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Brousseau-Paradis C, Genest C, Maltais N, Séguin M, Rassy J. Emergency department care experience of suicidal patients: A qualitative analysis of patients' perspectives. Int Emerg Nurs 2024; 74:101449. [PMID: 38669791 DOI: 10.1016/j.ienj.2024.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/24/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Individuals experiencing suicidal ideation or behavior frequently seek assistance at the emergency department (ED), yet the care they receive does not consistently align with their needs. This study explores the ED care experience of suicidal patients from their own perspective and offers recommendations to improve ED care for this population. METHOD This qualitative study uses a descriptive interpretative design. Semi-structured interviews were conducted with 7 individuals who sought care in an ED due to suicidal ideation or behavior. Transcripts were analyzed using thematic analysis. FINDINGS Participants' experiences were marked by an unsuited physical environment described as uncomfortable, noisy, and depressing. The organization of care was perceived as inadequate as patients complained about limited front-line access to mental health expertise, long waiting times, overworked staff, and inequities between patients with physical injuries and those with mental health concerns. Participants reported feelings of being trapped, left on their own and mistreated during their ED stay. Most found their care experience unhelpful or distressing, leaving them reluctant to reconsult. Specific recommendations based on patients' testimonials and literature are provided to enhance the ED care experience of suicidal patients. CONCLUSION This study highlights several areas for improvement of the ED care experience of suicidal patients. Changes in current practices are needed to offer suicidal patients the satisfying care experience they deserve.
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Affiliation(s)
- Camille Brousseau-Paradis
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Pavillon Roger-Gaudry, 2900 boul. Édouard-Montpetit, bureau S-750, H3T 1J4 Montreal, QC, Canada; Research Center of the University Institute in Mental Health of Montreal, 7331 Hochelaga Street, Montreal H1N 3V2, QC, Canada.
| | - Christine Genest
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada; Research Center of the University Institute in Mental Health of Montreal, Trauma Study Center, Montreal, QC, Canada; Center for Research and Intervention on Suicide, Ethical Issues and End-of- Life Practices, Montreal, QC, Canada.
| | - Nathalie Maltais
- Department of Health Sciences, University of Quebec at Rimouski, Rimouski, QC, Canada; Department of Psychoeducation and Psychology, University of Quebec at Outaouais, Gatineau, QC, Canada.
| | - Monique Séguin
- Department of Psychoeducation and Psychology, University of Quebec at Outaouais, Gatineau, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - Jessica Rassy
- Research Center of the University Institute in Mental Health of Montreal, 7331 Hochelaga Street, Montreal H1N 3V2, QC, Canada; Quebec Network on Suicide, Mood Disorders and Associated Disorders, Montreal, QC, Canada; Quebec Network on Nursing Intervention Research, Montreal, QC, Canada; School of Nursing, University of Sherbrooke, Longueuil, QC, Canada.
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2
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Wathelet M, Dézétrée A, Pauwels N, Vaiva G, Séguin M, Thomas P, Grandgenèvre P, Notredame CÉ. Validation of a French questionnaire assessing knowledge of suicide. Encephale 2023:S0013-7006(23)00180-X. [PMID: 38040504 DOI: 10.1016/j.encep.2023.08.016] [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] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES The objective of this study was to develop and validate the Knowledge of Suicide Scale (KSS), elaborated to assess adherence to myths about suicide. METHODS The KSS is a self-questionnaire including 22 statements relating to myths about suicide for which the respondent is asked to rate his degree of adherence on a scale ranging from 0 ("strongly disagree") to 10 ("completely agree"). Using the script concordance test scoring method, the respondents' scores were compared with those of experts to obtain, for each item, a score between 0 (maximum deviation with the experts) and 1 (minimum deviation with the experts). One thousand and thirty-five individuals (222 psychiatric interns, 332 medical interns in the first semester excluding psychiatry and 481 journalism students) were included. RESULTS According to the exploratory factor analysis, the KSS is a two-dimensional scale: the first subscale includes 15 items and the second seven items. The tool showed excellent face validity, correct convergent and divergent validities (multi-method multi-feature analyzes), and good internal consistency (Cronbach's alpha coefficient between 0.66 and 0.83 for scales and subscales). The KSS is moderately and negatively correlated with the Stigma of Suicide Scale (r=-0.3). It significantly discriminates groups with different expected levels of knowledge regarding suicide (P<0.001). CONCLUSIONS The KSS demonstrated good psychometric properties to measure adherence to myths about suicide. This tool could be useful in assessing the effectiveness of suicide prevention literacy improvement programs.
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Affiliation(s)
- Marielle Wathelet
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, 59000 Lille, France; Centre National de Ressources et de Résilience Lille-Paris (CN2R), 59000 Lille, France; Department of Psychiatry, CHU de Lille, 59000 Lille, France
| | - Arnaud Dézétrée
- Sistel Service Interprofessional Health Service at Work Eure-et-Loire, 28000 Chartes, France
| | - Nathalie Pauwels
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, 59000 Lille, France; Papageno program, France
| | - Guillaume Vaiva
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), 59000 Lille, France; Department of Psychiatry, CHU de Lille, 59000 Lille, France; University Lille, Inserm, CHU de Lille, U1172-LilNCog-Lille Neuroscience & Cognition, 59000 Lille, France; Group for the suicide study and prevention, France
| | | | - Pierre Thomas
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, 59000 Lille, France; Department of Psychiatry, CHU de Lille, 59000 Lille, France; University Lille, Inserm, CHU de Lille, U1172-LilNCog-Lille Neuroscience & Cognition, 59000 Lille, France
| | - Pierre Grandgenèvre
- Department of Psychiatry, CHU de Lille, 59000 Lille, France; Papageno program, France; University Lille, Inserm, CHU de Lille, U1172-LilNCog-Lille Neuroscience & Cognition, 59000 Lille, France
| | - Charles-Édouard Notredame
- Department of Psychiatry, CHU de Lille, 59000 Lille, France; Papageno program, France; University Lille, Inserm, CHU de Lille, U1172-LilNCog-Lille Neuroscience & Cognition, 59000 Lille, France; Group for the suicide study and prevention, France.
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Abstract
Background Suicide is a major public health problem and a cause of premature mortality. With a view to prevention, a great deal of research has been devoted to the determinants of suicide, focusing mostly on individual risk factors, particularly depression. In addition to causes intrinsic to the individual, the social environment has also been widely studied, particularly social isolation. This paper examines the social dimension of suicide etiology through a review of the literature on the relationship between suicide and social isolation. Methods Medline searches via PubMed and PsycINFO were conducted. The keywords were “suicid*” AND “isolation.” Results Of the 2,684 articles initially retrieved, 46 were included in the review. Conclusions Supported by proven theoretical foundations, mainly those developed by E. Durkheim and T. Joiner, a large majority of the articles included endorse the idea of a causal relationship between social isolation and suicide, and conversely, a protective effect of social support against suicide. Moreover, the association between suicide and social isolation is subject to variations related to age, gender, psychopathology, and specific circumstances. The social etiology of suicide has implications for intervention and future research.
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4
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Ligier F, Body Lawson F, Lamourette M, Giguère CE, Lesage A, Séguin M. Comparing Childhood Characteristics of Adopted and Non-adopted Individuals Deceased by Suicide. Front Psychiatry 2022; 13:756306. [PMID: 35722592 PMCID: PMC9203736 DOI: 10.3389/fpsyt.2022.756306] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Across the globe more than 35,000 children a year are adopted by non-relatives, and some studies suggest that adopted individuals may be more vulnerable to developing mental disorders. To map the differences in suicide risk factors in adopted and non-adopted individuals, this study will compare the development of mental disorders as well as life events occurring before the age of 18 for both adopted and non-adopted individuals deceased by suicide. METHODS This study included 13 adopted and 26 non-adopted individuals deceased by suicide as well as 26 non-adopted living control individuals. Cases were taken from a data bank created over the last decade by researchers of [our institution] comprising a mixture of 700 suicide cases and living control individuals aged from 14 to 84. Adopted and non-adopted individuals deceased by suicide; adopted individuals deceased by suicide and non-adopted living control individuals were each compared on Axis I and II disorders, early life events, and burdens of adversity. RESULTS Results show significant differences, with a higher rate of Attention Deficit Hyperactivity Disorder, mental health comorbidity and Cluster C personality disorders among adopted individuals. Furthermore, adopted individuals have higher adversity scores prior to the age of 15. CONCLUSION This study underlines the fact that adoptive families need to be supported throughout adoption. Health care professionals need specialized training on this matter, and the psychological challenges adopted individuals face need to be treated at the earliest juncture.
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Affiliation(s)
- Fabienne Ligier
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Psychiatry Department, Montréal University, Montréal, QC, Canada.,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,EA 4360 APEMAC, Université de Lorraine, Nancy, France.,PUPEA, Centre Psychothérapique de Nancy, Laxou, France
| | | | | | - Charles-Edouard Giguère
- Banque Signature, Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Alain Lesage
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Psychiatry Department, Montréal University, Montréal, QC, Canada.,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,Québec Network on Suicide Research, Québec, QC, Canada
| | - Monique Séguin
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Québec Network on Suicide Research, Québec, QC, Canada.,Department of Psychoeducation and Psychology, Québec University, Québec, QC, Canada.,Centre Intégré de Santé et Service Social de l'Outaouais (CISSSO), Gatineau, QC, Canada
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5
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Vachon M, Nicolas C, Notredame CE, Séguin M. [Investigating postvention best practices : The Delphi method]. Rev Epidemiol Sante Publique 2021; 69:367-379. [PMID: 34642047 DOI: 10.1016/j.respe.2021.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 04/23/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Postvention aims to implement services adapted to the needs of a population that may be vulnerable after suicide. While a plethora of postvention programs exist, they are generally based less on solid evidence than on the judgment of health professionals. Using the Delphi method, an Australian study obtained a consensus among experts as to which postvention actions are to be engineered in a postvention program. Since no similar study has been carried out for programs in French-speaking countries, it seemed important to reproduce the same type of study and to compare the respective results. The present study is aimed at establishing a French inventory of postvention actions and at achieving a consensus among experts as to the actions to be included in a postvention program. METHODS A systematic review of the scientific literature (PRISMA method) and the gray literature (documentation on the WEB) made it possible to identify the different actions that have been included in various postvention programs. Using the DELPHI method, experts endeavored to assess their relevance. RESULTS An inventory of 190 postvention actions was established and they were classified according to a sequential axis (pre-event, at the time of the event, and post-event), according to type of action (environment-centered or people-centered). The experts identified 128 actions to be included in a postvention program. CONCLUSION Convergence was observed among the experts, as they identified the practices to be encouraged following a suicide. When comparing the results in French-speaking countries to the 548 actions selected in the Australian study, we observe similarities between the two studies regarding types of postvention actions. This study provides an update for health professionals on the most relevant practices to be included in a postvention program.
