ORCID Profile
0000-0001-5652-918X
Current Organisations
Orygen The National Centre of Excellence in Youth Mental Health
,
University of Melbourne
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Mental Health | Communications and Media Policy | Public Health and Health Services not elsewhere classified | Public Health and Health Services |
Publisher: Informa UK Limited
Date: 06-2021
Publisher: Royal College of General Practitioners
Date: 27-02-2020
Publisher: Hogrefe Publishing Group
Date: 2012
DOI: 10.1027/0227-5910/A000095
Abstract: Background: In children and adolescents with a depressive disorder, predicting who will also go on to exhibit suicide-related behaviors (SRBs), including suicide attempt or self-harm, is a key challenge facing clinicians. Aims: To investigate the relative contributions of depressive disorder severity, hopelessness, family dysfunction, and perceived social support to the risk of suicide-related behaviors. Methods: This was a cross-sectional study of a group of 10–16-year-olds with major depressive disorders and dysthymic disorder. Results: Child-rated depressive disorder symptom severity emerged as the greatest predictor of risk. Hopelessness and family dysfunction were also significant predictors of SRBs. In combination these variables were strong predictors, accounting for 66% of the variance. This is a cross-sectional study design, rather than longitudinal, therefore risk prediction over time was not possible. Conclusions: Understanding the child and adolescents depressive disorder symptom severity from their perspective, their level of hopelessness, as well as their family context is critical in understanding the risk of SRBs. These findings may help to provide direction for targeted interventions to address these clinical risk factors.
Publisher: Wiley
Date: 05-02-2022
DOI: 10.1111/SLTB.12840
Abstract: Active contact and follow‐up interventions have been shown to be effective in reducing repetition of hospital‐treated self‐harm. The Way Back Support Service (WBSS) is a new service funded by the Australian government to provide three months of non‐clinical after‐care following a hospital‐treated suicide attempt. The aim of this study was to investigate the effectiveness of WBSS in reducing deliberate self‐poisoning (DSP) and psychiatric hospital admissions over a 12‐month follow‐up period for a population of DSP patients within the Hunter (Australia) region. A non‐randomized, historical controlled (two periods) trial design with intention‐to‐treat analyses. Outcome data were drawn from hospital records. There were a total of 2770 participants across study periods. There were no significant differences between cohorts for proportion with any, or number of, re‐admissions for DSP in the follow‐up period. For psychiatric admissions, the intervention cohort had a non‐significantly greater proportion with any psychiatric admission and significantly more admissions compared to one of the control cohorts. The WBSS model of care should be modified to strengthen treatment engagement and retention and to include established, clinical, evidence‐based treatments shown to reduce DSP repetition. Any modified WBSS model should be subject to further evaluation.
Publisher: Wiley
Date: 31-03-2014
DOI: 10.1111/EIP.12137
Abstract: Little evidence exists regarding the efficacy of suicide prevention programmes among the youth. This pilot study aimed to test the effects of a specifically designed, eight-module Internet-based programme on suicidal ideation among secondary school students. The study employed a pre-test ost-test design. Outcomes of interest were suicidal ideation, depression and hopelessness. Participants were recruited via the school well-being team, were assessed at baseline and immediately post-intervention. The intervention was delivered weekly at the young persons' school. Twenty-one students completed all eight modules and a post-intervention assessment, and constitute the observed case s le used for the analysis. Overall levels of suicidal ideation, depressive symptoms and hopelessness decreased significantly over the course of the study. This was a small pilot study with no control group. However, significant reductions were seen in suicidal ideation, depressive symptoms and hopelessness, indicating that Internet-based interventions may hold promise when it comes to reducing suicide risk among youth. Further investigation is warranted.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.PSYCHRES.2008.10.006
Abstract: In iduals with a first episode of psychotic illness are known to be at high risk of suicide, yet little is understood about the timing of risk in this critical period. The present study aimed to examine the temporal pattern of suicide risk in patients with early psychosis (EP) and to determine whether discrete periods of significantly elevated risk can be identified up to 24 months after commencing treatment. Suicidality ratings collected each month as part of patient routine assessment at the Early Psychosis Prevention and Intervention Centre (EPPIC) were retrieved from the service database for patients treated between December 2002 and December 2005 (N=696). Time-series analysis was performed on suicide risk estimated from the aggregated data of 94 in iduals who met the study inclusion criteria. Suicide risk was highest in the first month of treatment, decreasing rapidly over the next 6 months and declining slightly thereafter. A power function adequately described this curvilinear trend. Fluctuations around the trend were unpredictable, except for a mild tendency to reverse from month to month, and did not reach statistical significance. The findings suggest limited scope for preventative interventions driven by chronology alone. Intensive routine suicide screening across the course of treatment may facilitate identification and early management of EP patients at suicide risk.
Publisher: Wiley
Date: 31-03-2014
DOI: 10.1111/EIP.12136
Abstract: Suicide-related behaviour is a major problem among adolescents. Yet relatively few studies have tested the efficacy, acceptability and safety of interventions for this population. We developed and pilot tested an online intervention for at-risk school students, which has led to reduced suicidal ideation, hopelessness and depressive symptoms. The aims of this study were to examine the safety and acceptability of the programme, and to determine which components were found to be most helpful and enjoyable. This pilot study employed a pre-test ost-test design, with an 8-week intervention phase. Participants were assessed immediately before, and immediately after the intervention. Participants were also asked to complete a weekly questionnaire immediately after the intervention, and again 2 days later assessing suicidal ideation and distress. Twenty-one young people completed the intervention. Overall, the intervention did not lead to increases in suicidal ideation or distress. Participants reported enjoying the programme, in particular watching the video diaries and completing the activities, and said they would recommend the programme to a friend. Overall, the cognitive components of the programme were found to be most helpful. Overall, the programme appeared to be a safe and acceptable intervention for at-risk adolescents. This was a small, pilot study so we need to interpret the results with caution. However, the findings are promising and suggest that young people at risk of suicide can safely be included in trials as long as adequate safety procedures are in place. The programme is now being tested in a randomized controlled trial.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.JAD.2019.11.045
Abstract: The number of studies examining internet-based interventions (IBIs) for depression is increasing. Although many in iduals with depression experience suicidal ideation, there is only insufficient information available on how to manage and support in iduals at risk of suicide in IBI trials. Here, we examined the current practice regarding the management of in iduals experiencing suicidal thoughts or behaviors in studies of IBIs for depression. Information pertaining to the management of suicidality was extracted from 24 studies. Additionally, researchers in the field completed a questionnaire (n = 13) before being interviewed (n = 11) about their procedures and considerations regarding the management of suicidality. In most trials (N = 17 71%), in iduals at risk of suicide were excluded based on varying criteria. N = 7 studies used structured interviews and N = 5 studies used single items of self-report questionnaires for assessing suicidality. The nature and degree of support provided to in iduals at risk of suicide varied and only one intervention comprised suicide-specific content. Most experts referred to research on interventions with some level of human support (e.g. written feedback) which might limit the representativeness of the results of the interviews for unguided interventions. Suicidality is often treated more as an exclusion criterion rather than a treatable condition in research on IBIs for depression. This paper provides an overview of the current practice and gives recommendations for the design of future trials.
Publisher: Public Library of Science (PLoS)
Date: 15-11-2018
Publisher: Public Library of Science (PLoS)
Date: 10-03-2022
DOI: 10.1371/JOURNAL.PONE.0264984
Abstract: More than 700,000 people lose their lives to suicide each year and evidence suggests that the current COVID-19 pandemic is leading to increases in risk factors for suicide and suicide-related behaviour, in particular among young people. It is widely documented that some sectors of the population are over-represented in the suicide statistics. It is also well established that the pathways that lead someone to a suicidal crisis are complex and differ across regions and sectors of the population as such a multi-faceted approach to prevention is required. Many of us would also argue that novel approaches, that combine broad population-based strategies with in idual interventions, and approaches that capitalise on new technologies and methodologies are also required. For these reasons, when bringing together this collection, we deliberately sought studies that focused upon those groups who are over-represented in the suicide statistics yet under-represented in research. We also called for studies that reported on novel approaches to suicide prevention and for studies that reflected the voices of people with lived experience of suicide, also often unheard in research efforts.
