Patterns of follow-up mental health care after hospitalization for suicide-related behaviors among older adults in South Korea

OBJECTIVE

This study aimed to investigate the sociodemographic and clinical factors associated with receiving follow-up mental healthcare within 7 days and 30 days after hospitalization for suicide-related behaviors (SRB) among older adults in South Korea.

METHODS

Data from the Korean National Health Information Database were used, including information on sociodemographic variables and healthcare utilization. The study cohort consisted of individuals born in 1950 or before with a prior hospitalization record for suicide attempts or probable suicide attempts. Logistic regression analysis was conducted to predict the odds of receiving follow-up care within 7 days and 30 days, adjusting for covariates.

RESULTS

Among the 37,595 older adults discharged from hospitalization for SRB, 29.13 % and 37.86 % received follow-up care within 7 days and 30 days, respectively. Follow-up care was more common among younger individuals, women, those with higher socio-economic status (SES), urban residents, and individuals with comorbidities.

CONCLUSION

The provision of mental health follow-up care for older adults after hospitalization for suicide attempts is inadequate in South Korea. Increasing access to follow-up care among those with lower income, residing in rural areas, and older age is crucial. Public awareness campaigns, stigma reduction training for healthcare providers, and system-level changes, such as telemedicine and integrated care pathways, can help bridge the healthcare gap and reduce suicide mortality among older adults.

Needs for mobile and internet-based psychological intervention in patients with self-injury and suicide-related behaviors: a qualitative systematic review

BACKGROUND

In recent years, mobile psychological interventions have proven effective in reducing self-injury and suicide-related behaviors. Therefore, it is essential to continually enhance the user experience and address patients' needs to facilitate the development of mobile mental health interventions. Identifying patients with mobile mental health needs can be challenging for mental health professionals. To address this, we conducted a systematic review of qualitative research to synthesize the needs of patients engaged in self-injury and suicide-related behaviors for mobile and internet-based psychological interventions.

METHODS

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement (ENTREQ). We explored 11 databases and synthesized the results using thematic analysis.

RESULTS

Sixteen qualitative and mixed-method studies were included. The study found that the needs of patients with self-injury and suicide-related behaviors for mobile psychological intervention included therapy, technology, culture, privacy, communication, emotional support, personalization, and self-management. Consistent with the Technology Acceptance Model (TAM), the needs of patients with self-injury and suicide-related behaviors are influenced by the perceived ease of use and perceived usefulness of the mobile intervention. However, the findings also highlight the importance and unmet needs of peer support, communication, self-management, and empowerment in using mobile psychological interventions for patients with self-injury and suicide-related behaviors.

CONCLUSIONS

Studies in this area have shown that the needs of patients with self-harm and suicide-related behaviors cover multiple stages, including basic therapeutic and technical needs and advanced emotional needs. This complexity makes it challenging to address the needs of patients engaged in self-injury and suicide-related behaviors through digital interventions. In the future, mental health professionals should be encouraged to participate in multidisciplinary collaborations to expand the use of digital interventions, enhancing remote self-management for patients and providing new strategies for the ongoing care of psychiatric patients. We registered the review protocol on PROSPERO (CRD42022324958).

Effects of social support on suicide-related behaviors in patients with severe mental illness: A systematic review and meta-analysis

OBJECTIVE

Patients with severe mental illness have a high risk of suicide and frequently living eliminated from mainstream society, but the effects of social support on suicide-related behaviors among this crowd is inconclusive. The present study aimed to explore such effects among patients with severe mental illness.

METHODS

We implemented a meta-analysis and a qualitative analysis of relevant studies published before February 6, 2023. Correlation coefficients (r) and 95 % CI were selected as the effect size index in meta-analysis. Studies that did not report correlation coefficients were employed for qualitative analysis.

RESULTS

Out of 4241 identified studies, 16 were identified in this review (6 for meta-analysis, 10 for qualitative analysis). The meta-analysis presented that the pooled correlation coefficients (r) were - 0.163 (95%CI = -0.243, -0.080, P < 0.001), suggesting a negative correlation between social support and suicidal ideation. The subgroup analysis showed that this effect works in all bipolar disorder, major depression, and schizophrenia. Concerning qualitative analysis, social support presented positive effects on reducing suicidal ideation, suicide attempts, and suicide death. The effects were consistently reported in female patients. However, there existed some unaffected results in males.