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Affiliation(s)
- M Vachon
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada.
| | | | - C-E Notredame
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Lille, 59000Lille, France; Centre neurosciences et cognition de Lille, Subjectivité et plasticité, Inserm U1172, Université de Lille, 59000Lille, France
| | - M Séguin
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada; Groupe McGill d'études sur le suicide,; Réseau québécois de recherche sur le suicide, les troubles de l'humeur et les troubles associés,; Institut universitaire en santé mentale de l'Hôpital Douglas, Montréal, Canada
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6
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Tousignant M, Séguin M, Turecki G, Chawky N, Vanier C, Morissette R, Lesage A. Adult men suicide: a developmental approach. J Mens Health 2021. [DOI: 10.31083/jomh.2021.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Amadéo S, Rereao M, Vanquin David G, Nguyen N, Séguin M, Beauchamp G, Favro P, Trouche H, Malogne A, Goodfellow B, Gokalsing E, Spodenkiewicz M, Sy A, Bocage-Barthélémy Y, Sebti J, Tuheiava A, Jehel L, De Leo D. Suicide in French Polynesia: a retrospective analysis based on medicolegal documents and interview with family. J Int Med Res 2021; 49:3000605211003452. [PMID: 34521240 PMCID: PMC8447108 DOI: 10.1177/03000605211003452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective To analyse the epidemiological data on suicide in French Polynesia (FP). Methods Data on suicides were collected from the Public Health Direction, Judicial
Police Investigations Court of Justice records, the Centre d’Opérations et
de Renseignements de la Gendarmerie, patient records for those hospitalized
in psychiatry and from psychological autopsies. Results The dataset consisted of 316 suicide cases in FP over 25 years (1992–2016).
In FP, suicide was more frequent in men (sex ratio 3.2:1), young people
(mean age, 34.4 years) and individuals with previously diagnosed psychiatric
disorders (100 of 316; 31.6%) The most common method of suicide was hanging
(276 of 316; 87.3%). A history of previous suicide attempts was found in 25
of 56 (44.6%) of suicide cases, when documented. The most common potential
triggering factors for suicide were emotional problems. The suicide rates
have remained stable during 1992–2016 (mean 10.6/100 000 inhabitants per
year), with periods of economic crises increasing suicide rates. Conclusions These results provide valuable information to enable the effective targeting
of suicide prevention strategies toward those at high risk. Economic crises
had larger impacts in the French overseas territories than mainland France.
Given the unprecedented economic impact of the Covid-19 pandemic in FP,
there is an urgent need to implement suicide epidemiological surveillance
and prevention programmes.
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Affiliation(s)
- Stephane Amadéo
- Hospital Centre of French Polynesia (CHPF), Tahiti, French Polynesia.,Suicide Prevention Centre and Association SOS Suicide, Tahiti, French Polynesia.,MOODS Team Inserm Unity U1018, CESP, Paris, France.,Hospital University Centre (CHU), Fort de France, Martinique, FWI, France
| | - Moerani Rereao
- Hospital Centre of French Polynesia (CHPF), Tahiti, French Polynesia.,Suicide Prevention Centre and Association SOS Suicide, Tahiti, French Polynesia
| | | | | | - Monique Séguin
- Groupe McGill d'Étude sur le Suicide, Montreal, Canada.,Réseau québécois sur le suicide, les troubles de l'humeur et les troubles associés, Montreal, Canada
| | - Guy Beauchamp
- Réseau québécois sur le suicide, les troubles de l'humeur et les troubles associés, Montreal, Canada
| | - Patrick Favro
- EASTCO Research Laboratory, University of French Polynesia, Tahiti, French Polynesia
| | | | - Aurélia Malogne
- Hospital Centre of French Polynesia (CHPF), Tahiti, French Polynesia.,Suicide Prevention Centre and Association SOS Suicide, Tahiti, French Polynesia
| | | | - Erick Gokalsing
- MOODS Team Inserm Unity U1018, CESP, Paris, France.,CUMP/VigilanS Indian Ocean, Public Mental Health Hospital, La Réunion, France
| | - Michel Spodenkiewicz
- MOODS Team Inserm Unity U1018, CESP, Paris, France.,Department of Mental Health, CIC-EC 1410, University Hospital Centre (CHU) of la Réunion, Saint-Pierre, France
| | - Aminata Sy
- WHO Collaborative Center - EPSM LILLE Métropole, Lille, France.,Inserm Unity UMR 1123 - ECEVE, Paris, France
| | | | - Johan Sebti
- Hospital Centre of French Polynesia (CHPF), Tahiti, French Polynesia
| | - Annie Tuheiava
- Suicide Prevention Centre and Association SOS Suicide, Tahiti, French Polynesia
| | - Louis Jehel
- MOODS Team Inserm Unity U1018, CESP, Paris, France.,Hospital University Centre (CHU), Fort de France, Martinique, FWI, France
| | - Diego De Leo
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
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8
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Séguin M, Beauchamp G, Notredame CÉ. Adversity Over the Life Course: A Comparison Between Women and Men Who Died by Suicide. Front Psychiatry 2021; 12:682637. [PMID: 34447322 PMCID: PMC8382958 DOI: 10.3389/fpsyt.2021.682637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study sets out to compare the presence of life events across different domains throughout the life course which may contribute to the burden of adversity experienced differently among men and women who died by suicide. Method: In a sample of 303 individuals (213 men and 90 women), data was derived from extensive clinical interviews conducted with informants. Models allowed the identification of patterns of life trajectories. Results: Overall, the burden of adversity was similar across the life course except for the 5-9, 25-29, and 30-34 age ranges, where a significant difference appeared between genders [t-test = 2.13 (p < 0.05), 2.16 (p < 0.05) and 3.08 (p < 0.005), respectively] that seems to disadvantage women. The early adversities of violence and neglect, between 0 and 19 years old, are important for both groups. During the life course, women were more exposed to interpersonal adverse events such as being victims of negligence and violence, relational difficulties or abuse from their spouse, as well as tension with their own children. Men encountered more academic difficulties, legal entanglements and financial difficulties, and were more than three times more likely to develop an alcohol/drug abuse problem than women. Conclusions: The data suggests some gender differences in exposure to longstanding and severe life problems contributing to suicide vulnerability. For women, the continuing burden emerges from chronic interpersonal adversities, whereas, for men, the adverse events are to a larger degree socially exposed, compounded with alcohol misuse. The adversities, especially those of a public or social nature, may be witnessed by others, which should favor the detection of vulnerability over the life course, and psychosocial or mental health services should be offered and provided earlier during the life course. Yet more men die by suicide than women. Resiliency and protective factors may benefit women to a greater degree. Future research should tackle the challenge of investigating these important elements. Meanwhile, from a public health perspective, access to psychosocial and mental health services and social acceptability of seeking services should be part of an ongoing effort in all institutional structures as a way of decreasing downstream mental health problems and vulnerability to suicide.
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Affiliation(s)
- Monique Séguin
- Department of Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Réseau Québécois sur le Suicide, les Troubles de l'humeur et les Troubles Associés (RQSHA), Montreal, QC, Canada
| | - Guy Beauchamp
- Réseau Québécois sur le Suicide, les Troubles de l'humeur et les Troubles Associés (RQSHA), Montreal, QC, Canada
| | - Charles-Édouard Notredame
- Réseau Québécois sur le Suicide, les Troubles de l'humeur et les Troubles Associés (RQSHA), Montreal, QC, Canada
- INSERM UMR1172 Lille Neurosciences et Cognition, Nord-Pas-de-Calais, Lille, France
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9
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Montreuil M, Séguin M, P. Gros C, Racine E. Everyday ethics of suicide care: Survey of mental health care providers' perspectives and support needs. PLoS One 2021; 16:e0249048. [PMID: 33886553 PMCID: PMC8061990 DOI: 10.1371/journal.pone.0249048] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/09/2021] [Indexed: 11/18/2022] Open
Abstract
Suicide occurs in people of all ages and backgrounds, which negatively affects families, communities, and the health care providers (HCPs) who care for them. The objective of this study was to better understand HCPs' perspectives of everyday ethical issues related to caring for suicidal patients, and their perceived needs for training and/or support to address these issues. We conducted a mixed methods survey among HCPs working in mental health in Québec, Canada. Survey questions addressed their perspectives and experiences of everyday ethical challenges they encounter in their practice with people who are suicidal, and their perceived needs for training and/or support therein. 477 HCPs completed the survey. Most participants mentioned encountering ethical issues when caring for people who are suicidal. The challenges HCPs encounter in their practice with people who are suicidal are numerous, including issues related to maintaining privacy, confidentiality, freedom and the therapeutic relationship. The lack of time, resources and professional support to address these issues was emphasized. Most HCPs reported that the training or education they have received does not allow them to address everyday ethical issues related to suicide care. In sum, there is a clear reported need for better training and support for HCPs who are offering care to people who are suicidal in relation to everyday ethical issues they encounter. Implications for practice include providing greater access to training, including access to specialists in ethics to address specific issues. This additional support could alleviate morally distressing situations for HCPs.
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Affiliation(s)
- Marjorie Montreuil
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun, Quebec, Canada
- Institut de recherches cliniques de Montréal, Montreal, Quebec, Canada
| | - Monique Séguin
- Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun, Quebec, Canada
- Department of Psychology, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - Catherine P. Gros
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - Eric Racine
- Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun, Quebec, Canada
- Institut de recherches cliniques de Montréal, Montreal, Quebec, Canada
- Départements de Médecine et Médecine sociale et préventive, Université de Montréal, Montreal, Quebec, Canada
- Departments of Neurology and Neurosurgery, Medicine, and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
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10
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Affleck W, Chawky N, Beauchamp G, Inukpuk MM, Annanack E, Paradis V, Séguin M. Suicides in Nunavik: a life course study. Int J Circumpolar Health 2021; 80:1880143. [PMID: 33691591 PMCID: PMC7954501 DOI: 10.1080/22423982.2021.1880143] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This study reports results of a life course study conducted with Inuit in Nunavik to obtain information on the life adversities and cumulative burden of adversity for three groups: those who died by suicide, those who attempted suicide, and those who experienced suicidal ideation but never attempted. The study involved different levels of collaboration between health authorities, front-line health workers and the research team. Results indicate that substance misuse and relational difficulties are most associated with the burden of adversity for those people who died by suicide, while bullying is most associated with the burden of adversity for those people who have made suicide attempts and those who have never made a suicide attempt. Specifically targeting parent–child relations, substance misuse, and bullying may be an important upstream strategy for reducing future suicidality in Nunavik.