Publisher: Elsevier BV
Date: 03-2019
Publisher: Informa UK Limited
Date: 03-07-2019
DOI: 10.1080/13811118.2019.1619113
Abstract: To systematically review the quality of evidence regarding the effectiveness of supports for people affected by suicide. EMBASE, MEDLINE, and PsychINFO were searched for evaluations of community-based supports for people affected by suicide. Outcomes included suicide-related behavior, depression, grief, quality of life, caring ability, and qualitative experiences. Fifteen studies evaluated 15 supports of various modalities. Study quality was generally poor most studies examined bereaved in iduals with mixed findings. Few reduced suicide-related behavior, half improved depression, and grief, while studies of caring ability, quality of life, or qualitative experiences reported positive effects. Supports associated with better outcomes connected peers with similar experiences, were provided over a period of months, and involved veteran rather than novice facilitators. Supports for people affected by suicide may be effective for improving suicide-related behavior, psychological adjustment, quality of life and caregiving, but require further evaluation.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13058
Abstract: Objective Suicide prevention, including among youth, has been a national priority in Australia for some time. Yet despite this, rates of suicide, and related behaviour, remain high. The aim of this study was to review all suicide-prevention research that had been conducted in Australia between January 2007 and December 2011, with a specific emphasis on studies relating to young people, in order to determine whether or not we are prioritising the sort of research that can adequately inform policy development and guide ‘best practice’. Methods Data were collected from two sources. First, several electronic databases were searched in October 2012 in order to identify published journal articles relating to suicide, written by Australian authors. Second, summary data obtained from the National Health and Medical Research Council, the Australian Rotary Health Research Fund and the Australian Research Council were examined in order to identify currently funded studies that relate to suicide. Studies were then classified according to whether or not they had a focus on youth, and according to research type, type of suicide-related behaviour under investigation and method of suicide. Results There were 224 articles published and 12 grants funded that specifically focussed on suicide-related behaviour over the period January 2007 to December 2011. Of these, 47 articles (21%) and five funded grants (42%) focussed on young people. Youth studies, in particular those reported in the published articles, tended to be epidemiological in nature and only six of the published articles (13%) and two of the funded grants related to intervention studies. Conclusions Although the focus on youth is welcome, the lack of intervention studies is disappointing. Given that rates of suicide and related behaviour remain high, there is a clear need for a stronger body of intervention research that can inform national policy, if we are to successfully develop effective approaches to reducing suicide risk. What is known about the topic? Although the prevention of youth suicide has been a national priority for some time, rates of suicide and suicide-related behaviour remain high among young Australians. Much is known about the epidemiology of suicide however, relatively little is known about which interventions may be effective in reducing this risk. Previous research suggests that although youth receive a reasonable amount of research attention in Australia, the majority of studies focus on epidemiological as opposed to intervention research. What does this paper add? This paper reviews all suicide research that has been conducted in Australia between 2007 and 2011 in order to examine how much attention is currently given to studies relating to youth, and the relative priority given to intervention and epidemiological studies. Our findings support those reported previously, which suggest that although a significant proportion of suicide research focuses on youth, relatively little attention continues to be given to intervention studies. What are the implications for practitioners? This paper argues that further intervention research is needed if we are to build a sufficiently strong evidence base that can effectively inform policy development and guide best practice when it comes to preventing youth suicide in Australia.
Publisher: Computers, Materials and Continua (Tech Science Press)
Date: 2011
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.PSYCHRES.2010.10.010
Abstract: Despite the common use of the 12-item General Health Questionnaire (GHQ-12) with adolescents, there is limited data supporting its validity with this population. The aims of the study were to investigate the psychometric properties of the GHQ-12 among high school students, to validate the GHQ-12 against the gold standard of a diagnostic interview, and to suggest a threshold score for detecting depressive and anxiety disorders. Six hundred and fifty-four high school students from years 10 to 12 (ages 15-18) completed the GHQ-12 (Likert scored) and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV-Test Revision (DSM-IV-TR). Receiver operating characteristic (ROC) curves were plotted. The mean GHQ-12 score for the total s le was 9.9 (S.D.=5.4). Results from the ROC curve indicated that the GHQ-12 performed better than chance at identifying depressive and anxiety disorders (area under the curve (AUC)=0.781). A GHQ-12 threshold score of 9/10 for males and 10/11 for females was found to be optimal. Given the significant proportion of mental illness among high school students, there may be a need to introduce screening for mental illnesses as part of the school curriculum. This can assist with the early identification and enable low stigma preventive intervention within the school environment.
Publisher: Wiley
Date: 12-11-2021
DOI: 10.1111/EIP.13069
Abstract: Youth suicide research stands to benefit from involving young people with lived experience as research partners however, there may be a number of barriers to doing this successfully. The aim of this study was to identify the extent to which international youth suicide prevention researchers actively partner with young people in intervention research design, and to explore the barriers, facilitators and benefits to such engagement. Ninety‐seven eligible researchers were identified using a systematic literature search and invited via email to participate in an online questionnaire. Only 17 participants (17.5%) at least partially completed the questionnaire, and minimal qualitative data were provided. Analysis of the limited data together with the low response rate suggests that the rate of youth partnerships in suicide prevention intervention research is very low. Guidelines regarding how to safely and effectively partner with young people in this sensitive research area may help to address this gap.
Publisher: MDPI AG
Date: 13-01-2023
Abstract: International students are at risk of suicide and suicide prevention activities addressing their unique needs are required. However, no comprehensive review has been undertaken to identify effective suicide prevention approaches for international students. The current scoping review aimed to chart the extent, range, and nature of available evidence on the prevention strategies for international students. We systematically searched Medline, PsycInfo, ERIC, CINAHL, Proquest, and several gray literature databases to identify relevant peer-reviewed articles and gray literature. Eligible publications were those providing data or recommendations related to suicide prevention among international students 15 peer-reviewed articles and 19 gray literature documents were included in the review. No studies of prevention programs or policies directly targeting suicidal ideation, suicide attempts, or suicide in international students were identified. A narrative synthesis of the suicide prevention recommendations for international students identified four categories: (1) cultural competency training on suicide and provision of culturally sensitive services (2) improved and increased risk screening for suicide (3) proactive intervention and engagement strategies and (4) collaborative approaches to streamline service access and improve available support. These recommendations provide guidance on potential directions for international student suicide prevention. Research assessing the effectiveness of such recommendations will enable the development of novel evidence-based policies and interventions that reduce rates of suicide in international students.
Publisher: Royal College of Psychiatrists
Date: 11-2005
Abstract: Most previous investigations of imitative suicide have reported suicide clustering in the general population, either temporal clustering following media reporting of suicide or case studies of geographically localised clusters. To determine whether space–time and space–time–method clustering occur in a national case register of those who had recent contact with mental health services and had died by suicide and to estimate the suicide imitation rate in this population. Knox tests were used for space–time and space–time–method clustering. Model simulations were used to estimate effect size. Highly significant space–time and space–time–method clustering was found in a s le of 2741 people who died by suicide over 4 years who had had recent contact with one of 105 mental health trusts. Model simulations with an imitation rate of 10.1% (CI 4-17) reproduced the observed space–time–method clustering. This study provides indirect evidence that imitative suicide occurs among people with mental illnesses and may account for about 10% of suicides by current and recent patients.
Publisher: Elsevier BV
Date: 02-2020
Publisher: JMIR Publications Inc.
Date: 19-05-2023
DOI: 10.2196/44535
Abstract: Young people are more likely to be affected by suicide contagion, and there are concerns about the role social media plays in the development and maintenance of suicide clusters or in facilitating imitative suicidal behavior. However, social media also presents an opportunity to provide real-time and age-appropriate suicide prevention information, which could be an important component of suicide postvention activities. This study aimed to test an intervention designed to equip young people to communicate safely online about suicide (#chatsafe) with a s le of young people who had recently been exposed to a suicide or suicide attempt, with a view to determining the role social media can play as part of a postvention response. A s le of 266 young people from Australia, aged 16 to 25 years, were recruited to participate in the study. They were eligible if they had been exposed to a suicide or knew of a suicide attempt in the past 2 years. All participants received the #chatsafe intervention, which comprised 6 pieces of social media content that were sent to them weekly via direct message through Instagram, Facebook, or Snapchat. Participants were assessed on a range of outcome measures (social media use, willingness to intervene against suicide, internet self-efficacy, confidence, and safety when communicating about suicide on social media platforms) at baseline, immediately after the intervention, and at 4-week follow-up. After the 6-week #chatsafe intervention, participants reported substantial improvements in their willingness to intervene against suicide online, their internet self-efficacy, and their perceived confidence and safety when communicating about suicide online. Overall, the participants reported that it was appropriate to receive the #chatsafe intervention via social media, and no iatrogenic effects were recorded. The findings suggest that it is safe and acceptable to disseminate suicide prevention information entirely via social media among young people who have recently been exposed to a suicide or suicide attempt. Interventions such as #chatsafe could potentially mitigate the risk of distress and future suicidal behavior in young people by improving the quality and safety of online communication about suicide and, as such, can be an important component of delivering a postvention response to young people.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.SCHRES.2009.10.009
Abstract: In iduals with first-episode psychosis demonstrate high rates of suicide attempt (SA). 1) To examine the prevalence of, and risk factors for, SA in a first-episode psychosis (FEP) cohort over a 7.4 year follow-up period. 2) To investigate differences between single versus multiple suicide attempters. This study reports baseline and follow-up data from a naturalistic, prospective follow-up of 413 FEP patients treated at a specialist early psychosis centre. Assessments were conducted at treatment entry, initial symptom remission or stabilization, and long term follow-up. Binary logistic regression models were used to assess unadjusted and adjusted associations between early illness and sociodemographic characteristics and two outcome measures: any SA during follow-up and multiple SAs. Follow-up data were available for 282 participants. Sixty-one (21.6%) made a suicide attempt over the follow-up period, including 12 successful suicides. The following baseline risk factors increased the risk of any SA: history of self-harm (OR=4.27 p 50% of the initial psychotic episode (OR=2.49 p=0.045), and hopelessness (OR=2.03 p=0.030). History of problem alcohol use increased the risk of multiple SAs (OR=4.43 95% CI (1.05-18.7) p=0.043). The prevalence of suicide attempt in this study exceeds reports from short-term FEP studies but is comparable to longer term follow-up studies, indicating that risk remains elevated for at least 7 years following commencement of treatment. The key predictor of future suicide attempt was previous self-harm, indicating that interventions for self-harm are required.
