risk factors predictive of suicidal distress in men receiving a community-based brief psychological intervention

INTRODUCTION

Adaptable community-based approaches for assessment and delivery of suicide prevention interventions for men experiencing suicidal crisis are needed. The lay your cards on the table (LYCT) component of the James' Place Model is a novel therapeutic approach comprised of four sets of card variables that correspond with suicidal risk factors. This study investigated the LYCT in predicting suicidal distress among men.

METHODS

Cross-sectional data of 511 men aged 18-69 years (M = 34.59 years; SD = 12.30) collected between 1st August 2018 and 29th July 2021 were assessed to predict suicidal distress measured using the CORE Clinical Outcome Measures (CORE-OM).

RESULTS

From four categories comprising the LYCT, correlational analyses demonstrated that 20 associations emerged as statistically significant (r's = 0.12-0.19). When these were included in regression analyses, effect sizes explained 2%-5% variance in CORE-OM outcomes (R2).

CONCLUSION

Use of LYCT is supported for engaging men in the assessment of suicide risk factors and to inform tailoring of intervention delivery to suit the individual needs of men experiencing suicidal crisis.

A mixed-methods evaluation of the acceptability and fidelity of the James' Place model for men experiencing suicidal crisis

Background

Research supports development of informal, community-based suicide prevention interventions that can be tailored to suit men's unmet needs. The James' Place model (JPM) is a community-based, clinical suicide prevention intervention for men experiencing suicidal crisis. Evidence supports the efficacy of the JPM and there are plans to expand to additional sites across the UK. This study evaluates therapists perceived acceptability of the JPM, and if fidelity to the planned delivery of the model is maintained within therapeutic practice.

Method

A mixed-methods design was used. Descriptive analyses of 30 completed intervention cases were examined to review fidelity of the model against the intervention delivery plan. Eight therapists took part in semi-structured interviews between November 2021 and March 2022 exploring the perceived acceptability, and barriers and facilitators to delivering the JPM.

Results

Descriptive analyses of James' Place audit notes revealed high levels of adherence to the JPM amongst therapists, but highlighted components of the model needed to be tailored according to individual men's needs. Thematic analysis led to the development of five themes. The first theme, therapeutic environment highlighted importance of the therapy setting. The second theme identified was specialised suicide prevention training in the JPM that facilitated therapists understanding and expertise. The third theme identified was therapy engagement which discusses men's engagement in therapy. The fourth theme, person-centred care related to adaptation of delivery of JPM components. The final theme, adapting the JPM to individual needs describes tailoring of the JPM by therapists to be responsive to individual men's needs.

Conclusion

The findings evidence therapist's acceptability and their moderate adherence to the JPM. Flexibility in delivery of the JPM enables adaptation of the model and co-production of therapy to meet men's needs. Implications for clinical practice are discussed.

Evaluating the role and effectiveness of co-produced community-based mental health interventions that aim to reduce suicide among adults: A systematic review

BACKGROUND

Suicide is a major public health risk requiring targeted suicide prevention interventions. The principles of co-production are compatible with tailoring suicide prevention interventions to meet an individual's needs.

AIMS

This review aimed to evaluate the role and effectiveness of co-produced community-based suicide prevention interventions among adults.

METHODS

Four electronic databases (PsycInfo, CINAHL, MEDLINE and web of science) were systematically searched. A narrative synthesis was conducted.

RESULTS

From 590 papers identified through searches, 14 fulfilled the inclusion criteria. Most included studies elicited the views and perspectives of stakeholders in a process of co-design/co-creation of community-based suicide prevention interventions.

CONCLUSION

Stakeholder involvement in the creation of community-based suicide prevention interventions may improve engagement and give voice to those experiencing suicidal crisis. However, there is limited evaluation extending beyond the design of these interventions. Further research is needed to evaluate the long-term outcomes of co-produced community-based suicide prevention interventions.

PATIENT AND PUBLIC INVOLVEMENT

This paper is a systematic review and did not directly involve patients and/or the public. However, the findings incorporate the views and perspectives of stakeholders as reported within the studies included in this review, and the findings may inform the future involvement of stakeholders in the design, development and delivery of community-based suicide prevention interventions for adults.

Public psychological crisis reports: an investigation during the remission of COVID-19 in China

Purpose

The COVID-19 outbreak has been effectively controlled in China, but the resulting public psychological crisis is a latent, persistent and torturous disaster. This crisis affects not only the individual’s health but also social stability. This study aims to reveal the structure and situation of public psychological crisis during the remission period of the COVID-19 epidemic.

Design/methodology/approach

A questionnaire survey of the psychological crisis was conducted from February to May 2021. Data was collected from 1,056 respondents from different provinces in China.

Findings

The findings reveal the dangerous risks of public psychological crises. The specific results are as follows: first, a hierarchical state structure of psychological crisis is constructed and characterized as a significant gradient decline, namely, anxious state>panic state>depressive state>hostile state. Second, 43.939% of respondents reported an anxious state, 46.780% reported a panic state, 40.909% reported a depressive state, 28.883% reported a hostile state and 22.254% of the respondents had four psychological crisis states. Third, those with 56–65 years of age, equal or below high school and PhD, with monthly family incomes of ¥50,000–¥100,000 and living in the county and city areas have relatively high levels of psychological crisis.

Originality/value

This study enriches the research on the evolution of the psychological crisis in terms of structure and periods. This study also provides substantial evidence for hierarchical intervention and differentiated intervention of psychological crisis.

James’ Place model: application of a novel clinical, community-based intervention for the prevention of suicide among men

Purpose

High suicide rates among men presents a global challenge for commissioners and clinicians. Innovative approaches towards suicide prevention interventions designed for men are needed. The James’ Place (JP) service opened in 2018, and its model of practice is a clinical, community-based intervention for men experiencing suicidal crisis. This paper aims to describe the implementation framework within which the JP model is applied.

Design/methodology/approach

Fostering a public health case study approach, this paper provides a description of how the JP service operates, including the referral pathways, key components of this innovative model and its impact upon the men who receive the intervention. Illustrative case studies derived from semi-structured interviews from men and therapists are reported.

Findings

The JP model is dynamic and flexible, allowing the tailoring of a suicidal crisis intervention to suit the needs and priorities of the individual and the wider local community. Clinical and practical implications, such as reduction in suicidality, are discussed.

Originality/value

Rapidly accessible, effective community-based interventions for men experiencing suicidal crisis are required. Yet, while widely advocated in policy, there remains a dearth of evidence illustrating the real-world application and value of such services within a community-setting. To the best of the authors’ knowledge, the JP model is the first of its kind in the UK and an example of an innovative clinical, community-based suicide prevention intervention offering support for men experiencing suicidal crisis.