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Affiliation(s)
- William Affleck
- Department of Psychology and Psycho-education, Institut Universitaire En Santé Mentale Douglas, Montreal, Canada.,Université Du Québec En Outaouais (UQO), Gatineau, Canada
| | - Nadia Chawky
- Department of Psychology and Psycho-education, Institut Universitaire En Santé Mentale Douglas, Montreal, Canada
| | - Guy Beauchamp
- Université Du Québec En Outaouais (UQO), Gatineau, Canada
| | - Martha Malaya Inukpuk
- Sungirtuivik Family House, Inukjuaq, Canada.,Nunavik Regional Board of Health and Social Services, Kuujuaq, Canada
| | | | - Véronique Paradis
- Nunavik Regional Board of Health and Social Services, Kuujuaq, Canada
| | - Monique Séguin
- Department of Psychology and Psycho-education, Institut Universitaire En Santé Mentale Douglas, Montreal, Canada.,Université Du Québec En Outaouais (UQO), Gatineau, Canada
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11
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Notredame CE, Chawky N, Beauchamp G, Vaiva G, Séguin M. The Role of Adolescence in Development Paths Toward Suicide: Specificities and Shaping of Adversity Trajectories. Front Psychiatry 2020; 11:557131. [PMID: 33192671 PMCID: PMC7661797 DOI: 10.3389/fpsyt.2020.557131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/14/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose: Adolescence is a key period of transitions in the psychological, cognitive, neurobiological and relational domains, which is associated to high susceptibility to adverse life experiences. However, the way adolescent development alters life paths toward suicide remains unclear. Thereby, we aimed at testing whether and how adolescence interfered with the adversity trajectories of individuals who died by suicide. Methods: In a sample of 303 individuals who died by suicide, longitudinal Burden of Adversity ratings were derived from extensive psychological autopsies and life trajectory narrative interviews conducted with informants. Piecewise Joint Latent Class Models allowed the identification of patterns of adversity trajectories and tested the introduction of breakpoints in life-paths. Classes inferred from the optimal model were compared in terms of socio-demographics, psychopathology, and rate of different adverse life events. Results: The most accurate model derived 2 trajectory patterns with a breakpoint in early adolescence. In the first class (n = 39), the burden of adversity increased steadily from birth to death, which occurred at 23 (SE = 1.29). In the second class (n = 264), where individuals died at 43 years of age (SE = 0.96), the burden of adversity followed a similar trajectory during infancy but stabilized between 10 and 14 years and started to increase again at about 25. Childhood family instability, dependent events, exposure to suicide, intra-family sexual victimization and affective disorders at death were more frequent in class 1. Conclusions: A bifurcation in trajectories between early and late suicides occurs during adolescence. The dynamic pattern of adversity during this period is a key issue to understand the developmental heterogeneity in suicide risk.
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Affiliation(s)
- Charles-Edouard Notredame
- Psychiatry Department, CHU Lille, Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, Lille, France
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
| | - Nadia Chawky
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
- McGill Group for Suicide Studies, Douglas University Mental Health Institute, Verdun, QC, Canada
| | - Guy Beauchamp
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
| | - Guillaume Vaiva
- Psychiatry Department, CHU Lille, Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, Lille, France
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
- Centre National de Ressources et Résilience pour les Psychotraumatismes (Cn2r), Lille, France
| | - Monique Séguin
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
- McGill Group for Suicide Studies, Douglas University Mental Health Institute, Verdun, QC, Canada
- Department of Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
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12
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Beauchamp MH, Séguin M, Gagner C, Lalonde G, Bernier A. The PARENT model: a pathway approach for understanding parents’ role after early childhood mild traumatic brain injury. Clin Neuropsychol 2020; 35:846-867. [DOI: 10.1080/13854046.2020.1834621] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- M. H. Beauchamp
- Department of Psychology, University of Montreal, Canada
- Sainte-Justine Hospital Research Center, Montreal, Canada
| | - M. Séguin
- Department of Psychology, University of Montreal, Canada
- Sainte-Justine Hospital Research Center, Montreal, Canada
| | - C. Gagner
- Department of Psychology, University of Montreal, Canada
- Sainte-Justine Hospital Research Center, Montreal, Canada
| | - G. Lalonde
- Department of Psychology, University of Montreal, Canada
- Sainte-Justine Hospital Research Center, Montreal, Canada
| | - A. Bernier
- Department of Psychology, University of Montreal, Canada
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13
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Ligier F, Rassy J, Fortin G, van Haaster I, Doyon C, Brouillard C, Séguin M, Lesage A. Being pro-active in meeting the needs of suicide-bereaved survivors: results from a systematic audit in Montréal. BMC Public Health 2020; 20:1534. [PMID: 33036601 PMCID: PMC7547412 DOI: 10.1186/s12889-020-09636-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/30/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Suicide is a major public health concern. In 2017, the suicide rate in Canada was 11 per 100,000 inhabitants. According to literature, 1 in 5 people have experienced a death by suicide during their lifetime. The aim of this study was to describe the met and unmet needs of suicide-bereaved survivors and to provide postvention recommendations. METHODS Further to an exploratory mixed-method audit of 39 suicides that occurred in Montreal (Canada) in 2016, suicide-bereaved survivors (n = 29) participated in semi-structured interviews and completed instruments to discuss and assess potential pathological grief, depression (PHQ-9), and anxiety (GAD-7), as well as health and social services utilization. A panel then reviewed each case and provided recommendations. The mean age of participants was 57.7 years and 23 were women. RESULTS Although help was offered initially, in most cases by a health professional or service provider (16/29), 22 survivors would have liked to be contacted by telephone in the first 2 months post suicide. Four categories of individual unmet needs (medical/pharmacological, information, support, and outreach) and one collective unmet need (suicide pre/postvention training and delivery) emerged. CONCLUSIONS Although Quebec provincial services have been developed and offered to suicide-bereaved survivors in the past decade, many dwindled over time and none has been applied systematically. Recommendations for different stakeholders (Ministry of Health and Social Services, coroners, NGOs, and representatives of suicide-bereaved survivors) outlined in this study could be an interesting first step to help develop a suicide pre/postvention strategy.
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Affiliation(s)
- Fabienne Ligier
- Centre Psychothérapique de Nancy, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, 1 rue du Dr Archambault, F-54520, Laxou, France. .,EA 4360 APEMAC, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
| | - Jessica Rassy
- School of Nursing, Université de Sherbrooke, Longueuil, Canada.,Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Gabrielle Fortin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Ian van Haaster
- CIUSSS de l'Est de l'Ile de Montréal, CLSC St-Michel, Montreal, Canada
| | - Claude Doyon
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Charlie Brouillard
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Monique Séguin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada.,Centre intégré de santé et service social de l'Outaouais (CISSSO), Outaouais, Quebec, Canada
| | - Alain Lesage
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry, Université de Montréal, Quebec, Canada
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14
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Ligier F, Michaud L, Kabuth B, Lesage A, Corriveau P, Séguin M. A Quantitative and Qualitative Study of Notes Left by Youth Who Died by Suicide in Quebec from 1895 to 1985. Arch Suicide Res 2020; 24:554-567. [PMID: 31335304 DOI: 10.1080/13811118.2019.1645068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The study of suicide notes and the evolution of their content could contribute to a better understanding of reasons conducive to suicide mortality and offer further prevention strategies. From 1895 to 1985, 706 coroner's inquests of individuals who died by suicide and were 20 years old or younger were found in the province of Quebec. Quantitative analysis compared those who left notes (n = 47) to those who did not leave notes (n = 659). Furthermore, notes were subjected to inductive thematic analysis. Sociodemographic characteristics of the deceased individuals did not change over time. Qualitative analysis revealed four superordinate themes: (1) last wishes, (2) to those I leave behind, (3) about me and how and why I did it, and (4) self-positioning in the world. Only the last theme evolved over the time period considered. Suicide notes shed light on the psychological state of the majority of young note leavers and suggest the persistent feelings of distress and entrapment before the suicide, which may be important factors for caregivers and family members to monitor.
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Montreuil M, Séguin M, Gros CP, Racine E. Survey of Mental Health Care Providers’ Perspectives on the Everyday Ethics of Medical-Aid-in-Dying for People with a Mental Illness. bioethics 2020. [DOI: 10.7202/1070236ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Context: In most jurisdictions where medical-aid-in-dying (MAiD) is available, this option is reserved for individuals suffering from incurable physical conditions. Currently, in Canada, people who have a mental illness are legally excluded from accessing MAiD. Methods: We developed a questionnaire for mental health care providers to better understand their perspectives related to ethical issues in relation to MAiD in the context of severe and persistent suffering caused by mental illness. We used a mixed-methods survey approach, using a concurrent embedded model with both closed and open-ended questions. Findings: 477 healthcare providers from the province of Québec (Canada) completed the questionnaire. One third of the sample (34.4%) were nurses, one quarter psychologists (24.3%) and one quarter psycho-educators (24%). Nearly half of the respondents (48.4%) considered that people with a severe mental illness should be granted the right to opt for MAiD as a way to end their suffering. Respondents were more likely to feel comfortable listening to the person and participating in discussions related to MAiD for a mental illness than offering care or the means for the person to access MAiD. Most (86.2%) reported that they had not received adequate/sufficient training, education or preparation in order to address ethical questions surrounding MAiD. Conclusions: The findings highlight how extending MAiD to people with a mental illness would affect daily practices for mental healthcare providers who work directly with people who may request MAiD. The survey results also reinforce the need for adequate training and professional education in this complex area of care.
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Affiliation(s)
- Marjorie Montreuil
- Ingram School of Nursing, McGill University, Montreal; Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun; Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
| | - Monique Séguin
- Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun; Department of Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Catherine P. Gros
- Ingram School of Nursing, McGill University, Montreal; Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun, Québec, Canada
| | - Eric Racine
- Institut de recherches cliniques de Montréal, Montréal; Université de Montréal, Montréal; McGill University, Montreal, Québec, Canada
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Michaud L, Ligier F, Bourquin C, Corbeil S, Saraga M, Stiefel F, Séguin M, Turecki G, Richard-Devantoy S. Differences and similarities in instant countertransference towards patients with suicidal ideation and personality disorders. J Affect Disord 2020; 265:669-678. [PMID: 32090784 DOI: 10.1016/j.jad.2019.11.115] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 11/21/2019] [Accepted: 11/28/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Previous findings showed that suicidal patients elicit mostly negative countertransference such as distress, hopelessness, feelings of inadequacy, and apprehension, and that a concurrent personality disorder is associated with more feelings of entrapment and mistreatment, among other adverse reactions. No studies were however conducted on instant countertransference (iCT), i.e., after a single encounter, for example in an emergency setting. We aimed to evaluate the impact of suicidal ideations, self-harm and presence of personality disorders on instant Countertransference (iCT). METHODS Caregivers rated their iCT with two validated and standardized questionnaires after a first emergency or outpatient consultation. Suicidal ideation, self-harm and personality disorders were tested as predictors for iCT in a multivariate and multilevel analysis. RESULTS Thirty caregivers rated their iCT towards 321 patients. Personality disorders and suicidal ideation, but neither recent nor past history of self-harm, predicted iCT. Common iCT included tension, lack of self-confidence and feeling of being tied. iCT specifically associated with suicidal ideation included distress, lack of hope, confusion, and sense that the patient's life had little worth. In contrast, iCT towards patients with personality disorders suggested tension in the therapeutic relationship (low affiliation with patient, anger, disappointment, devaluation). LIMITATIONS Caregiver's characteristics were not considered in the analysis. Furthermore, while countertransference also includes unconscious phenomena, only conscious iCT was assessed. CONCLUSIONS Patients with suicidal ideation and personality disorders elicit common but also specific negative iCT. Mental health institutions need to devote specific resources (such as clinical supervision and training) to help caregivers manage their iCT.