Publisher: Royal College of Psychiatrists
Date: 03-2015
DOI: 10.1192/BJP.BP.114.147819
Abstract: There is growing interest in brief contact interventions for self-harm and suicide attempt. To synthesise the evidence regarding the effectiveness of brief contact interventions for reducing self-harm, suicide attempt and suicide. A systematic review and random-effects meta-analyses were conducted of randomised controlled trials using brief contact interventions (telephone contacts emergency or crisis cards and postcard or letter contacts). Several sensitivity analyses were conducted to examine study quality and subgroup effects. We found 14 eligible studies overall, of which 12 were amenable to meta-analyses. For any subsequent episode of self-harm or suicide attempt, there was a non-significant reduction in the overall pooled odds ratio (OR) of 0.87 (95% CI 0.74–1.04, P = 0119) for intervention compared with control. The number of repetitions per person was significantly reduced in intervention v. control (incidence rate ratio IRR = 066, 95% CI 0.54–0.80, P ). There was no significant reduction in the odds of suicide in intervention compared with control (OR = 0.58, 95% CI 0.24–1.38). A non-significant positive effect on repeated self-harm, suicide attempt and suicide and a significant effect on the number of episodes of repeated self-harm or suicide attempts per person (based on only three studies) means that brief contact interventions cannot yet be recommended for widespread clinical implementation. We recommend further assessment of possible benefits in well-designed trials in clinical populations.
Publisher: Hogrefe Publishing Group
Date: 05-2012
DOI: 10.1027/0227-5910/A000122
Abstract: Background: One methodological difficulty in research into suicide attempts and suicide is distinguishing these phenomena from nonsuicidal self-harming behaviors and accidents. This is problematic because a reliable assessment of the presence or absence of the outcome variable is fundamental for the validity of the findings. Aims: To develop a standardized rating system, the Classification Algorithm for the Determination of Suicide Attempt and Suicide (CAD-SAS), and to investigate its psychometric properties. Methods: To examine the test-retest reliability, one investigator rated 217 narratives of real-life self-harming incidents at initial assessment and 4 weeks later. To establish the interrater reliability, three independent raters assessed a random s le of 70 narratives using the CAD-SAS. To examine the validity, one investigator using the CAD-SAS compared ratings to clinical judgments made by a consultant psychiatrist without the CAD-SAS on the same random set of 70 narratives. Results: Test-retest reliability was excellent (97.2% agreement) and interrater reliability was substantial (70.0% agreement, κ = 0.70). Agreement in the classification of incidents with the “real-world” clinical judgments supports the validity of the CAD-SAS (64.3% agreement, κ = 0.46). Conclusions: The reliability and validity of future studies can be enhanced through the standardized assessment and classification of incidents.
Publisher: Royal College of Psychiatrists
Date: 02-2006
Abstract: Suicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge. To describe the social and clinical characteristics of a comprehensive s le of in-patient and post-discharge cases of suicide. A national clinical survey based on a 4-year (1996–2000) s le of cases of suicide in England and Wales who had been in recent contact with mental health services ( n =4859). There were 754 (16%) current in-patients and a further 1100 (23%) had been discharged from psychiatric in-patient care less than 3 months before death. Nearly a quarter of the in-patient deaths occurred within the first 7 days of admission 236 (31%) occurred on the ward, the majority by hanging. Post-discharge suicide was most frequent in the first 2 weeks after leaving hospital the highest number occurred on the first day. Suicide might be prevented among in-patients by improving ward design and removing fixtures that can be used in hanging. Prevention of suicide after discharge requires early community follow-up and closer supervision of high-risk patients.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.JAD.2018.06.028
Abstract: Suicide is a major public health problem and is the second leading cause of death in young people worldwide. Indicating a lack of adequate treatment approaches, recent data suggest a rising suicide rate. Current approaches to suicide prevention do not sufficiently account for the specific needs of young people or the ways in which they engage with the health system, nor are they adequately theory-driven. In this paper, we review an empirically-supported theoretical model of suicide together with the latest evidence in treating young people who are at risk. We discuss the potential efficacy of social-media-based online interventions, with a particular focus on how they may be uniquely placed to target interpersonal risk factors for suicide. We highlight the risks associated with such interventions, including the potential for contagion to occur. Based on prominent theoretical models and gaps in existing treatment approaches, we propose a newly-developed, theory-driven, online social-networking-based intervention for suicide prevention in young people.
Publisher: JMIR Publications Inc.
Date: 23-01-2018
DOI: 10.2196/MENTAL.9041
Abstract: Effective treatment of depression in young people is critical, given its prevalence, impacts, and link to suicide. Clinical practice guidelines point to the need for regular monitoring of depression symptom severity and the emergence of suicidal ideation to track treatment progress and guide intervention delivery. Yet, this is seldom integrated in clinical practice. The objective of this study was to address the gap between guidelines about monitoring and real-world practice by codesigning an app with young people that allows for self-monitoring of mood and communication of this monitoring with a clinician. We engaged young people aged 18 to 25 years who had experienced depression, suicidal ideation including those who self-harm, as well as clinicians in a codesign process. We used a human-centered codesign design studio methodology where young people designed the features of the app first in idually and then as a group. This resulted in a minimal viable product design, represented through low-fidelity hand-drawn wireframes. Clinicians were engaged throughout the process via focus groups. The app incorporated a mood monitoring feature with innovative design aspects that allowed customization, and was named a “well-being tracker” in response to the need for a positive approach to this function. Brief personalized interventions designed to support young people in the intervals between face-to-face appointments were embedded in the app and were immediately available via pop-ups generated by a back-end algorithm within the well-being tracker. Issues regarding the safe incorporation of alerts generated by the app into face-to-face clinical services were raised by clinicians (ie, responding in a timely manner) and will need to be addressed during the full implementation of the app into clinical services. The potential to improve outcomes for young people via technology-based enhancement to interventions is enormous. Enhancing communication between young people and their clinicians about symptoms and treatment progress and increasing access to timely and evidence-based interventions are desirable outcomes. To achieve positive outcomes for young people using technology- (app) based interventions, it is critical to understand and incorporate, in a meaningful way, the expectations and motivations of both young people and clinicians.
Publisher: CSIRO Publishing
Date: 2006
DOI: 10.1071/AH060271
Abstract: Australia?s National Suicide Prevention Strategy (NSPS) is about to move into a new funding phase. In this context this paper considers the emphasis of the NSPS since its inception in 1999. Certain high-risk groups (particularly people with mental illness and people who have selfharmed) have been relatively neglected, and some promising approaches (particularly selective and indicated interventions) have been under-emphasised. This balance should be redressed and the opportunity should be taken to build the evidence-base regarding suicide prevention. Such steps have the potential to maximise the impact of suicide prevention activities in Australia.
Publisher: JMIR Publications Inc.
Date: 10-06-2021
DOI: 10.2196/29645
Publisher: Springer Science and Business Media LLC
Date: 18-02-2006
DOI: 10.1007/S10488-006-0035-5
Abstract: This research uses population-based administrative data linking health service use to longitudinal postal code information to describe the residential mobility of in iduals with a severe mental illness (SMI), schizophrenia. This group is compared to two cohorts, one with no mental illness, and one with a severe physical illness of inflammatory bowel disease. The percentage of in iduals with one or more changes in postal code in a 3-year period is examined, along with measures of rural-to-rural regional migration and rural-to-urban migration. Demographic, socioeconomic, and health service use characteristics are examined as determinants of mobility. The odds of moving were twice as high for the SMI cohort as for either of the other two cohorts. There were no statistically significant differences in rural-to-rural or rural-to-urban migration among the cohorts. Marital status, income quintile, and use of physicians are consistent determinants of mobility. The results are discussed from the perspectives of health services planning and access to housing.