LIMITATIONS

The included studies were from middle- and high-income countries and used inconsistent measurement tools, our results may have some bias.

CONCLUSIONS

The effects of social support in reducing suicide-related behaviors were positive, but it showed better effects in both female patients and adults. Males and adolescents deserve more attention. Future research needs to pay more attention to the implementation methods and effects of personalized social support.

[Effect of Family Function on Suicide-Related Behaviors of Junior Middle School Students: The Mediating Effect of Depression]

Objective

To examine the prevalence of suicide-related behaviors among junior middle school students, and to explore the mediating role of depression in the relationship between suicide-related behaviors and family function.

Methods

A total of 2572 junior middle school students from three middle schools in Chengdu were interviewed face-to-face by using suicide-related items from Youth Risk Behavior Surveillance System (YRBSS), Chinese Family Assessment Instrument (C-FAI), and Center for Epidemiologic Studies Depression Scale for Children (CES-DC). The mediating role of depression was analyzed with structural equation model.

Results

The prevalence of suicide-related behaviors was 26.01% among the respondents. The prevalence of suicide ideation, suicide plan and suicide attempt were 24.38%, 13.49% and 10.77%, respectively. Depression played a partial mediating role in how family function impacted on suicide-related behaviors, presenting a direct effect value of 0.170 (95% CI: 0.117-0.218, P<0.001) and an indirect effect value of 0.205 (95% CI: 0.176-0.234, P<0.001), with the mediating effect accounting for 54.67% of the total effect.

Conclusion

Poor family function may increase the risk of suicide-related behaviors, and this effect is produced mostly through the impact on children's mental health. Improving family function will not only improve children's psychological status, but also reduce suicide-related behaviors.

Parents' and medical staff's experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study

BACKGROUND

Currently, there is increasing awareness of suicide-related behaviors. Mental health services are a key location for assisting people with suicide-related behaviors. However, few studies focused on the evaluation and experience of the mental health care system from families and the medical staff's perspective in China. The study aims to explore parents' and the front-line medical staff's experience of an adolescent with suicide-related behaviors admitted to the psychiatry department of a general hospital in China.

DESIGN

Qualitative study was employed in the study. Participants were recruited from a general hospital in China characterized by high levels in the Chinese mental health system.

METHODS

Semi-structured in-depth interviews were conducted exploring their experience and perceptions when an adolescent was admitted to the hospital. The theme analysis method is used for data analysis.

RESULTS

Participants expressed dissatisfaction in the psychiatric department. Other barriers in their work were identified, such as the shortage of staff and difficulties in caring or communicating with patients. Besides, the imperfect treatment system also contributes to the low satisfaction of patients and their families. Two themes and six subthemes were identified: 1) staff perceive patients with SRBs as difficult to engage (feelings of helplessness, the need for compassion, challenges of professional self-efficacy, the recommendations to the health care service); 2) parents not satisfied with the existing hospital services (doubt the hospitalization treatment and the advice to the health care service).

CONCLUSION

This study found that insufficient staffing and lacking of systematic professional treatment models are the major challenges. We suggest increasing the input of mental health resources to expand and train the mental health service team and establish a complete set of a treatment model for SRBs.

The Columbia-Suicide Severity Rating Scale: Associations between interrupted, aborted, and actual suicide attempts among adolescent inpatients

The Columbia-Suicide Severity Rating Scale divides suicide attempt behaviors into actual, interrupted, and aborted attempts, but limited data have been reported regarding associations between interrupted, aborted, and actual attempts. This study provided initial data on the ability of interrupted and aborted attempts to estimate the frequency of actual suicide attempts. Participants were adolescent psychiatric inpatients (59.9% female), 12-17 years (mean = 14.73, SD = 1.62). Results suggest that interrupted and aborted suicide attempts are associated with the frequency of actual suicide attempts, controlling for suicidal ideation and depressive symptoms. Future research should evaluate whether interrupted and aborted attempts prospectively predicting actual suicide attempts.