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Affiliation(s)
- Laurent Michaud
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada; Psychiatric Liaison Service, Lausanne University Hospital, 23, 1011, Beaumont, Lausanne, Switzerland.
| | - Fabienne Ligier
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada; Pôle Universitaire de Psychiatrie de l'enfant et de l'adolescent - Centre Psychothérapique de Nancy, Laxou, France
| | - Céline Bourquin
- Psychiatric Liaison Service, Lausanne University Hospital, 23, 1011, Beaumont, Lausanne, Switzerland
| | - Sylvie Corbeil
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
| | - Michael Saraga
- Psychiatric Liaison Service, Lausanne University Hospital, 23, 1011, Beaumont, Lausanne, Switzerland
| | - Friedrich Stiefel
- Psychiatric Liaison Service, Lausanne University Hospital, 23, 1011, Beaumont, Lausanne, Switzerland
| | - Monique Séguin
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada; Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Canada
| | - Gustavo Turecki
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
| | - Stéphane Richard-Devantoy
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
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17
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Ligier F, Giguère CE, Notredame CE, Lesage A, Renaud J, Séguin M. Are school difficulties an early sign for mental disorder diagnosis and suicide prevention? A comparative study of individuals who died by suicide and control group. Child Adolesc Psychiatry Ment Health 2020; 14:1. [PMID: 31956339 PMCID: PMC6958641 DOI: 10.1186/s13034-019-0308-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/30/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Suicide is the third leading cause of death worldwide among youth aged 10- to 19, and mental disorders are often associated in the etiology of suicidal behavior. Mental disorders are often under-diagnosed and under-treated in young people, a situation likely to increase the severity of the disorder and suicide risk. Presence of school difficulties may, in some cases, be a consequence of mental disorder, and theses difficulties are observable. Therefore, early detection and early intervention of school difficulties may alleviate the development of mental disorders and suicide vulnerability. The aim of this study is to understand the link between school difficulties and suicide risk. METHODS We used the data bank gathered by the McGill Group on Suicide Studies over the past two decades through interviews with the relatives of individuals who died by suicide and with individuals from the community as a control group. We included data on common sociodemographic characteristics, life events and mental health characteristics identified before age 18, among individuals who died before the age of 35 or were interviewed before the age of 35. We identified 200 individuals who died by suicide and 97 living controls. We compared groups according to gender and characteristics. RESULTS Within the total sample, 74% were male, 13% had met with academic failure, 18% had engaged in inappropriate behavior at school, and 18% presented combined school difficulties. Combined school difficulties (academic failure and inappropriate behavior) for both sexes and academic failure alone for males were associated with higher suicide risk before the age of 35. School difficulties generally began in early childhood and were linked to mental disorders/difficulties and substance abuse before age 18. CONCLUSIONS This study underlines the importance for parents, teachers, and educators to identify children with school difficulties-academic failure and behavioral difficulties at school-as early as possible in order to be able to propose adapted interventions. Early identification and proper diagnosis may prevent chronicity of some disorders, accumulation of adverse events, and even suicide.
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Affiliation(s)
- Fabienne Ligier
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0001 2194 6418grid.29172.3fEA 4360 APEMAC, Faculty of Medicine, Université de Lorraine, 54500 Vandoeuvre-lès-Nancy, France ,Centre Psychothérapique de Nancy, PUPEA, rue du Dr Archambault, 54520 Laxou, France ,0000 0004 1765 1301grid.410527.5Département Pédopsychiatrie, CHRU Nancy, Rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France
| | - Charles-Edouard Giguère
- 0000 0001 2292 3357grid.14848.31Banque Signature, Research Center, Institut Universitaire en Santé Mentale de Montréal, 7401 Rue Hochelaga, Unit 218, Montreal, QC H1N 3M5 Canada
| | - Charles-Edouard Notredame
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,0000 0004 0471 8845grid.410463.4Centre Hospitalier Régional Universitaire de Lille, 2 Avenue Oscar Lambret, 59037 Lille Cedex, France
| | - Alain Lesage
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0001 2292 3357grid.14848.31Department of Psychiatry, Université de Montréal, Montreal, QC Canada ,0000 0001 2292 3357grid.14848.31Institut Universitaire en Santé Mentale de Montréal, 7401 Rue Hochelaga, Unit 218, Montreal, QC H1N 3M5 Canada
| | - Johanne Renaud
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0004 4910 4652grid.459278.5Manulife Centre for breackthroughs in Teen Depression and Suicide Prevention, Douglas Institute, 7070, Boulevard Champlain, Montreal, QC H4H 1R3 Canada
| | - Monique Séguin
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0001 2112 1125grid.265705.3Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 283 Boulevard Alexandre-Taché, Gatineau, QC J8X 3X7 Canada ,Centre intégré de santé et service social de l’Outaouais (CISSSO), Outaouais, Canada
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Ligier F, Giguère CE, Séguin M, Lesage A. Survey evidence of the decline in child abuse in younger Canadian cohorts. Eur J Pediatr 2019; 178:1423-1432. [PMID: 31338674 DOI: 10.1007/s00431-019-03432-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Received: 02/11/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 01/25/2023]
Abstract
Physical and sexual abuse in childhood is a worldwide phenomenon with potentially dramatic consequences of both a psychological and physical nature. Measures of primary prevention have been developed in some countries. In the USA, child protection services reports and research surveys indicate that child sexual abuse has been on the decline in recent decades. Results are less clear for physical and overall abuse. The aim of this study was to describe how childhood abuse has changed over the years in Canada through an analysis of the 2012 Canadian Community Health Survey: Mental Health Edition data. The sample comprised 22,775 respondents ages 20 and over who completed a child abuse questionnaire. Respondents born from 1983 to 1992 reported significantly less overall abuse, physical abuse, and sexual abuse than did older generations, with the exception of people born in 1942 or earlier. The decrease was observed among men and women and across all the regions of Canada.Conclusion: The results are encouraging in that they may have an impact on life expectancy, severity of various chronic disorders, and suicide in the population. They also support policies that have focused on improving the childhood environment in the 1990s. Results also underline the importance of using different kinds of data sources for evaluating child abuse. What is Known: • Physical and sexual abuse in childhood has been associated with lower life expectancy in connection with an array of chronic diseases, including mental disorders, and with suicide. • Measures of primary prevention have been developed in some countries, such as the USA and Canada. What is New: • Canadians born from 1983 to 1992 report significantly less overall abuse, physical abuse, and sexual abuse than older generations do. • These encouraging results support policies implemented in the 1990s focused on improving the childhood environment.
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Affiliation(s)
- Fabienne Ligier
- McGill Group on Suicide Studies, Montréal, Québec, Canada. .,Psychiatry Department, Montréal University, Montreal, Québec, Canada. .,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montreal, Québec, Canada. .,EA 4360 APEMAC, Université de Lorraine, Nancy, France. .,Centre Psychothérapique de Nancy, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, 2 rue du Dr Archambault, 54520, Laxou, France.
| | - Charles-Edouard Giguère
- Banque Signature, Research Center, Institut Universitaire en Santé Mentale de Montréal, Montreal, Québec, Canada
| | - Monique Séguin
- McGill Group on Suicide Studies, Montréal, Québec, Canada.,Department of Psychoeducation and Psychology, Québec University, Outaouais, Canada.,Centre intégré de santé et service social de l'Outaouais (CISSSO), Outaouais, Canada
| | - Alain Lesage
- McGill Group on Suicide Studies, Montréal, Québec, Canada.,Psychiatry Department, Montréal University, Montreal, Québec, Canada.,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montreal, Québec, Canada.,Québec Network on Suicide Research, Montreal, Québec, Canada
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19
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Séguin M. Book Review: Why People Kill Themselves: A 2000 Summary of Research on Suicide. J Palliat Care 2019. [DOI: 10.1177/082585970201800414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Monique Séguin
- Department of Psychology, Université du Québec à Hull, Laboratoire d'étude sur le suicide et le deuil, Centre de recherche Femand-Séguin, Montreal, Quebec, Canada
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Robert M, Desgranges A, Séguin M, Beauchamp G. Risk factors reduction in suicidal youth through social connectedness opportunities provided by community services. Psychol Community Health 2018. [DOI: 10.5964/pch.v7i1.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim
This study examined the trajectory (life course) of youths, referred to community services following their suicidal behavior, in order to measure the extent to which these young people have taken this opportunity to modify connectedness with family, school, and workplace, and to change high-risk factors related to suicidal behaviors (mental health problems, delinquency, drug consumption).
Method
Fifteen youths (aged 16-19), who made one or more suicide attempts or had serious ideation in the previous 24 to 48 months, were referred to community services (Vallée-Jeunesse). They were interviewed using an intensive personal interview measures (Trajectory Instrument Measure, TIM) in order to document significant life events and adversities that occured during different periods of their life.In addition, we administered the Structured Clinical Interview for DSM-IV Axis-I and Axis-II disorders (SCID-I and SCID-II) to identify past and current psychopathologies.
Results
Several important changes took place following their entry into the community services: a reduction in delinquency and substance abuse/dependence, and positive changes in occupational status and suicidal behaviors (ideation and suicide attempt).
Conclusion
Our findings can inform policies and strategies that support the prevention of suicidal behavior among young adults. Community services providers can play a role in the prevention of suicidal behaviors for the most vulnerable youths. These types of services could complement traditional suicide prevention strategies, which are mostly mental-health based.