Publisher: Informa UK Limited
Date: 11-2018
DOI: 10.1111/CP.12173
Publisher: JMIR Publications Inc.
Date: 17-02-2023
DOI: 10.2196/44300
Abstract: Suicide is the leading cause of death among Australians. One commonly cited explanation is the impact of social media, in particular, the ways in which young people use social media to communicate about their own experiences and their exposure to suicide-related content posted by others. Guidelines designed to assist mainstream media to safely report about suicide are widespread. Until recently, no guidelines existed that targeted social media or young people. In response, we developed the #chatsafe guidelines and a supporting social media c aign, which together make up the #chatsafe intervention. The intervention was tested in a pilot study with positive results. However, the study was limited by the lack of a control group. The aim of this study is to assess the impact of the #chatsafe social media intervention on young people’s safety and confidence when communicating on the web about suicide. The study employs a pragmatic, parallel, superiority randomized controlled design. It will be conducted in accordance with the Consolidated Standards of Reporting Trials statement over 18 months. Participants will be 400 young people aged 16-25 years (200 per arm). Participants will be recruited via social media advertising and assessed at 3 time points: time 1—baseline time 2—8-week postintervention commencement and time 3—4-week postintervention. They will be asked to complete a weekly survey to monitor safety and evaluate each piece of social media content. The intervention comprises an 8-week social media c aign including social media posts shared on public Instagram profiles. The intervention group will receive the #chatsafe suicide prevention content and the control group will receive sexual health content. Both groups will receive 24 pieces of content delivered to their mobile phones via text message. The primary outcome is safety when communicating on the web about suicide, as measured via the purpose-designed #chatsafe online safety questionnaire. Additional outcomes include willingness to intervene against suicide, internet self-efficacy, safety, and acceptability. The study was funded in November 2020, approved by the University of Melbourne Human Research Ethics Committee on October 7, 2022, and prospectively registered with the Australian New Zealand Clinical Trials registry. Trial recruitment began in November 2022 and study completion is anticipated by June 2024. This will be the first randomized controlled trial internationally to test the impact of a social media intervention designed to equip young people to communicate safely on the web about suicide. Given the rising rates of youth suicide in Australia and the acceptability of social media among young people, incorporating social media–based interventions into the suicide prevention landscape is an obvious next step. This intervention, if effective, could also be extended internationally, thereby improving web-based safety for young people not just in Australia but globally. Australian New Zealand Clinical Trials Registry ACTRN12622001397707 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384318 DERR1-10.2196/44300
Publisher: BMJ
Date: 12-07-2017
Abstract: Suicide-related behaviours are common in young people and associated with a range of negative outcomes. There are few evidence-based interventions however, cognitive behavioural therapy (CBT) shows promise. Internet delivery of CBT is popular, with potential to increase reach and accessibility. To test the effectiveness of an internet-based CBT program (Reframe-IT) in reducing suicide-related behaviours, depression, anxiety, hopelessness and improving problem solving and cognitive and behavioural skills in school students with suicide-related behaviours. A parallel randomised controlled trial testing the effectiveness of Reframe-IT plus treatment as usual (TAU) compared with TAU alone in reducing suicidal ideation, suicide attempts, depression, hopelessness, symptoms of anxiety, negative problem orientation and cognitive and behavioural skill acquisition was undertaken. We recruited students experiencing suicidal ideation from 18 schools in Melbourne, Australia, between August 2013 and December 2016. The intervention comprised eight modules of CBT delivered online over 10 weeks with assessments conducted at baseline, 10 weeks and 22 weeks. Only 50 of the planned 169 participants were recruited. There were larger improvements in the Reframe-IT group compared with the TAU group for the primary outcome of suicidal ideation (intervention -61.6, SD 41.6 control -47.1, SD 42.3, from baseline to 22-week follow-up intervention) however, differences were non-significant (p=0.593). There were no increases in distress in the majority of participants (91.1%) after completion of each module. Changes in depression and hopelessness partly mediated the effect of acquisition of CBT skills on suicidal ideation. The trial was underpowered due to difficulties recruiting participants as a result of the complex recruitment procedures that were used to ensure safety of participants. Although there were no significant differences between groups, young people were safely and generally well engaged in Reframe-IT and experienced decreases in suicidal ideation and other symptoms as well as improvements in CBT skills. The study is the first online intervention trial internationally to include young people demonstrating all levels of suicide risk. Integration of internet-delivered interventions for young people with suicide-related behaviour may result in reductions in these behaviours. Further research is needed, but researchers should feel more confident about being able to safely undertake research with young people who experience these behaviours. ACTRN12613000864729.
Publisher: MDPI AG
Date: 08-12-2021
Abstract: General Practitioners (GPs) play a crucial role in the identification and support of young people at risk of suicidal behaviour and self-harm however, no studies have explored GPs’ perspectives, approaches, challenges, and resource needs when working with this cohort in an Australian setting. This was a qualitative study where fifteen GPs (Mage = 45.25 years) from multiple clinics in Western Australia took part in semi-structured interviews, and data were analysed thematically. Seven main themes were identified: (1) working with young people has its unique challenges (2) screening and assessment tools can help to manage uncertainty and discomfort (3) going beyond tools–the dialogue and relationship are most important (4) there are limits to what we can offer in the time available (5) the service access and referral pathways lack clarity and coordination (6) the provision of mental health support should not fall on GPs alone and (7) more comprehensive training in suicide and self-harm is needed. The findings highlight a number of opportunities to enhance care and better assist GPs working with young people who present with suicidal behaviour and self-harm, including considerations for conducting assessments, targeted resources such as training, and system and service improvements.
Publisher: Springer Science and Business Media LLC
Date: 15-08-2017
Publisher: Cambridge University Press (CUP)
Date: 19-02-2007
DOI: 10.1017/S0033291707000104
Abstract: Background. Few controlled studies have investigated factors associated with suicide in current in-patients. We aimed to identify psychosocial, behavioural and clinical risk factors, including variations in care, for in-patient suicide. Method. We conducted a national population-based case-control study of people who died by suicide between 1 April 1999 and 31 December 2000 while in psychiatric in-patient care in England. Cases were 222 adult mental health in-patients who died by suicide matched on date of death with 222 living controls. Results. Nearly a quarter of suicides took place within the first week of admission most of these died on the ward or after absconding. After the first week, however, most suicides occurred away from the ward, the majority of patients having left the ward with staff agreement. Previous deliberate self-harm, recent adverse life events, symptoms of mental illness at last contact with staff and a co-morbid psychiatric disorder were associated with increased risk for suicide. Being off the ward without staff agreement was a particularly strong predictor. Those patients who were detained for compulsory treatment were less likely to die by suicide. Independent predictors of in-patient suicide were male sex, a primary diagnosis of affective disorder and a history of self-harm. Being unemployed or on long-term sick leave appeared to be independently protective. Conclusion. Prevention of in-patient suicide should emphasize adequate treatment of affective disorder, vigilance in the first week of admission and regular risk assessments during recovery and prior to granting leave. Use of compulsory treatment may reduce risk.
Publisher: Research Square Platform LLC
Date: 20-05-2021
DOI: 10.21203/RS.3.RS-518233/V1
Abstract: Background Suicide is the leading cause of death among young Australians, accounting for one-third of all deaths in those under 25. Schools are a logical setting for youth suicide prevention activities, with universal, selective and indicated approaches all demonstrating efficacy. Given that international best practice recommends suicide prevention programs combine these approaches, and that to date this has not been done in school settings, this study aims to evaluate a suicide prevention program incorporating universal, selective and indicated components in schools. Methods This study is a trial of a multimodal suicide prevention program for young people. The program involves delivering universal psychoeducation (safeTALK) to all students, screening them for suicide risk, and delivering internet-based Cognitive Behavioural Therapy (Reframe IT) to those students identified as being at high risk for suicide. The program will be trialled in secondary schools in Melbourne, Australia, and target year 10 students (15 and 16 year-olds). safeTALK and screening will be evaluated using a single group pre-test ost-test case series, and Reframe IT will be evaluated in a Randomised Controlled Trial. The primary outcome is change in suicidal ideation other outcomes include help-seeking behaviour and intentions, and suicide knowledge and stigma. The program’s cost-effectiveness will also be evaluated. Discussion This study is the first to evaluate a suicide prevention program comprising universal, selective and indicated components in Australian schools. If the program is found to be efficacious and cost-effective, it could be more widely disseminated in schools and may ultimately lead to reduced rates of suicide and suicidal behaviour in school students across the region.
