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Gordon M, Jayakumar N, Atzema C, Korczak DJ, Kennedy S, Schaffer A, Goldstein B, Orser BA, Yee D, Fiksenbaum L, Choi LHL, Phillips A, McFarlan A, Kreller M, Freedman C, Tanenbaum B, McDowall D, Ceniti A, Sinyor M. Self-harm presentations to hospital trauma centre emergency departments during the first year of the COVID-19 pandemic. Psychiatry Res 2024; 336:115892. [PMID: 38642422 DOI: 10.1016/j.psychres.2024.115892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/22/2024]
Abstract
The COVID-19 pandemic raised concerns regarding increased suicide-related behaviours. We compared characteristics and counts of Emergency Department (ED) presentations for self-harm, an important suicide-related outcome, during versus prior to the pandemic's first year. We included patients presenting with self-harm to the ED of two trauma centres in Toronto, Canada. Time series models compared intra-pandemic (March 2020-February 2021) presentation counts to predictions from pre-pandemic data. The self-harm proportion of ED presentations was compared between the intra-pandemic period and preceding three years. A retrospective chart review of eligible patients seen from March 2019-February 2021 compared pre- vs. intra-pandemic patient and injury characteristics. While monthly intra-pandemic self-harm counts were largely within expected ranges, the self-harm proportion of total presentations increased. Being widowed (OR=9.46; 95 %CI=1.10-81.08), employment/financial stressors (OR=1.65, 95 %CI=1.06-2.58), job loss (OR=3.83; 95 %CI=1.36-10.76), and chest-stabbing self-harm (OR=2.50; 95 %CI=1.16-5.39) were associated with intra-pandemic presentations. Intra-pandemic self-harm was also associated with Intensive Care Unit (ICU) admission (OR=2.18, 95 %CI=1.41-3.38). In summary, while the number of self-harm presentations to these trauma centres did not increase during the early pandemic, their proportion was increased. The association of intra-pandemic self-harm with variables indicating medically severe injury, economic stressors, and being widowed may inform future suicide and self-harm prevention strategies.
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Affiliation(s)
- Madeleine Gordon
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; Faculty of Medicine, University of Ottawa. 451 Smyth Rd, Ottawa K1H 8M5, ON, Canada.
| | - Navitha Jayakumar
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Clare Atzema
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Daphne J Korczak
- Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, ON, Canada
| | - Sidney Kennedy
- Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; St. Michael's Hospital. 36 Queen St E, Toronto M5B 1W8, ON, Canada
| | - Ayal Schaffer
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Benjamin Goldstein
- Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; Centre for Addiction and Mental Health. 250 College St, Toronto M5T 1R8, ON, Canada
| | - Beverley A Orser
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Doreen Yee
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Lisa Fiksenbaum
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; York University. 4700 Keele St, Toronto M3J 1P3, ON, Canada
| | - Liz Hanbyul Lee Choi
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Andrea Phillips
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Amanda McFarlan
- St. Michael's Hospital. 36 Queen St E, Toronto M5B 1W8, ON, Canada
| | - Margaret Kreller
- The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, ON, Canada
| | - Corey Freedman
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Brandy Tanenbaum
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Dorothy McDowall
- The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, ON, Canada
| | - Amanda Ceniti
- St. Michael's Hospital. 36 Queen St E, Toronto M5B 1W8, ON, Canada
| | - Mark Sinyor
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
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Morton M, Wang S, Tse K, Chung C, Bergmans Y, Ceniti A, Flam S, Johannes R, Schade K, Terah F, Rizvi S. Gatekeeper training for friends and family of individuals at risk of suicide: A systematic review. J Community Psychol 2021; 49:1838-1871. [PMID: 34125969 DOI: 10.1002/jcop.22624] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
AIMS Gatekeeper training (GKT) is an important suicide prevention strategy. Studies have evaluated the effectiveness of GKT in different populations, often neglecting family and friends who play a vital role in caring for people with suicide risk. This review evaluated GKT programs targeting family and friends to determine their effectiveness in this specific population. METHODS Academic databases were searched for studies on GKT programs. Programs involving family and friends caring for people with suicide risk were assessed for any impact on knowledge, self-efficacy, attitudes, and suicide prevention skills. RESULTS Seventeen studies were reviewed. GKT showed significant gains on outcomes of interest. Three studies targeted family and friends, with one involving them in program creation and conduction and another adjusting the program after their input. CONCLUSIONS GKT programs have potentially positive effects on family and friends caring for people with suicide risk. Few programs address the specific needs of this group, and programs adapted specifically for them are scarce. Future program development recommendations are discussed.
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Affiliation(s)
- Michael Morton
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Shijing Wang
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Kristen Tse
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Carolyn Chung
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Yvonne Bergmans
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Amanda Ceniti
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Shelley Flam
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Robb Johannes
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Health Promotions Program, Fred Victor, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Kathryn Schade
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Flora Terah
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Sakina Rizvi
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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