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Notredame CE, Grandgenèvre P, Pauwels N, Morgiève M, Wathelet M, Vaiva G, Séguin M. Leveraging the Web and Social Media to Promote Access to Care Among Suicidal Individuals. Front Psychol 2018; 9:1338. [PMID: 30154742 PMCID: PMC6102313 DOI: 10.3389/fpsyg.2018.01338] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/12/2018] [Indexed: 12/14/2022] Open
Abstract
After two decades of exponential development, the Internet has become an inseparable component of suicide prevention matters. More specifically, social media has turned out to be a privileged space for suicidal individuals to express their distress and seek support. Although this tendency carries with it specific risks and challenges, it creates unprecedented opportunities to face the challenges of help seeking and access to care. In this paper, we present the empirical, technological, and theoretical evidence supporting the implementation of a digitally augmented prevention policy that would increase its reach. Congruent to the clinical observations and theories on the help-seeking process, we argue that social media can help undertake three main functions of increasing proactivity to bring suffering Web users to care. The gateway function relates to the properties of social media interactions to leverage help-seeking barriers and enable ambivalent individuals to access the mental healthcare system. The communication outreach function aims to broadcast pro-help-seeking messages, while drawing on the functional structure of the social media network to increase its audience. The intervention outreach function consists in using machine learning algorithms to detect social media users with the highest risk of suicidal behaviors and give them a chance to overcome their dysfunctional reluctance to access help. We propose to combine these three functions into a single coherent operational model. This would involve the joint actions of a communication and intervention team on social networks, working in close collaboration with conventional mental health professionals, emergency service, and community resources.
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Affiliation(s)
- Charles-Edouard Notredame
- Department of Psychiatry, Centre Hospitalier Regional et Universitaire de Lille, Lille, France.,SCALab, Centre National de la Recherche Scientifique, Lille, France.,McGill Group for Suicide Studies, Douglas Institute, McGill University, Montreal, QC, Canada
| | - Pierre Grandgenèvre
- Department of Psychiatry, Centre Hospitalier Regional et Universitaire de Lille, Lille, France.,SCALab, Centre National de la Recherche Scientifique, Lille, France
| | - Nathalie Pauwels
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, Lille, France
| | - Margot Morgiève
- Department of Psychiatry, Fondation FondaMental, Hospital Albert Chenevier, Créteil, France
| | - Marielle Wathelet
- Department of Public Health, Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Guillaume Vaiva
- Department of Psychiatry, Centre Hospitalier Regional et Universitaire de Lille, Lille, France.,SCALab, Centre National de la Recherche Scientifique, Lille, France.,Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, Lille, France
| | - Monique Séguin
- McGill Group for Suicide Studies, Douglas Institute, McGill University, Montreal, QC, Canada.,Department of Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
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Nicolas C, Lauzier M, Séguin M, Laberge M. Mieux comprendre les causes du présentéisme: Une analyse systématique à partir des facteurs du modèle exigences-ressources. Canadian Psychology/Psychologie canadienne 2018. [DOI: 10.1037/cap0000134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Nicolas C, Chawky N, Jourdan-Ionescu C, Drouin MS, Page C, Houlfort N, Beauchamp G, Séguin M. Stresseurs professionnels et troubles mentaux courants : quels liens de causalité ? Encephale 2018; 44:200-207. [DOI: 10.1016/j.encep.2017.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/04/2017] [Accepted: 01/06/2017] [Indexed: 02/03/2023]
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Affiliation(s)
- Charles-Edouard Notredame
- Psychiatry and Forensic Medicine Department, Hôpital Fontan, CHU Lille, 2 Rue André Verhaeghe, 59000, Lille, France. .,SCALab Laboratory, CNRS, UMR 9193, Université de Lille, 1 Place de Verdun, 59045, Lille Cedex, France. .,McGill Group for Suicide Studies, Douglas Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada.
| | - Pierre Grandgenèvre
- Psychiatry and Forensic Medicine Department, Hôpital Fontan, CHU Lille, 2 Rue André Verhaeghe, 59000, Lille, France.,SCALab Laboratory, CNRS, UMR 9193, Université de Lille, 1 Place de Verdun, 59045, Lille Cedex, France
| | - Guillaume Vaiva
- Psychiatry and Forensic Medicine Department, Hôpital Fontan, CHU Lille, 2 Rue André Verhaeghe, 59000, Lille, France.,SCALab Laboratory, CNRS, UMR 9193, Université de Lille, 1 Place de Verdun, 59045, Lille Cedex, France
| | - Monique Séguin
- McGill Group for Suicide Studies, Douglas Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada.,Department of Psychology, Université du Québec en Outaouais, 283, Boulevard Alexandre-Taché, Gatineau, QC, J9A 1L8, Canada
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Beaudoin V, Séguin M, Chawky N, Affleck W, Chachamovich E, Turecki G. Protective Factors in the Inuit Population of Nunavut: A Comparative Study of People Who Died by Suicide, People Who Attempted Suicide, and People Who Never Attempted Suicide. Int J Environ Res Public Health 2018; 15:ijerph15010144. [PMID: 29337928 PMCID: PMC5800243 DOI: 10.3390/ijerph15010144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 12/05/2022]
Abstract
Epidemiological data shows an alarming prevalence of suicide in Aboriginal populations around the world. In Canada, the highest rates are found in Inuit communities. In this article, we present the findings of a secondary analysis conducted with data previously collected as part of a larger study of psychological autopsies conducted in Nunavut, Canada. The objective of this secondary analysis was to identify protective factors in the Inuit population of Nunavut by comparing people who died by suicide, people from the general population who attempted suicide, and people from the general population who never attempted suicide. This case-control study included 90 participants, with 30 participants in each group who were paired by birth date, sex, and community. Content analysis was first conducted on the clinical vignettes from the initial study in order to codify the presence of protective variables. Then, inferential analyses were conducted to highlight differences between each group in regards to protection. Findings demonstrated that (a) people with no suicide attempt have more protective variables throughout their lifespan than people who died by suicide and those with suicide attempts within the environmental, social, and individual dimensions; (b) people with suicide attempts significantly differ from the two other groups in regards to the use of services; and (c) protective factors that stem from the environmental dimension show the greatest difference between the three groups, being significantly more present in the group with no suicide attempt. Considering these findings, interventions could focus on enhancing environmental stability in Inuit communities as a suicide prevention strategy.
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Affiliation(s)
- Véronique Beaudoin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Monique Séguin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - Nadia Chawky
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - William Affleck
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Eduardo Chachamovich
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
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Besson J, Grivel J, Tomei A, Andronicos M, Zullino D, Thorens G, Tsartsalis S, Gothuey I, Séguin M. [Addictions]. Rev Med Suisse 2018; 14:12-14. [PMID: 29337440] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This year, the actuality for addictions in this edition addresses four points. The disease model of addiction is criticized by the cognitive neurosciences which need to consider the agentivity of the persons. Regarding the societal actuality, clinical pharmacology review of cannabidiol presents an update on legal cannabis. The suicidality of excessive gamblers may be prevented specifically. Addiction and first psychotic episodes need an integrated care.
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Affiliation(s)
- Jacques Besson
- Section d'addictologie, Service de psychiatrie communautaire, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Jeremy Grivel
- Section d'addictologie, Service de psychiatrie communautaire, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Alexander Tomei
- Section d'addictologie, Service de psychiatrie communautaire, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Mélina Andronicos
- Section d'addictologie, Service de psychiatrie communautaire, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Daniele Zullino
- Service d'addictologie, Département de santé mentale et de psychiatrie, HUG, 1211 Genève 14
| | - Gabriel Thorens
- Service d'addictologie, Département de santé mentale et de psychiatrie, HUG, 1211 Genève 14
| | - Stergios Tsartsalis
- Service d'addictologie, Département de santé mentale et de psychiatrie, HUG, 1211 Genève 14
| | - Isabelle Gothuey
- Réseau fribourgeois de santé mentale (RFSM), c/o Centre de soins hospitaliers, L'Hôpital 140, 1633 Marsens
| | - Monique Séguin
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Pavillon Alexandre-Taché, 283, boulevard Alexandre-Taché, Gatineau (Québec) Canada J9A 1L8
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Kopp-Bigault C, Audouard-Marzin Y, Scouarnec P, Beauchamp G, Séguin M, Walter M. [French translation and validation of a short version of the Suicide Intervention Response Inventory-2 (SIRI-2-VF)]. Encephale 2017; 44:435-445. [PMID: 29096910 DOI: 10.1016/j.encep.2017.07.006] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Training health professionals about suicidal crisis is one major line of suicide prevention worldwide. France has one of the highest suicide rates in Europe, and although crisis intervention training has been set up since 2001, there presently is no training assessment tool in the French language for health professionals trained in suicide prevention. In the four levels of Kirpatrick's education pyramid, training that takes place in France today solely assesses level one status, that is to say relative to the level of satisfaction of participants (self-report). This study proposes a validated short French version of the Suicide Intervention Response Inventory-2 (SIRI-2) of Neimeyer & Mc Innes. The SIRI-2 questionnaire assesses the ability of first line intervention in dealing with suicidal individuals. METHODS The translation methodology was inspired from Vallerand's model of cross-cultural back translation. This method is regularly used for translating from the English language to a French version. In order to translate the English version, we used an extensive 7-step methodology implicating several bilingual translators, expert reviewers (psychologists and psychiatrists) and a scientific committee. Participants were 107 students from different French universities and study programs: psychology, medicine and nursing (17 were men; average age was 26.6). Fifteen of these participants answered the SIRI-2-VF on two occasions (separated by a 15-day interval) in order to estimate the temporal stability of the instrument. The scores of the students were compared to six French experts in suicide prevention and with the original expert group who worked on the development of SIRI-2 (n=7). We used Student t Test for construct validity, Cronbach's Alpha for internal consistency and Pearson's correlation coefficient for temporal stability. RESULTS Following a fidelity comparison of the results of the French experts with those of the American experts, ten items presenting the least good fidelity were suppressed in order to obtain a short version of the SIRI-2 containing 15 questions (SIRI-2-VF). Statistical analyses of the short version (15 questions, SIRI-2-VF) showed good validity (difference between experts and subjects is significant: t=31.5, P<0.001) and reliability (good internal consistency: α=0.850 for positive statements and α=0.830 for negative statements, and a temporal stability: r=0.827, bilateral test, P<0.001). CONCLUSIONS This tool should improve the range of specific instruments in French suicidology adapted for French culture of suicide intervention. It is the first tool in France that reaches level 2a of Kirkpatrick's pyramid to assess clinical skills after training in suicidology.