Publisher: Paris Scholar Publishing
Date: 05-2016
DOI: 10.14485/HBPR.3.3.7
Publisher: Wiley
Date: 22-08-2014
DOI: 10.1111/EIP.12084
Abstract: Suicidal behaviours (suicide attempts and suicides) are common among in iduals experiencing, or having recently experienced, a first-episode psychosis (FEP). Current interventions for suicidal behaviours are crisis driven and focused on hospital admission of patients at imminent risk of ending their lives. This paper aims to describe ideas for universal, selective and indicated strategies that may complement existing practices to suicide risk management in first-episode patients. Key findings from the Suicidal Behaviours in FEP Project were used to develop suggested interventions. The project examined the temporal course of suicide risk, common characteristics of suicidal behaviours and predictors of suicidal behaviours in 699 patients with FEP. Key findings included: (i) 12% of FEP cohort engaged in suicidal behaviours during treatment (up to 3 years) (ii) first month of treatment conferred the highest suicide risk (iii) 64% of suicidal behaviours were overdoses, usually on antipsychotics (iv) 20% of suicidal behaviours occurred on psychiatric units and all involved hanging/strangulation (v) most suicidal behaviours were impulsive, precipitated by psychosocial stressors and with serious intent and (vi) proximal non-suicidal self-injurious behaviour and proximal negative life events were the strongest predictors. Comprehensive approach by mental health services to prevention of suicidal behaviours among first-episode patients could be facilitated by: delineating safe quantities of prescribed medications available to outpatients regular audits of fixtures on inpatient units enhancing risk recognition by family members routinely monitoring suicide risk levels developing crisis cards with all new FEP patients to facilitate help seeking during distress and skills training programs targeting distress tolerance, interpersonal effectiveness and problem-solving.
Publisher: MDPI AG
Date: 27-03-2019
Abstract: Given the increasing trend in suicide mortality and its burden on in iduals, families and communities, ethically sound research is crucial to improve the prevention of suicidal behaviour. However, few studies have looked at the experiences of researchers in obtaining ethics approval for their studies. This study addressed this gap by investigating researchers’ experiences in obtaining ethics approval and how they dealt with the concerns raised by ethics committees. Respondents were recruited from September to November 2018 through the Australian Suicide Prevention Research Leaders Network, and 33 respondents (35%) completed the study survey, comprising forced-choice and open-ended questions. Respondents most commonly reported concerns from ethics committees regarding potential harm to participants and researchers’ responsibilities to participants within the context of intervention and evaluation studies. Most researchers modified their ethics application and/or consulted with their ethics committee to reply to the concerns raised. Most respondents perceived the impact of the modification as positive or neutral. The study concludes that researchers may anticipate potential concerns of ethics committees. Improved understanding of how ethics committees work and dialogue between researchers and ethics committees should sustain the quality in suicide-related research.
Publisher: Wiley
Date: 26-03-2019
DOI: 10.1111/SLTB.12460
Abstract: We sought to compare clusters of suicidal events between two different time periods and examine the extent to which earlier clusters predict later clusters. We included data on suicides and suicide attempts from New South Wales between July 2001 and June 2012 and Western Australia between January 2000 and December 2011. Suicide attempts included admissions to hospital for deliberate self-harm and suicides were deaths due to deliberate self-harm. We combined data on suicides and suicide attempts and grouped them into two equal time periods. We detected clusters in each period using Poisson discrete scan statistics adjusted for socio-economic status. We estimated the predictive values of earlier clusters on later clusters. The results showed that clusters from earlier time period had a moderate power (36%) in predicting later clusters. During the later time period, some additional cluster areas (14%) were found and some earlier cluster areas subsided (64%). Historical clusters predict 36% of the subsequent clusters, which is probably not sufficient for targeting interventions. Our study highlights the need for other strategies to detect emerging clusters, for ex le, up-to-date data.
Publisher: Informa UK Limited
Date: 16-06-2016
DOI: 10.1080/10410236.2016.1140269
Abstract: Media c aigns have received increased attention as an intervention for combating suicide. Suicide prevention c aigns involving public service announcements (PSAs) have not been well described and have been subject to minimal evaluation. This study aimed to identify suicide prevention PSAs from around the world and analyze and describe their content. We searched the Internet for short, English-language PSAs that had been screened as part of suicide prevention c aigns and identified 35. Most commonly, these PSAs focused on the general population and/or people who might be at risk of suicide, and had a particular emphasis on young people. Almost 60% promoted open discussion about suicide, around 50% indicated that the life of a suicidal person was important, about 40% acknowledged the suffering associated with suicidal thoughts and feelings, about 25% stressed that suicide is preventable, and about 20% focused on the devastating impact of suicide for those left behind. Most PSAs promoted some sort of support for people at risk of suicide, usually a helpline or website. Although these messages appeared appropriate and practical there is a lack of research on the impact that they may have on people with varying degrees of suicide risk. Further work is needed to ensure that they are consistent with theories of behavior change, and that they are having their desired impacts.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2006
DOI: 10.1007/S00127-006-0087-6
Abstract: Suicide prevention is a health service priority. Homeless mental health patients present a challenge to services because of their complex health and social needs. To establish the numbers of homeless patients in contact with services who die by suicide to describe their suicide methods and their social and clinical characteristics including aspects of clinical care. A national clinical survey based on a 4-year (1996-2000) s le of people in England and Wales who died by suicide. Detailed data were collected on those who had been in contact with mental health services in the year before death. A total of 131 in iduals who died by suicide were reported to have been homeless at the time of death--3% of all suicides by psychiatric patients, over 30 per year. Hanging was the most common cause of death. The most frequent diagnosis was schizophrenia. Around half were in-patients at the time of death. Social and clinical risk factors for suicide were common, including drug and alcohol misuse, and recent suicidal ideas and behaviour. Despite this, their clinical care was characterised by disengagement from services as a result of missed contacts, self-discharge, lack of follow-up and lack of key worker. In order to reduce the number of deaths by suicide in those who are homeless and mentally ill, improvements in in-patient safety and engagement in the community are needed. This may be achieved through assertive community treatment, dual diagnosis services, and dedicated community mental health teams.
Publisher: MDPI AG
Date: 19-01-2022
Abstract: Young people may be particularly vulnerable to the mental health impacts of the COVID-19 pandemic and may also be more likely to use social media at this time. This study aimed to explore young people’s mental health and social media use during the COVID-19 pandemic and examined their use of social media to seek and provide support for suicidal thoughts and self-harm during this period. Young people aged 16–25 (n = 371, M = 21.1) from the general population in Australia completed an anonymous, cross-sectional online survey advertised on social media from June to October 2020. Participants reported high levels of psychological distress, with over 40% reporting severe levels of anxiety and depression, and those with a mental health diagnosis were more likely to perceive the pandemic to have had a negative impact on their mental health. Gender- erse participants appeared the most negatively impacted. Social media use was high, with 96% reporting use at least once a day, and two-thirds reporting an increase in social media use since the start of the pandemic. One-third had used social media to seek support for suicidal thoughts or self-harm, and half had used it to support another person. This study adds to a growing literature suggesting social media can provide an opportunity to support young people experiencing psychological distress and suicide risk. Uniquely, this study points to the utility of using social media for this purpose during high-risk periods such as pandemics, where access to face-to-face support may be limited. To promote the quality and safety of support provided on social media, resources for help-seekers and help-givers should be developed and disseminated. Social media companies must consider the vulnerability of some users during pandemics and do what they can to promote wellbeing and safety.
Publisher: JMIR Publications Inc.
