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Meurk C, Roberts S, Lam M, Wittenhagen L, Callaway L, Moss K, Lucke J, Barker R, Waterson E, Rawlinson C, Malmstrom N, Weaver E, Hoehn E, Bosley E, Watson S, Heffernan E. Suicide crises among women and mothers during and around the time of pregnancy: Prevalence and timing of initial contact with first responders and health services. Aust N Z J Psychiatry 2023; 57:291-301. [PMID: 35652302 DOI: 10.1177/00048674221101517] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Suicide is a leading cause of maternal mortality. Suicidality during and around the time of pregnancy can have detrimental impacts on a child's development and outcomes. This paper examines prevalence, demographic characteristics, and timing of initial contact with first responders and health services for a cohort of women who experienced suicidality during and around the time of pregnancy. METHODS Findings are drawn from the Partners in Prevention (PiP) study, a population-wide linked data set of suicide-related attendances by police or paramedics in Queensland, Australia. A sub-cohort of women was identified, who were between 6 months preconception and 2 years postpartum at the time of a suicide-related contact with police or paramedics (PiP-Maternal). Findings are compared to other girls and women who had a suicide-related contact with police or paramedics (PiP-Female). Prevalence, demographic characteristics, timing of contact with first responders and health services, re-presentations, and mortality are reported. RESULTS The PiP-Maternal cohort comprised 3020 individuals and 3400 births. Women in the PiP-Maternal cohort were younger, more likely to be of Aboriginal and/or Torres Strait Islander descent and live outside of a major city than the PiP-Female cohort. There were high rates of out-of-hours calls to police and ambulance, and similar perceived seriousness of the call between women in the PiP-Maternal and PiP-Female cohorts. Women in the PiP-Maternal cohort were less likely to be admitted to an emergency department within 24 hours, even after matching on covariates. Prevalence of suicidality for women who were pregnant and up to 2 years postpartum was 1.32% (95% CI = [1.27, 1.37]). CONCLUSION Vulnerabilities and high rates of contact with police or paramedics, coupled with lower levels of follow-up, highlight the critical need to improve service responses for women with mental health needs during these phases of life.
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Affiliation(s)
- Carla Meurk
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Queensland Health, West Moreton Hospital and Health Service, Wacol, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Susan Roberts
- Lavender Mother and Baby Unit, Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Michael Lam
- Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Lisa Wittenhagen
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Queensland Health, West Moreton Hospital and Health Service, Wacol, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Leonie Callaway
- Royal Brisbane Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Department of Obstetric Medicine, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Katherine Moss
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Queensland Health, West Moreton Hospital and Health Service, Wacol, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia.,Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Jayne Lucke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Ruth Barker
- Queensland Children's Hospital, Queensland Health, Brisbane, QLD, Australia.,Queensland Injury Surveillance Unit, Jamieson Trauma Institute, Brisbane, QLD, Australia
| | - Elissa Waterson
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Queensland Health, West Moreton Hospital and Health Service, Wacol, QLD, Australia.,Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Catherine Rawlinson
- Queensland Centre for Perinatal and Infant Mental Health, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | | | - Edward Weaver
- Department of Obstetrics and Gynaecology/Women's and Children's, Griffith University School of Medicine and Dentistry, Sunshine Coast, QLD, Australia
| | - Elisabeth Hoehn
- Queensland Centre for Perinatal and Infant Mental Health, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Emma Bosley
- Information Support, Research and Evaluation, Office of the Medical Director, Queensland Ambulance Service, Kedron, QLD, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Shelby Watson
- State Domestic, Family Violence and Vulnerable Persons Unit, Vulnerable Persons Group, Domestic Family Violence and Vulnerable Persons Command, Queensland Police Service, Brisbane, QLD, Australia
| | - Ed Heffernan
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Queensland Health, West Moreton Hospital and Health Service, Wacol, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia.,Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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Meurk C, Wittenhagen L, Bosley E, Steele ML, Bunting D, Waterson E, Edwards B, Martain B, Heffernan E. Suicide crisis calls to emergency services: Cohort profile and findings from a data linkage study in Queensland, Australia. Aust N Z J Psychiatry 2022; 56:144-153. [PMID: 33904321 DOI: 10.1177/00048674211009604] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Police and paramedics play a crucial role in responding to suicide crises in the community. However, little is known about the nature, extent, precipitating factors, pathways and outcomes of a suicide-related call to emergency services and what responses will most effectively and compassionately meet the needs of those in crisis. Partners in Prevention: Understanding and Enhancing First Responses to Suicide Crisis Situations (PiP) was established to address these knowledge gaps. METHODS This article describes (1) the methodology used to construct the PiP dataset, a population-wide linked dataset that investigates the characteristics and health pathways of individuals in Queensland who were the subject of a suicide-related call to police or paramedics; and (2) preliminary findings on service demand, demographics and health services utilisation. RESULTS We identified 219,164 suicide-related calls to Queensland Police Service or Queensland Ambulance Service that were made over the 3-year period 1 February 2014 to 31 January 2017. A total of 70,893 individuals were identifiable via records linkage. The cohort linked to more than 7,000,000 health records. We estimated that police or paramedics in Queensland received on average 209 calls per day, with increases year on year over the study period. Analysis of demographic data highlighted the heterogeneous nature of this cohort and important demographic variations between individuals in contact with police versus ambulance services. DISCUSSION The PiP dataset provides a strong foundation for a multi-modal dataset that can be built on over time, both cross-sectionally and longitudinally. Further linkages to Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and social care datasets are planned. CONCLUSION Detailed population-level analysis that data linkage can provide is critical to improving understanding and responses to suicide crisis situations. The PiP study is a world first and provides a unique opportunity to improve responses to this public health problem.