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Affiliation(s)
- C Kopp-Bigault
- University of Strasbourg (EA3071), 67000 Strasbourg, France; Morlaix Hospital, 29600 Brittany, France.
| | - Y Audouard-Marzin
- Collège des hautes études en médecine (CHEM), 29200 Brest, France; CRPV, centre hospitalier universitaire régional de Brest, 29200 Brest, France
| | - P Scouarnec
- Morlaix Hospital, 29600 Brittany, France; Collège des hautes études en médecine (CHEM), 29200 Brest, France; CRPV, centre hospitalier universitaire régional de Brest, 29200 Brest, France
| | - G Beauchamp
- Department of psychoeducation and psychology, université du Québec, Outaouais, Canada
| | - M Séguin
- Department of psychoeducation and psychology, université du Québec, Outaouais, Canada; McGill Group on Suicide Studies, Montréal, Québec, Canada; Québec Network on Suicide Research, Québec, Canada; Centre intégré de santé et service social de l'Outaouais (CISSSO), Outaouais, Canada
| | - M Walter
- Psychiatry Unit, Brest University and Research Hospital, 29200 Brest, France
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Beaulac É, Andronicos M, Lesage A, Robert M, Larochelle S, Séguin M. Quelle est l’influence du genre dans la recherche de soins chez les joueurs? JGI 2017. [DOI: 10.4309/jgi.2017.35.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cette étude vise à décrire l’influence du genre sur les différentes étapes amenant un joueur ayant des problèmes de jeu à prendre la décision de rechercher de l’aide. Le modèle de recherche d’aide de Goldsmith, Jackson et Hough (1988) a été utilisé pour conceptualiser les étapes de prise de décision menant à consulter des services d’aide pour un problème de jeu de hasard et d’argent. Au total, 83 participants, dont 45 femmes et 38 hommes adultes, y ont pris part. Les résultats indiquent que, comparativement aux hommes, les femmes sont plus nombreuses à habiter en couple, ont plus souvent de faibles revenus et subviennent moins fréquemment seules à leurs besoins, rapportent des conduites de jeu plus conséquentes, souffrent davantage de troubles anxieux au cours de leur vie et, enfin, consultent surtout des services non spécialisés. Au cours des 12 derniers mois, les femmes avaient consulté plus souvent les services médicaux de première ligne et avaient eu moins fréquemment recours aux services spécialisés que les hommes.The aim of this study was to describe the influence of gender on the various stages of the decision-making process that bring problem gamblers to seek help. The authors used the help-seeking model developed by Goldsmith, Jackson and Hough (1988) to conceptualize the different stages of the process that leads to consulting support services for a gambling problem. A total of 83 participants (45 females and 38 males) took part in the study. Results show that women are more likely to have a partner and to earn a lower income; they provide for their own needs less frequently than men; report more consistent gaming behaviours; are more prone to anxiety disorder during their lifetime; and consult primarily non-specialized services. In the previous 12 months, they had accessed front-line services more often and specialized services less frequently than men.
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Harvey M, Martel M, Houde F, Daguet I, Séguin M, Leonard G. USING TRANSCRANIAL DIRECT CURRENT STIMULATION TO REDUCE CHRONIC PAIN IN ELDERLY INDIVIDUALS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M. Harvey
- Research Centre on Aging, Sherbrooke, Quebec, Canada,
- University of Sherbrooke - Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada,
| | - M. Martel
- Research Centre on Aging, Sherbrooke, Quebec, Canada,
- University of Sherbrooke - Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada,
| | - F. Houde
- Research Centre on Aging, Sherbrooke, Quebec, Canada,
- University of Sherbrooke - Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada,
| | - I. Daguet
- Université Claude Bernard Lyon 1, Lyon, France,
| | - M. Séguin
- University of Sherbrooke - Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada,
- Sherbrooke University Hospital Centre - Department of Neurosurgery, Sherbrooke, Quebec, Canada
| | - G. Leonard
- Research Centre on Aging, Sherbrooke, Quebec, Canada,
- University of Sherbrooke - Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada,
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Paquette G, Tourigny M, Baril K, Joly J, Séguin M. Mauvais traitements subis dans l’enfance et problèmes de santé mentale à l’âge adulte : une étude nationale conduite auprès des Québécoises. smq 2017. [DOI: 10.7202/1040243ar] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
L’étude vise à déterminer la contribution spécifique de différentes formes de mauvais traitements à la santé mentale de femmes québécoises. Une enquête téléphonique a été réalisée auprès d’un échantillon représentatif de 1 001 femmes québécoises. Diverses variables sociodémographiques et quatre formes de mauvais traitements durant l’enfance ont été mesurées afin d’explorer leur association avec l’état de stress post-traumatique et la dépression des répondantes au moment de l’enquête. La violence conjugale au cours des 12 derniers mois ainsi que la négligence et la violence physique subies durant l’enfance sont associées à la présence de symptômes de stress post-traumatique d’intensité clinique. Le plus jeune âge des répondantes, la violence sexuelle et psychologique durant l’enfance sont associés à la présence de dépression. Les résultats soulignent l’importance de considérer les mauvais traitements durant l’enfance et leur cooccurrence dans l’évaluation et l’intervention en santé mentale auprès des femmes adultes.
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Affiliation(s)
- Geneviève Paquette
- Ph. D., Groupe de recherche sur les inadaptations sociales de l’enfance, Département de psychoéducation, Université de Sherbrooke
| | - Marc Tourigny
- Ph. D., Groupe de recherche sur les inadaptations sociales de l’enfance, Département de psychoéducation, Université de Sherbrooke
| | - Karine Baril
- Ph. D., Département de psychoéducation et de psychologie, Université du Québec en Outaouais
| | - Jacques Joly
- Ph. D., Groupe de recherche sur les inadaptations sociales de l’enfance, Département de psychoéducation, Université de Sherbrooke
| | - Monique Séguin
- Ph. D., Département de psychoéducation et de psychologie, Université du Québec en Outaouais
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Dalmai G, Imelik B, Séguin M. N° 15. — Modification de l’activité catalytique et de la texture des gels de silice irradiés dans les piles. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1961580292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
Abstract. Background: Personality and character traits may be a key predisposing factor to consider in the life course of people who are vulnerable to suicide. Aims: The aim of this study is first to explore the possible presence of different subgroups of suicide decedents based on developmental profiles of adversity, and secondly to examine the association of personality and character dimensions (covariates) with the trajectory outcome. Method: A total of 90 cases of suicide decedents were analyzed using growth mixture modeling (GMM). Results: Results generated two different life trajectories and identified specific temperament profiles. Subjects assigned to the trajectory of high burden of adversity demonstrated a greater predisposition for harm avoidance and those in the trajectory characterized by low burden of adversity displayed greater predisposition for self-directedness. Conclusion: Our results add to the literature by suggesting that different subgroups of suicide completers show a predisposition for either harm avoidance or self-directedness.
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Affiliation(s)
- Monique Séguin
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
- McGill Group for Suicide Studies, Montréal, Canada
| | - Marie Robert
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Guy Beauchamp
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
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Paquette G, Tourigny M, Baril K, Joly J, Séguin M. [Childhood Maltreatment and Mental Health Problems in Adulthood: A National Study of Women in Quebec]. Sante Ment Que 2017; 42:43-63. [PMID: 28792561] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective The study aims to estimate the specific contribution of various forms of child maltreatment on the mental health among a Quebeckers' women representative sample. Method A telephone survey was conducted with a representative sample of 1001 women from the province of Quebec (Canada). Different demographic variables, all four child maltreatment forms (sexual, physical, psychological and neglect) and intimate partner violence experienced in the last 12 months were evaluated to explore their links with depression and post-traumatic stress symptoms of the participants at the time of the investigation.Results Domestic violence during the last 12 months as well as negligence and physical violence during childhood are associated with the presence of clinical intensity post-traumatic symptoms. Youngest age, sexual and psychological violence during childhood are associated with the presence of depression.Conclusion Those results underlie the importance to consider different forms of maltreatment during childhood and their co-occurrence in the evaluation and the intervention in mental health with adult women.
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Affiliation(s)
- Geneviève Paquette
- Groupe de recherche sur les inadaptations sociales de l'enfance, Département de psychoéducation, Université de Sherbrooke
| | - Marc Tourigny
- Groupe de recherche sur les inadaptations sociales de l'enfance, Département de psychoéducation, Université de Sherbrooke
| | - Karine Baril
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais
| | - Jacques Joly
- Groupe de recherche sur les inadaptations sociales de l'enfance, Département de psychoéducation, Université de Sherbrooke
| | - Monique Séguin
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais
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Saigle V, Séguin M, Racine E. Identifying Gaps in Suicide Research: A Scoping Review of Ethical Challenges and Proposed Recommendations. IRB 2017; 39:1-9. [PMID: 30146864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Andronicos M, Beauchamp G, Robert M, Besson J, Séguin M. Male gamblers – suicide victims and living controls: comparison of adversity over the life course. International Gambling Studies 2016. [DOI: 10.1080/14459795.2016.1151914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Encrenaz G, Miras A, Contrand B, Séguin M, Moulki M, Queinec R, René JS, Fériot A, Mougin M, Bonfils M, Marien P, Michel G, Lagarde E. [Suicide among the French National Police forces: Implication of life events and life trajectories]. Encephale 2015; 42:304-13. [PMID: 26452434 DOI: 10.1016/j.encep.2015.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 01/20/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Research indicates that suicide rates are high among members of law enforcement. Our objectives were: (1) to determine life events implicated in suicide mortality among French law enforcement; and (2) to describe the different life trajectories of police officers who deceased by suicide. METHODS All suicides of police officers which occurred during 2008 (n=49) were explored using the psychological autopsy method. Key informants were: a supervisor, a colleague and a member of the family or a close friend. Each of them were interviewed by trained psychologists using standardized questionnaires exploring: sociodemographic characteristics, life events, social integration and support, health service use, mental health with the Composite International Diagnostic Interview short form (CIDI-SF), occupational stress with the Spielberger Inventory, impulsiveness with the Barratt Impulsiveness Scale and aggressiveness with the Brown-Goodwin Lifetime Aggression Scale. Information was then summarized in a timetable life trajectory of all life areas. All cases were finally appraised by at least two experts in order to identify the determinants of the suicide and to determine psychiatric diagnoses. For each period of time, a burdensomeness score was determined, from 6 (no adversity) to 1 (adversities in each sphere of life). RESULTS Of the 49 cases of suicide, two were excluded and 39 were investigated and appraised (response rate: 39/47=83%). Eighty-two percent of the suicide cases were men and the mean age at death was 35years. In more than half of the cases, police officers used their service weapon to commit suicide. All deceased police officers were suffering from mental health symptoms (primarily depression). Of them, two thirds had used healthcare for this distress. The main other cause of suicide was problems in the married life (70% of the cases). Four distinct types of life trajectories of adversities could be identified by a qualitative analysis. DISCUSSION It is the first time such a study was performed in France, and results are concordant with those of the literature. This study showed that all deceased police officers were suffering from mental disorders and that there was not one single profile of life trajectory: screening and support of police officers in distress need to be prioritized. Moreover, results suggested that the availability of the service weapon during off-duty periods should be reconsidered. This study helped the Home ministry to elaborate and improve strategies to prevent suicide among police officers.