Date: 05-04-2021
DOI: 10.2196/24260
Abstract: Web-based interventions are a promising approach to support youth at risk of suicide, and those incorporating peer-to-peer social networking may have the added potential to target interpersonal states of perceived burdensomeness and thwarted belongingness. Owing to feasibility and safety concerns, including fear of contagion, this had not been tested until recently. In 2018, we conducted a pilot evaluation to test the feasibility, safety, and acceptability of a Moderated Online Social Therapy intervention, called Affinity, with a s le of young people with active suicidal ideation. The aim of this study is to report qualitative data collected from study participants regarding their experience of the web-based social network and the consequent safety features. Affinity is a closed website incorporating 3 key components: therapeutic content delivered via comics, peer-to-peer social networking, and moderation by peers and clinicians. Semistructured interviews were conducted with 17 young people who participated in the pilot study after 8 weeks of exposure to the intervention. Interview data from 2 young people who did not use Affinity were excluded from the analysis. The interviews were analyzed using thematic analysis, with the frequency of responses characterized using the consensual qualitative research method. The results are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. A total of 4 overarching themes were identified: a safe and supportive environment, the importance of mutual experiences, difficulty engaging and connecting, and the pros and cons of banning discussions about suicide. Interestingly, although Affinity was perceived to be safe and free of judgment, concerns about negative evaluation and triggering others were significant barriers to posting on the social network. Participants generally supported the banning of conversations about suicide, although for some this was perceived to reinforce stigma or was associated with frustration and distress. The results not only support the safety and potential therapeutic benefit of the social networking aspect of Affinity but also highlight several implementation challenges. There is a need to carefully balance the need for stringent safety and design features while ensuring that the potential for therapeutic benefit is maximized.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2006
DOI: 10.1097/00131746-200605000-00002
Abstract: A reduction in suicide among in iduals with mental illness is an international public-health priority. Approximately 10% of patients with schizophrenia will die by suicide. The goal of this study was to describe social and clinical characteristics of people with schizophrenia who completed suicide, including aspects of the clinical care they received. A national clinical survey was conducted based on a 4-year (1996-2000) s le of people in England and Wales who had died by suicide and had been in contact with mental health services in the previous 12 months. Of 20,927 in iduals who committed suicide, 5,099 (24%) were known to have been in contact with mental health services in the year prior to death. Completed questionnaires were returned on 4,859 cases of suicide. Of these, 960 (20%) were diagnosed with schizophrenia. These suicides were characterized by more violent modes of death, with over a quarter (27%) jumping from a height or in front of a moving vehicle compared to 10% of the remaining s le. They were more likely than the other in iduals in the s le to be young, male, unmarried, and from an ethnic minority with high rates of unemployment. Rates of previous violence and drug abuse were high and they were proportionally more likely to be inpatients at the time of death and to have been noncompliant with medication. Patients with schizophrenia and comorbid substance abuse showed particularly complex social and clinical morbidity. Measures that may prevent suicide among patients with schizophrenia include improved ward safety, closer supervision in both inpatient and community settings, particularly for those with poor medication compliance, and effective treatment of substance abuse.
Publisher: SAGE Publications
Date: 2011
DOI: 10.3109/00048674.2010.511147
Abstract: Objective: Risk of suicide attempt, suicidal ideation and deliberate self-harm is high among young people, yet limited evidence exists regarding effective interventions, particularly from randomized controlled trials. The aim of this study was to conduct a systematic review and meta-analysis of all randomized controlled trials testing interventions for adolescents and young adults who have presented to a clinical setting with any of these behaviours. Methods: The Cochrane Central Register of Controlled Trials, Medline, EMBASE and PsycINFO were searched for articles published from 1980 to June 2010. The following keywords formed the basis of the search strategy: ‘self-injurious behaviour’, ‘attempted suicide’, ‘suicide’, ‘suicidal behaviour’, ‘self-inflicted wounds’, ‘self-mutilation’, ‘self-harm’. We also hand searched conference abstracts from two major suicide prevention conferences and the reference lists of all retrieved articles and previous reviews. Results: There were 15 trials included in the review, with six ongoing trials also identified. In general, the reporting of the conduct of trials was poor, making it difficult to assess the risk of bias. The reporting of outcome data was inconsistent. No differences were found between treatment and control groups except in one study that found a difference between in idual cognitive behavioural therapy and treatment as usual. Conclusion: The evidence regarding effective interventions for adolescents and young adults with suicide attempt, deliberate self-harm or suicidal ideation is extremely limited. Many more methodologically rigorous trials are required. However, in the meantime CBT shows some promise, but further investigation is required in order to determine its ability to reduce suicide risk among young people presenting to clinical services.
Publisher: Hogrefe Publishing Group
Date: 07-2008
DOI: 10.1027/0227-5910.29.4.180
Abstract: This project sought to inform priority setting in Australian suicide prevention research, by empirically examining existing priorities and by seeking stakeholders views on where future priorities might lie. Existing priorities were examined via reviews of Australian literature published and grants funded during the life of the National Suicide Prevention Strategy (1999–2006). Stakeholders views of future priorities were elicited via a questionnaire administered to 11 groups comprising 231 in iduals with an interest in suicide prevention. The study identified 263 journal articles and 36 grants. The journal articles most commonly reported on studies of descriptive epidemiology, while the grants tended to fund intervention studies. Both gave roughly equal weight to completed and attempted suicide, and gave little emphasis to studies of suicide methods. Young people were the most frequently-researched target group, with people with mental health problems and people who had attempted suicide or deliberately self-harmed also receiving attention. Stakeholders indicated that emphasis should be given to intervention studies, and that completed suicide and attempted suicide are both important. In terms of suicide method, they felt the focus should be on poisoning by drugs and hanging. They had mixed views about the target groups that should be afforded priority, although young people and people with mental health problems were frequently ranked highly. This paper presents a picture of the current focus with regard to suicide prevention research, identifying some areas where there are clear gaps and others where relatively greater efforts have been made. By combining this information with stakeholders views of where future priorities should lie, the paper provides some guidance as to the shape a future suicide prevention research agenda for Australia should take. A strategic approach to suicide prevention research will help fill internationally-identified gaps in knowledge about what works and what doesnt work in suicide prevention.
Publisher: Springer Science and Business Media LLC
Date: 09-03-2013
Abstract: ‘Suicide hotspots’ include tall structures (for ex le, bridges and cliffs), railway tracks, and isolated locations (for ex le, rural car parks) which offer direct means for suicide or seclusion that prevents intervention. We searched Medline for studies that could inform the following question: ‘ What interventions are available to reduce suicides at hotspots, and are they effective?’ There are four main approaches: (a) restricting access to means (through installation of physical barriers) (b) encouraging help-seeking (by placement of signs and telephones) (c) increasing the likelihood of intervention by a third party (through surveillance and staff training) and (d) encouraging responsible media reporting of suicide (through guidelines for journalists). There is relatively strong evidence that reducing access to means can avert suicides at hotspots without substitution effects. The evidence is weaker for the other approaches, although they show promise. More well-designed intervention studies are needed to strengthen this evidence base.
Publisher: SAGE Publications
Date: 26-02-2018
Abstract: Improving the care that patients receive after a suicide attempt will reduce the risk of a subsequent suicide attempt. We described how care for these patients can be improved and identified the available guidelines. We reviewed the literature on crisis and aftercare, psychosocial assessment, risk assessment, brief contact interventions, and brief interventions. People who have made a suicide attempt are at increased risk of suicide, and the period immediately after discharge from hospital is particularly risky. Patients require an empathic response at their first point of contact, comprehensive psychosocial assessment, effective discharge planning, rapid and assertive follow-up, and coordinated care in the subsequent months. Empathic and effective care that begins in the emergency department and extends through to community care is imperative. Enough is known about the risks of inadequate care and the key ingredients of effective care to proceed with changes to Australia’s healthcare response to a suicide attempt.
Publisher: JMIR Publications Inc.
Date: 04-10-2017
DOI: 10.2196/MENTAL.7847
Abstract: Social media is increasingly being used by young people for health-related issues, including communicating about suicide. Due to the concerns about causing distress or inducing suicidal thoughts or behaviors, to date young people neither have been engaged in the development of social media–based suicide prevention interventions nor have interventions focused on educating young people about safe ways to communicate about suicide online. Given the potential that social media holds to deliver messages to vast numbers of people across space and time and the fact that young people often prefer to seek help from their friends and peers, safely educating and engaging young people to develop suicide prevention messages that can be delivered via social media is an obvious next step. The objectives of this study were to (1) provide education to a small number of secondary school students about safe ways to communicate about suicide via social media (2) engage the same young people in the development of a suite of social media–based suicide prevention multimedia messages (3) assess the impact of this on participants and (4) assess the acceptability and safety of the messages developed. This study involved two phases. In phase 1, 20 participants recruited from two schools took part in an 8- to 10-week program during which they were provided with psychoeducation about mental health and suicide, including how to talk safely about suicide online, and they were then supported to design and develop their own media messages. These participants completed an evaluation questionnaire at the conclusion of the program. In phase 2, a larger group of participants (n=69), recruited via an opt-in process, viewed the media messages and completed a short questionnaire about each one. Participants in phase 1 enjoyed the program and reported that they learned new skills, such as how to talk safely about suicide online, and felt more able to provide emotional support to others (16/20, 80%). No participants reported that the program made them feel suicidal. Participants in phase 2 generally rated the media messages as safe and acceptable, although some messages were rated more highly than others. This study suggests that young people can be safely engaged in developing suicide prevention messages, which can be disseminated via social media. Engaging young people in this process may improve the traction that such c aigns will have with other young people. The study also suggests that educating young people regarding how to talk safely about suicide online has multiple benefits and is not associated with distress. Overall, these findings pave the way for new approaches to prevent suicide among young people.