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Affiliation(s)
- Carla Meurk
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia.,Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Lisa Wittenhagen
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Emma Bosley
- Information Support, Research & Evaluation, Office of the Medical Director, Queensland Ambulance Service, Kedron, QLD, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Megan L Steele
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Denise Bunting
- Information Support, Research & Evaluation, Office of the Medical Director, Queensland Ambulance Service, Kedron, QLD, Australia
| | - Elissa Waterson
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | | | - Ben Martain
- Queensland Police Service, Brisbane, QLD, Australia
| | - Ed Heffernan
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia.,Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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Waterson E, Harms E, Qupe L, Maritz J, Manning M, Makobe K, Chabeli M. Strategies to improve the performance of learners in a nursing college. Part I: Issues pertaining to nursing education. Curationis 2006; 29:56-65. [PMID: 16910135 DOI: 10.4102/curationis.v29i2.1077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The aim of this contextual, exploratory, descriptive and qualitative study was to describe strategies to improve the performance of learners in a nursing college. The article seeks to deal with factors relating to nursing education that contribute to the poor performance of learners and to outline related strategies to improve the situation. Three focus group interviews were conducted. One group was formed by seven tutors, and the other two groups were formed by fourth-year learners following a four-year comprehensive diploma course. All participants voluntarily took part in the study. Data was analyzed using the descriptive method of open coding by Tesch (in Creswell, 1994:154-156). Trustworthiness was ensured in accordance with Lincoln and Guba's (1985:290-326) principles of credibility, conformability, transferability and dependability. The findings were categorized into issues pertaining to nursing education as follows: curriculum overload; lack of theory and practice integration; teaching and assessment methods that do not promote critical thinking; tutors' lack of skills and experience; inadequate preparation of tutors for lectures; insufficient knowledge of tutors regarding outcomes-based education approach to teaching and learning; inadequate process of remedial teaching; discrepancies between tutors' marking; lack of clinical role-models and high expectations from the affiliated university as regards standards of nursing development programme by the staff development committee of the nursing college under study for implementation. Future research should focus on the effectiveness of the described strategies to improve the learners' performance. It is also recommended that similar studies be conducted or replicated in other nursing colleges to address the problem of poor performance of learners engaged in a four-year comprehensive diploma course.
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Waterson E, Harms E, Qupe L, Maritz J, Manning M, Makobe K, Chabeli M. Strategies to improve the performance of learners in a nursing college. Part II: Issues pertaining to management, attitudes and values. Curationis 2006; 29:66-76. [PMID: 16910136 DOI: 10.4102/curationis.v29i2.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
UNLABELLED This article forms part two of a bigger study that was conducted in a nursing college to explore and describe the reasons for the poor performance of learners. Part one of the study dealt with the issues pertaining to education, while this article (part two) seeks to describe issues pertaining to management, attitudes and values that lead to the poor performance of learners in the nursing college under study. A qualitative, exploratory and descriptive design that was contextual in nature was employed, and three focus groups interviews were conducted. Seven tutors formed one group while other two groups were formed by fourth-year learners following a comprehensive diploma course. All participants voluntarily participated in the study. Data was analyzed using the descriptive method of open coding in accordance with Tesch's protocol (in Creswell, 1994:154-156). Trustworthiness was ensured using the following principles: credibility, conformability, transferability and dependability (Lincoln & Guba 1985:290-326). Findings were categorized into issues pertaining to management, attitudes and values that had an influence on the poor performance of learners as follows: MANAGEMENT Inadequate resources and study facilities; policies that change frequently; tutors' dissatisfaction with regard to staff development, the lack of involvement by management and lack of management support, staff shortage and maldistribution of staff members; ineffective selection process of learners; inconsistent regulations, and too many of them; policies and procedures resulting in confusion and poor discipline. Attitudes and values: Tutors' lack of motivation and interest, lack of respect by learners and no team work among tutors. Through a conceptualization process and the recommendations by participants, strategies to improve the learners' performance were described. It is recommended that these strategies be submitted to the staff development committee for implementation and future follow-up research be undertaken to determine the effectiveness of the strategies. It is also recommended that other nursing colleges replicate the study within their context.
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