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Affiliation(s)
- G Encrenaz
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France; COMPTRASEC UMR 5114 CNRS, université de Bordeaux, avenue Léon-Duguit, 33608 Pessac, France.
| | - A Miras
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - B Contrand
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - M Séguin
- Université du Québec en Outaouais et groupe McGill d'étude sur le suicide, institut universitaire Douglas, Canada
| | - M Moulki
- Pôle 347, unité Régis, centre hospitalier Charles-Perrens, 33000 Bordeaux, France
| | - R Queinec
- Centre hospitalier de Cadillac, 33410 Cadillac, France
| | - J-S René
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - A Fériot
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - M Mougin
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
| | - M Bonfils
- Association Entr'Actes, 92700 Colombes, France
| | - P Marien
- Laboratoire EA psychologie, santé et qualité de vie, université de Bordeaux, 33000 Bordeaux, France
| | - G Michel
- Laboratoire EA psychologie, santé et qualité de vie, université de Bordeaux, 33000 Bordeaux, France
| | - E Lagarde
- Équipe « prévention et prise en charge des traumatismes », centre Inserm U897, université de Bordeaux, 33000 Bordeaux, France
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O'Connor K, Robert M, Pérodeau G, Séguin M. Trajectory-based methods in clinical psychology: A person centred narrative approach. New Ideas in Psychology 2015. [DOI: 10.1016/j.newideapsych.2015.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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38
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Andronicos M, Beauchamp G, DiMambro M, Robert M, Besson J, Séguin M. Do male and female gamblers have the same burden of adversity over their life course? International Gambling Studies 2015. [DOI: 10.1080/14459795.2015.1024706] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
This study sought to explore the phenomenon of peer counseling in suicide bereavement by addressing the question, what are the lived experiences of suicide survivors who become peer counselors? Participants were 15 individuals bereaved through suicide who had been volunteering with others bereaved in the same manner. This research employed the interpretative phenomenological analysis (IPA) approach to provide a detailed description of participants' journeys that went from experiencing the suicide of a loved one, to the decision to become a peer counselor, to, finally, providing support to other survivors. The findings suggest that participants understand the provision of peer counseling as a transformative process. Being a peer counselor means actively challenging the silence around suicide by speaking out about suicide-related issues and offering other survivors a safe space to share their stories. The broader implications of these findings for suicide postvention research and clinical practice are addressed.
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Affiliation(s)
| | - Roy Moodley
- Ontario Institute for Studies in Education, University of Toronto
| | - Monique Séguin
- McGill Group for Suicide Studies, Université du Québec en Outaouais, Douglas Mental Health University Institute
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Renaud J, Séguin M, Lesage AD, Marquette C, Choo B, Turecki G. Service use and unmet needs in youth suicide: a study of trajectories. Can J Psychiatry 2014; 59:523-30. [PMID: 25565685 PMCID: PMC4197786 DOI: 10.1177/070674371405901005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 07/01/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims. METHOD We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects' psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received. RESULTS Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance. CONCLUSIONS Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people.
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Affiliation(s)
- Johanne Renaud
- Child and Adolescent Psychiatrist and Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Medical Chief—Youth Section Outpatient Clinic of Depressive and Suicidal Disorders, Douglas Mental Health University Institute, Montreal, Quebec; Standard Life Senior Fellow, Standard Life Centre for Breakthroughs in Teen Depression and Suicide Prevention, Douglas Mental Health University Institute, McGill University, Montreal, Quebec; Researcher, McGill Group for Suicide Studies, McGill University, Montreal, Quebec
| | - Monique Séguin
- Psychologist, Université du Québec en Outaouais, Gatineau, Quebec; Professor, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Quebec; Researcher, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec
| | - Alain D Lesage
- Psychiatrist and Professor, Department of Psychiatry, Institut universitaire en santé mentale de Montréal, Université de Montréal, Montreal, Quebec
| | - Claude Marquette
- Psychiatrist and Assistant Professor, Department of Psychiatry, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec
| | - Bettina Choo
- Resident in Psychiatry, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec
| | - Gustavo Turecki
- Psychiatrist and Professor, Departments of Psychiatry, Human Genetics, and Neurology and Neurosurgery, McGill University, Montreal, Quebec; Vice-Chair, Research and Academic Affairs, Department of Psychiatry, McGill University, Montreal, Quebec; Director, McGill Group for Suicide Studies, McGill University, Montreal, Quebec; Co-Director, Douglas–Bell Canada Brain Bank (Suicide Studies), Montreal, Quebec; Head, Depressive Disorders Program, Douglas Mental Health University Institute, McGill University, Montreal, Quebec; Director, Réseau québécois de recherche sur le suicide, Montreal, Quebec
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Abstract
BACKGROUND Most developmental studies on suicide do not take into account individual variations in suicide trajectories. AIMS Using a life course approach, this study explores developmental models of suicide trajectories. METHOD Two hundred and fourteen suicides were assessed with mixed methods. Statistical analysis using combined discrete-time survival (DTS) and growth mixture modelling (GMM) generated various trajectories, and path analysis (Mplus) identified exogenous and mediating variables associated with these trajectories. RESULTS Two groups share common risk factors, and independently of these major risk factors, they have different developmental trajectories: the first group experienced a high burden of adversity and died by suicide in their early 20s; and the second group experienced a somewhat moderate or low burden of adversity before they took their own life. Structural equation modelling identified variables specific to the early suicide trajectory: conduct and behavioural difficulties, social isolation/conflicts mediated by school-related difficulties, the end of a love relationship, and previous suicide attempts. CONCLUSIONS Psychosocial adversity between 10 and 20 years of age may warrant key periods of intervention.
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Affiliation(s)
- Monique Séguin
- Monique Séguin, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec, and McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec; Guy Beauchamp, PhD, Marie Robert, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec; Mélanie DiMambro, MSc, Gustavo Turecki, MD, PhD, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Guy Beauchamp
- Monique Séguin, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec, and McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec; Guy Beauchamp, PhD, Marie Robert, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec; Mélanie DiMambro, MSc, Gustavo Turecki, MD, PhD, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Marie Robert
- Monique Séguin, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec, and McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec; Guy Beauchamp, PhD, Marie Robert, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec; Mélanie DiMambro, MSc, Gustavo Turecki, MD, PhD, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Mélanie DiMambro
- Monique Séguin, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec, and McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec; Guy Beauchamp, PhD, Marie Robert, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec; Mélanie DiMambro, MSc, Gustavo Turecki, MD, PhD, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Gustavo Turecki
- Monique Séguin, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec, and McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec; Guy Beauchamp, PhD, Marie Robert, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec; Mélanie DiMambro, MSc, Gustavo Turecki, MD, PhD, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
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Miquelon P, Lesage A, Boyer R, Guay S, Bleau P, Séguin M. Mental Health Service Utilization among Students and Staff in 18 Months Following Dawson College Shooting. AIMS Public Health 2014; 1:84-99. [PMID: 29546078 PMCID: PMC5689797 DOI: 10.3934/publichealth.2014.2.84] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/14/2014] [Indexed: 11/25/2022] Open
Abstract
Objectives The aim of this study was to investigate service utilization by students and staff in the 18 months following the September 13, 2006, shooting at Dawson College, Montreal, as well as the determinants of this utilization within the context of Canada's publicly managed healthcare system. Methods A sample of 948 from among the college's 10,091 students and staff agreed to complete an adapted computer or web-based standardized questionnaire drawn from the Statistics Canada 2002 Canadian Community Health Survey cycle 1.2 on mental health and well-being. Results In the 18 months following the shooting, there was a greater incidence and prevalence not only of PTSD, but also of other anxiety disorders, depression, and substance abuse. Staff and students were as likely to consult a health professional when presenting a mental or substance use disorder, with females more likely to do so than males. Results also indicated that there was relatively high internet use for mental health reasons by students and staff (14% overall). Conclusions Following a major crisis event causing potential mass trauma, even in a society characterized by easy access to public, school and health services and when the population involved is generally well educated, the acceptability of consulting health professionals for mental health or substance use problems represents a barrier. However, safe internet access is one way male and female students and staff can access information and support and it may be useful to further exploit the possibilities afforded by web-based interviews in anonymous environments.
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Affiliation(s)
- Paule Miquelon
- Department of Psychology, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC G9A 5H7
| | - Alain Lesage
- Institut universitaire en santé mentale de Montréal, 7401, rue Hochelaga, Montréal, QC H1N 3M5
| | - Richard Boyer
- Department of Psychiatry, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, QC H3T 1J4
| | - Stéphane Guay
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, 7401, rue Hochelaga, Montréal, QC H1N 3M5
| | - Pierre Bleau
- Department of Psychiatry, Royal Victoria Hospital, McGill University Health Centre, 687 Pine Avenue West, Montreal, QC H3A 1A1
| | - Monique Séguin
- Department of Psychology, Université du Québec en Outaouais, Case postale 1250, succursale Hull, Gatineau, QC J8X 3X7
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Aimé A, LeBlanc L, Séguin M, Brunet A, Brisebois C, Girard N. [Are mental health disorders' characteristics such as presence and severity related to the nature of a crisis, its dangerousness and the types of services offered?]. Sante Ment Que 2014; 38:235-56. [PMID: 24719011 DOI: 10.7202/1023998ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED The mandate of crisis centres varies substantially from one country to the next according to the government policies in effect. In the United States, crisis centres were developed based on Caplan's theory, which defines crisis as a psychosocial disorganization following a life event that is resolved with a return to balance. This approach aims at preventing the onset of mental health disorders through short-term intervention. It is different in Quebec, where crisis centres were developed in a deinstitutionalization context and ought to constitute an alternative to hospitalisation. Such mandate of Quebec crisis centres is not necessarily of the preventive nature associated with Caplan's theory and it has led to services having to be adapted to a heterogeneous clientele that may or may not suffer from mental health problems. It has implications related to the crisis characteristics such as its nature, intensity, and dangerosity, as well as implications regarding the organization of crisis centre services, which have been the object of few studies so far. OBJECTIVE The present study aims at distinguishing clinical profiles of crisis centre callers according to the presence or absence of a mental health disorder and its nature, that is severe and persistent (psychotic or bipolar disorder) or not (mood, anxiety or personality disorder). In order to do so, participants are compared on the characteristics of the crisis and the services they received. METHOD In this descriptive study, the files of 1170 new assistance applicants are retrospectively analyzed based on a predetermined grid that was used to collect data according to the main clinical characteristics of persons in distress, as recognized in the literature. The subgroup of persons presenting a psychotic or bipolar disorder was examined separately from the one comprising persons with an anxiety, mood or personality disorder because of its clinical complexity, which generally requires intensive, multidisciplinary follow-up. RESULTS Among the new applicants, 48% had a mental health disorder and, of these, 9% reported a serious mental health disorder, that is, a psychotic or bipolar disorder. The results indicate that having an anxiety-, mood- or personality-type disorder is associated with a higher probability of reporting stressful interpersonal-type events, a more intense crisis, as well as a greater risk of auto-aggressive behaviours. Meanwhile, persons with a psychotic or bipolar disorder are more frequently provided with accommodations and more likely to receive intensive and support services, such as emergency interventions or the use of the Act respecting the protection of persons whose mental state presents a danger to themselves or others (P-38). CONCLUSIONS This descriptive portrait of the crisis centre clientele contributes to the reflection on differential intervention with persons in a crisis situation. It appears important to take an interest in the presence and type of mental health disorders of crisis centre callers, since these characteristics help to better foresee not only the nature and intensity of the crisis but also the type of services required. However, Quebec crisis centres have to respond to the needs of a heterogeneous clientele without having access to a typology and a theoretical model that consider this clinical diversity. Other studies should be conducted to validate, on the one hand, a crisis typology that would make it easier for caseworkers to collect data for evaluation purposes and, on the other hand, a differential intervention model.