Publisher: Springer Science and Business Media LLC
Date: 02-11-2023
Publisher: SAGE Publications
Date: 15-03-2018
Abstract: Youth suicide rates are unacceptably high. Schools have long been accepted as an appropriate setting for suicide prevention activities. This review aims to synthesise the evidence for all types of suicide prevention interventions across educational settings. The review draws on two previous reviews conducted by the authors. In order to be included, studies had to test a specific suicide prevention intervention in an educational setting, have a suicide-related outcome and target young people. A totally of 21 studies were included: 17 were conducted in school settings and four in universities. Seven of the school-based studies (41%) and one of the university studies (25%) were randomised controlled trials. Overall, the trials conducted in schools reported positive effects, as did four of the non- randomised controlled trials. Two of the university-based studies reported positive effects. Both universal and indicated interventions showed positive results no iatrogenic effects were reported. School-based studies can have a positive impact on suicide-related behaviour and, overall, do not appear to cause harm. Study quality is variable, and the number of studies conducted in school settings far exceed those conducted in universities. These gaps need to be addressed by future research.
Publisher: Springer Science and Business Media LLC
Date: 23-09-2009
Publisher: Springer Science and Business Media LLC
Date: 30-01-2019
Publisher: Wiley
Date: 19-01-2012
DOI: 10.1111/J.1751-7893.2011.00334.X
Abstract: Suicide attempt, ideation and deliberate self-harm are common among adolescents. Limited evidence exists regarding interventions that can reduce risk however, research indicates that maintaining contact with at-risk adults following discharge from services via letter or postcard can reduce risk. The aim of the study was to test a postcard intervention among people aged 15-24 who presented to mental health services but were not accepted, yet were at risk of suicide. A randomized controlled trial of 3 years in duration was used. The intervention consisted of 12 postcards sent once a month for 12 months following presentation to the service. Key outcomes of interest were reduced rates of suicide attempt, suicidal ideation and deliberate self-harm, assessed at 12 and 18 months. Participants reported that they liked receiving the postcard and that they used the strategies recommended. However, no significant effect of the postcard intervention was found on suicide risk, although participants in both groups improved on measures of mental health over the course of the study. There remains a need for further research into youth-friendly interventions for young people at risk of suicide.
Publisher: Wiley
Date: 21-09-2021
DOI: 10.1002/AUR.2614
Abstract: The COVID‐19 pandemic has had a significant impact on the mental health and wellbeing of the world's population, with particularly negative effects on vulnerable populations, including autistic people. Although some consensus regarding specific impact on aspects of wellbeing and mental health in autism is starting to emerge, it is unclear whether the pandemic has increased suicide risk. The goals of this study were to examine (a) potential associations between COVID‐19 impact and depression, personal wellbeing, and suicide risk factors in Australian autistic adults and (b) age and gender effects. The COVID‐19 Impact Scale (CIS), Personal Wellbeing Index, Patient Health Questionnaire, and the Suicide Behavior Questionnaire, Revised (SBQ‐R), were administered to 111 autistic adults aged 20 to 71 years during the second wave of the COVID‐19 pandemic in Australia. COVID‐19 impact showed small associations with poorer personal wellbeing ( r = −0.224, p = 0.023, [−0.409, −0.016]) and higher depressive symptoms ( r = 0.268, p = 0.006, [0.056, 0.445]) and was not associated with the SBQ‐R suicide risk score ( r = 0.081, p = 0.418, [−0.118, 0.264). No significant effects were identified for age. Although model results were similar for women and men, the strength of the associations between personal wellbeing and depression ( z = −2.16, p = 0.015), and depression and SBQ‐R suicide risk ( z = 1.961, p = 0.025), were stronger in women than in men. Qualitative analysis of an open response question from the CIS suggested that the pandemic had both positive and negative impacts on participants. The COVID‐19 pandemic has had a large impact on the mental health and wellbeing of the world's population, particularly vulnerable populations such as autistic people. It is not known if these impacts on mental health and wellbeing have increased suicide risk. Our findings suggest that the impact of the COVID‐19 pandemic may be associated with poorer wellbeing and higher depression, but is not associated with suicide risk. Overall, autistic people reported both positive and negative impacts of the pandemic on their lives.
Publisher: Wiley
Date: 15-09-2020
DOI: 10.1111/EIP.13044
Abstract: Young people use social media to communicate about suicide, however, they often feel ill‐equipped to share their own experiences or to respond to expressions of risk by others. To describe the adaptation of the Australian #chatsafe guidelines for an international audience, and their initial roll out via social media. An online survey (n = 48) and two workshops (n = 47) conducted between August and December 2019. Thirty‐eight countries were represented. Minimal adaptation of the Australian guidelines was required however, an abbreviated version and a suite of social media assets were developed. In the 6 weeks following publication the international guidelines were downloaded ~4100 times and the social media content reached over one million young people. The fact that the guidelines and c aign content appear to have had such success speaks to the need for young people to feel better equipped to communicate safely about suicide online.
Publisher: Cambridge University Press (CUP)
Date: 07-08-2014
DOI: 10.1017/S1754470X14000129
Abstract: Problem-solving and coping skills deficits have been shown in adolescents who experience suicide-related behaviours, including suicidal ideation. Little evidence exists about effective interventions for this population. We undertook a pilot study of an Internet-based CBT programme that included problem-solving skills training to investigate its impact on skills deficits. The study employed a pre-test ost-test design. Outcomes of interest were negative problem orientation, emotion- and task-focused coping, and adolescents’ perception of helpfulness of the intervention. Participants, recruited via the school wellbeing team, were assessed at baseline, at weekly intervention sessions and immediately post-intervention. Twenty-one adolescents completed the intervention. Over the course of the intervention, negative problem-solving orientation improved and students relied less on emotion-focused coping strategies. Because there was no control group, we cannot be certain that the changes seen between baseline and post-intervention can be attributed to the intervention. Adolescents rated the problem-solving and cognitive restructuring modules as particularly helpful. Interventions that include enhancement of problem-solving skills, as well as cognitive restructuring to address adolescents’ appraisal of problems and their ability to solve them appear promising for adolescents with suicidal ideation. Further investigation is warranted.
Publisher: Elsevier BV
Date: 04-2019
Publisher: Hogrefe Publishing Group
Date: 05-2017
DOI: 10.1027/0227-5910/A000422
Abstract: Abstract. Background: Routine monitoring of depression symptoms and suicide risk is essential for appropriate treatment planning and risk management, but not well implemented by clinicians. We developed a brief online monitoring tool to address this issue. Aims: To investigate whether the online tool can feasibly improve monitoring whether it is acceptable and useful for young people and their clinicians and to determine whether a shorter tool could be implemented. Method: In a naturalistic longitudinal cohort study, 101 young people with depression completed the online tool on a tablet, prior to their consultation. Their results were immediately available to their clinician. Clients and clinicians answered questionnaires about acceptability and usefulness. Results: The tool was feasible to implement. Young people and clinicians found the tool acceptable and useful for understanding symptoms and risk. A brief three-item suicidal ideation screening measure correlated well with a validated measure of suicidal ideation. Conclusion: The online tool facilitates the quick exchange of key information about suicide risk, allowing clinicians to immediately address this. This level of responsiveness is likely to improve treatment outcomes. The brief version allows full integration into clinical practice to support clinicians managing those at risk of suicide.
Publisher: AOTA Press
Date: 09-2021
Abstract: Importance: For a person with mild cognitive impairment (MCI) or early-stage dementia, driving is important for independence. However, driving presents safety concerns for both the person and family members. It is important to determine whether occupational therapy interventions can prolong safe driving for this population. Objective: To determine the effectiveness of occupational therapy interventions to improve driving performance in older people with MCI or early-stage dementia. Data Sources: We conducted a search of MEDLINE, PsycINFO, CINAHL, and gray literature using Google Scholar. Study Selection and Data Collection: Studies were included if they evaluated interventions that (1) aimed to improve the driving performance of older people (M age ≥60 yr) with MCI or early-stage dementia and (2) could be designed or delivered by an occupational therapy practitioner who specializes in driving. Citations were reviewed independently by two authors, and quality appraisal was conducted using the Cochrane risk-of-bias guidelines. Findings: One Level I randomized controlled trial (RCT) and 4 Level III quasi-experimental studies were included these studies had 231 participants in total with reported M ages of 65.6–72.5 yr. One study evaluated a compensatory approach, whereas the others evaluated a remedial approach. The studies used different measures to assess outcomes and reported mixed effects. Conclusions and Relevance: Low strength of evidence suggests that occupational therapy interventions may improve the driving performance of older people with MCI or early-stage dementia. More RCTs are needed that include long-term follow-up measures and address clinically important outcomes. What This Article Adds: In the absence of conclusive evidence from research studies and best practice guidelines, occupational therapy practitioners must rely on their clinical experience and their clients’ abilities. Development of evidence and guidelines in this area is critical. It is also important for practitioners to work closely with clients, families, and interdisciplinary team members to carefully monitor fitness to drive.