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Abstract
The objective of this study was to review the literature and make suggestions for further investigation into the topic of professionals' reactions following a patient's suicide. An extensive search of the literature has been undertaken using computer database search. Even if findings are heterogenous, most studies suggest limited stress-related or affective-related reactions for the majority of respondents. Whereas, findings with regards to the impact on professional practice are consistent in identifying important consequences in the way professionals conduct their clinical assessment and reach treatment decisions after a patient's suicide. Future research should investigate how this event changes the clinician's personal growth and capacity to establish a therapeutic alliance with other suicidal patients.
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Affiliation(s)
- Monique Séguin
- a Université du Québec en Outaouais, Department of Psychology , Gatineau , Québec , Canada
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45
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Dransart DAC, Gutjahr E, Gulfi A, Didisheim NK, Séguin M. Patient suicide in institutions: emotional responses and traumatic impact on Swiss mental health professionals. Death Stud 2014; 38:315-321. [PMID: 24593010 DOI: 10.1080/07481187.2013.766651] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The reactions of professionals after a patient suicide are still a subject of controversy in academic literature. This article reports on retrospective data about the aftermath experienced by mental health professionals working in institutional settings in Switzerland. Findings indicate that both self-rated emotional responses and traumatic impact were low for the majority of the 258 professionals surveyed. Variables that mediated the impact included the support received and the characteristics of the professional-patient relationship. No significant differences were found with regard to gender and profession.
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Affiliation(s)
- Dolores Angela Castelli Dransart
- a School of Social Work and Social Education , University of Applied Sciences and Arts Western Switzerland , Givisiez , Switzerland
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46
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Séguin M, Di Mambro M, Desgranges A. [The contribution of research in psychology in the complex comprehension of the etiology of suicide]. Sante Ment Que 2013; 37:95-105. [PMID: 23666283 DOI: 10.7202/1014946ar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
If certain risk factors are known to increase suicidal behaviors, the question is to determine the differential weight of these various risk factors, on which individuals, in which context and in what period of their lives? We have put to test a model that explains different life trajectories leading to suicide. This research allows to surpass a correlation model of identification of risk factors and to target four distinct sub-groups of individuals for whom the developmental history seems quite different. It is clear that suicide is a complex, multidimensional and multilevel issue. Being at the crossroads of many scientific disciplines, psychology may help integrate and connect knowledge with other disciplines in order to clarify the contexts that affect suicidal individuals differently. This knowledge may help in identifying specific prevention interventions that could modify this chain of events leading ultimately to suicide.
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Affiliation(s)
- Monique Séguin
- Groupe McGill d'étude sur le suicide, Département de psychoéducation et de psychologie, Université du Québec en Outaouais
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47
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Séguin M, Robert M, DiMambro M, Lesage A, Reidi G, Roy M, Gagnon A, Larochelle S, Dutrisac S. Gambling over the life course and treatment-seeking. International Gambling Studies 2013. [DOI: 10.1080/14459795.2013.812675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Séguin M, Chawky N, Lesage A, Boyer R, Guay S, Bleau P, Miquelon P, Szkrumelak N, Steiner W, Roy D. Evaluation of the Dawson College Shooting Psychological Intervention: Moving Toward a Multimodal Extensive Plan. Psychol Trauma 2013; 5:268-276. [PMID: 24795790 DOI: 10.1037/a0027745] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In 2006, following the shooting at Dawson College, the authorities implemented an intervention plan. This provided an opportunity to analyze the responses to services offered, and afforded a learning opportunity, which led to the proposal of an extensive multimodal short- and long-term psychological plan for future needs. Both quantitative and qualitative data were gathered 18 months after the event, involving the participation of 948 students and staff. Mental health problems and the perception of services offered after the shooting were investigated, using standardized measures. Second, focus groups and individual interviews were conducted among a subgroup of participants (support team members; teachers and employees; students and parents) and permitted to gather data on services received and services required. Individual report of events, the extent of psychological impact and services offered and received were analyzed in terms of the following dimensions: intervention philosophy, training, ongoing offer of services and finally, detection and outreach. A significant incidence of disorders and a high rate of exacerbation of preexisting mental disorders were observed within the 18 months following the shooting. Postimmediate and short-term intervention appeared adequate, but the long-term collective vision toward community support and availability of mental health services were lacking. Lessons learned from this evaluation and other school shootings suggest that preparedness and long-term community responses are often overlooked. A multimodal extensive plan is proposed based on a theoretical model from which interventions strategies could be drawn.
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Affiliation(s)
- Monique Séguin
- Department of Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada, and McGill Group on Suicide Studies, McGill University, Montréal, Québec, Canada
| | - Nadia Chawky
- Department of Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada, and McGill Group on Suicide Studies, McGill University, Montréal, Québec, Canada
| | - Alain Lesage
- Department of Psychiatry, Université de Montréal and Centre de Recherche Fernand-Seguin de l'Hôpital Louis-H. Lafontaine, Montréal, Québec, Canada
| | - Richard Boyer
- Department of Psychiatry, Université de Montréal and Centre de Recherche Fernand-Seguin de l'Hôpital Louis-H. Lafontaine, Montréal, Québec, Canada
| | - Stéphane Guay
- Centre de Recherche Fernand-Seguin de l'Hôpital Louis-H. Lafontaine, and École de Criminologie, Université de Montréal, Montréal, Québec, Canada
| | - Pierre Bleau
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Paule Miquelon
- Department of Psychology, Université du Québec à Trois-Rivières, Montréal, Québec, Canada
| | - Nadia Szkrumelak
- Department of Psychiatry, McGill University Health Centre, McGill University
| | - Warren Steiner
- Department of Psychiatry, McGill University Health Centre, McGill University
| | - Denise Roy
- Centre de Recherche Fernand-Seguin de l'Hôpital Louis-H. Lafontaine, Montréal, Québec, Canada
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Monthuy-Blanc J, Bouchard S, Maïano C, Séguin M. Factors influencing mental health providers' intention to use telepsychotherapy in First Nations communities. Transcult Psychiatry 2013; 50:323-43. [PMID: 23666941 DOI: 10.1177/1363461513487665] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [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: 01/18/2023]
Abstract
Telemental health is the use of information and communications technologies and broadband networks to deliver mental health services and support wellness. Although numerous studies have demonstrated the efficiency and utility of telemental health, certain barriers may impede its implementation, including the attitudes of mental health service providers. The current study draws on the technology acceptance model (TAM) to understand the role of mental health service providers' attitudes and perceptions of telemental health (psychotherapy delivered via videoconferencing) on their intention to use this technology with their patients. A sample of 205 broadly defined mental health service providers working on 32 First Nations reserves in the province of Quebec completed the questionnaire adapted to assess TAM for telepsychotherapy. Confirmatory factor analysis and structural equation modeling provided evidence for the factor validity and reliability of the TAM in this sample. The key predictor of the intention to use telepsychotherapy was not mental health providers' attitude toward telepsychotherapy, nor how much they expected this service to be complicated to use, but essentially how useful they expect it to be for their First Nations patients. If telemental health via videoconferencing is to be implemented in First Nations communities, it is essential to thoroughly demonstrate its utility to mental health providers. Perceived usefulness will have a positive impact on attitudes toward this technology, and perceived ease of use will positively influence perceived usefulness. Cultural issues specific to the populations receiving telemental health services may be more efficiently addressed from the angle of perceived usefulness.
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Riedi G, Mathur A, Séguin M, Bousquet B, Czapla P, Charpentier S, Genestal M, Cailhol L, Birmes P. Alcohol and Repeated Deliberate Self-Harm. Crisis 2012; 33:358-63. [DOI: 10.1027/0227-5910/a000148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Repeated episode(s) of deliberate self-harm (RDSH) is a major risk factor for suicide. Aims: To identify specific risk factors for RDSH among patients admitted following an episode of deliberate self-harm (DSH) through acute intoxication. Methods: A prospective 6-month study was conducted with 184 patients (71% female) admitted to the emergency room (ER) as a result of self-poisoning (SP). Results: Rate of RDSH stood at 18% after 6 months. The sociodemographic variables associated with repeated deliberate self-harm were to have no principal activity, consultation with a medical professional during the 6 months preceding the self-poisoning, and referral to psychiatric services upon release from the ER. The clinical variable associated with RDSH was alcohol addiction (OR = 2.7; IC 95% = 1.2–6.1, p < .05) as assessed at the time of the initial ER admission. Conclusions: When patients are initially admitted to the ER as a result of self-poisoning, it is important to evaluate specific factors, particularly alcohol use, that could subsequently lead to repeated deliberate self-harm. The goal is to improve the targeting and referral of patients toward structures that can best respond to their needs.
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Affiliation(s)
- G. Riedi
- Toulouse University, UPS, Laboratoire du Stress Traumatique, France
| | - A. Mathur
- Toulouse University, UPS, Laboratoire du Stress Traumatique, France
| | - M. Séguin
- McGill Group for Suicide Studies, Douglas Hospital Research Center, Montréal, Canada
| | - B. Bousquet
- Toulouse University, UPS, Laboratoire du Stress Traumatique, France
| | - P. Czapla
- Toulouse University, UPS, Laboratoire du Stress Traumatique, France
| | - S. Charpentier
- Adult ER, Purpan Hospital, Toulouse University Hospital, France
| | - M. Genestal
- Anesthesiology and Intensive Care, Purpan Hospital, Toulouse University Hospital, France
| | - L. Cailhol
- National Institute of Health and Medical Research (INSERM), Clinical Investigation Center 9302, Purpan Hospital, Toulouse University Hospital, France
| | - P. Birmes
- Toulouse University, UPS, Laboratoire du Stress Traumatique, France
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