Publisher: Hogrefe Publishing Group
Date: 07-2012
DOI: 10.1027/0227-5910/A000144
Abstract: Background: Suicide clusters have commonly been documented in adolescents and young people. Aims: The current review conducts a literature search in order to identify and evaluate postvention strategies that have been employed in response to suicide clusters in young people. Methods: Online databases, gray literature, and Google were searched for relevant articles relating to postvention interventions following a suicide cluster in young people. Results: Few studies have formally documented response strategies to a suicide cluster in young people, and at present only one has been longitudinally evaluated. However, a number of strategies show promise, including: developing a community response plan educational sychological debriefings providing both in idual and group counseling to affected peers screening high risk in iduals responsible media reporting of suicide clusters and promotion of health recovery within the community to prevent further suicides. Conclusions: There is a gap in formal evidence-based guidelines detailing appropriate postvention response strategies to suicide clusters in young people. The low-frequency nature of suicide clusters means that long-term systematic evaluation of response strategies is problematic. However, some broader suicide prevention strategies could help to inform future suicide cluster postvention responses.
Publisher: Royal College of Psychiatrists
Date: 02-2006
Abstract: Suicide prevention is a health service priority but the most effective approaches to prevention may differ between different patient groups. To describe social and clinical characteristics in cases of suicide from different age and diagnostic groups. A national clinical survey of a 4-year (1996–2000) s le of cases of suicide in England and Wales where there had been recent ( 1 year) contact with mental health services ( n =4859). Deaths of young patients were characterised by jumping from a height or in front of a vehicle, schizophrenia, personality disorder, unemployment and substance misuse. In older patients, drowning, depression, living alone, physical illness, recent bereavement and suicide pacts were more common. People with schizophrenia were often in-patients and died by violent means. About athird of people with depressive disorder died within a year of illness onset. Those with substance dependence or personality disorder had high rates of disengagement from services. Prevention measures likely to benefit young people include targeting schizophrenia, dual diagnosis and loss of service contact those aimed at depression, isolation and physical ill-health should have more effect on elderly people.
Publisher: Wiley
Date: 19-02-2015
DOI: 10.1111/EIP.12229
Abstract: Social media platforms are commonly used for the expression of suicidal thoughts and feelings, particularly by young people. Despite this, little is known about the ways in which social media can be used for suicide prevention. The aim of this study was to conduct a systematic review to identify current evidence pertaining to the ways in which social media are currently used as a tool for suicide prevention. Medline, PsycInfo, Embase, CINHAL and the Cochrane Library were searched for articles published between 1991 and April 2014. English language articles with a focus on suicide-related behaviour and social media were included. No exclusion was placed on study design. Thirty studies were included 4 described the development of social media sites designed for suicide prevention, 6 examined the potential of social media in terms of its ability to reach or identify people at risk of suicide, 15 examined the ways in which people used social media for suicide prevention-related purposes, and 5 examined the experiences of people who had used social media sites for suicide prevention purposes. No intervention studies were identified. Social media platforms can reach large numbers of otherwise hard-to-engage in iduals, may allow others to intervene following an expression of suicidal ideation online, and provide an anonymous, accessible and non-judgmental forum for sharing experiences. Challenges include difficulties controlling user behaviour and accurately assessing risk, issues relating to privacy and confidentiality and the possibility of contagion. Social media appears to hold significant potential for suicide prevention however, additional research into its safety and efficacy is required.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JAD.2016.12.035
Abstract: The aim of this review was to assess whether suicide prevention provided in the primary health care setting and delivered by GPs results in fewer suicide deaths, episodes of self-harm, attempts and lower frequency of thoughts about suicide. We conducted a systematic review and meta-analysis using PRIMSA guidelines. Eligible studies: 1) evaluated an intervention provided by GPs 2) assessed suicide, self-harm, attempted suicide or suicide ideation as outcomes, and 3) used a quasi-experimental observational or trial design. Study specific effect sizes were combined using the random effects meta-analysis, with effects transformed into relative risk (RR). We extracted data from 14 studies for quantitative meta-analysis. The RR for suicide death in quasi-experimental observational studies comparing an intervention region against another region acting as a "control" was 1.26 (95% CI 0.58, 2.74). When suicide in the intervention region was compared before and after the GP program, the RR was 0.78 (95% CI 0.62, 0.97). There was no evidence of a treatment effect for GP training on rates of suicide death in one cRCT (RR 1.07, 95% CI 0.79, 1.45). There was no evidence of effect for the most other outcomes studied. All of the studies included in this review are likely to have a high level of bias. It is also possible that we excluded or missed relevant studies in our review process CONCLUSIONS: Interventions have produced equivocal results, which varied by study design and outcome. Given these results, we cannot recommend the roll out of GP suicide prevention initiatives.
Publisher: Wiley
Date: 20-05-2019
DOI: 10.1111/CAMH.12335
Publisher: MDPI AG
Date: 20-04-2018
Publisher: Springer Science and Business Media LLC
Date: 22-11-2016
Publisher: SAGE Publications
Date: 10-07-2019
Abstract: Researchers and research ethics committees share a common goal of conducting ethically sound research. However, little is known of researchers’ experiences in obtaining ethics approval for suicide-related studies. This study aimed to investigate what concerns researchers have received on suicide-related ethics applications and how they dealt with it. Thirty-four respondents, recruited through the International Association for Suicide Prevention, filled out an online survey. The study found that researchers have received important concerns regarding potential harm and researchers’ responsibilities to participants. Researchers modified their application and/or consulted their research ethics committee in response to the concerns, which had a positive/neutral impact on their given study. Anticipating concerns and improved collaboration between researchers and research ethics committees should protect the quality of suicide prevention research.
Publisher: JMIR Publications Inc.
Date: 17-12-2019
Abstract: oung people commonly use social media platforms to communicate about suicide. Although research indicates that this communication may be helpful, the potential for harm still exists. To facilitate safe communication about suicide on social media, we developed the #chatsafe guidelines, which we sought to implement via a national social media c aign in Australia. Population-wide suicide prevention c aigns have been shown to improve knowledge, awareness, and attitudes toward suicide. However, suicide prevention c aigns will be ineffective if they do not reach and resonate with their target audience. Co-designing suicide prevention c aigns with young people can increase the engagement and usefulness of these youth interventions. his study aimed to document key elements of the co-design process to evaluate young people’s experiences of the co-design process and to capture young people’s recommendations for the #chatsafe suicide prevention social media c aign. n total, 11 co-design workshops were conducted, with a total of 134 young people aged between 17 and 25 years. The workshops employed commonly used co-design strategies however, modifications were made to create a safe and comfortable environment, given the population and complexity and sensitivity of the subject matter. Young people’s experiences of the workshops were evaluated through a short survey at the end of each workshop. Recommendations for the c aign strategy were captured through a thematic analysis of the postworkshop discussions with facilitators. he majority of young people reported that the workshops were both safe (116/131, 88.5%) and enjoyable (126/131, 96.2%). They reported feeling better equipped to communicate safely about suicide on the web and feeling better able to identify and support others who may be at risk of suicide. Key recommendations for the c aign strategy were that young people wanted to see bite-sized sections of the guidelines come to life via shareable content such as short videos, animations, photographs, and images. They wanted to feel visible in c aign materials and wanted all materials to be fully inclusive and linked to resources and support services. his is the first study internationally to co-design a suicide prevention social media c aign in partnership with young people. The study demonstrates that it is feasible to safely engage young people in co-designing a suicide prevention intervention and that this process produces recommendations, which can usefully inform suicide prevention c aigns aimed at youth. The fact that young people felt better able to safely communicate about suicide on the web as a result of participation in the study augurs well for youth engagement with the national c aign, which was rolled out across Australia. If effective, the c aign has the potential to better prepare many young people to communicate safely about suicide on the web.
Publisher: Informa UK Limited
Date: 26-07-2019
Publisher: Springer Science and Business Media LLC
Date: 15-09-2008
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-1997
DOI: 10.1097/00005650-199709000-00006
Abstract: A cardiovascular health survey of a representative s le of the adult population of Manitoba, Canada was combined with the provincial health insurance claims database to determine the accuracy of survey questions in detecting cases of diabetes, hypertension, ischemic heart disease, stroke, and hypercholesterolemia. Of 2,792 subjects in the survey, 97.7% were linked successfully using a scrambled personal health insurance number. Hospital and physician claims were extracted for these in iduals for the 3-year period before the survey. The authors found no benefits to using restrictive criteria for entrance into the study (ie, requiring more than one diagnosis to define a case). Using additional years of data increased agreement between data sources. Kappa values indicated high levels of agreement between administrative data and self-reports for diabetes (0.72) and hypertension (0.59) kappa values were approximately 0.4 for the other conditions. Using administrative data as the "gold standard," specificity was generally very high, although cases with hypertension and hypercholesterolemia (diagnosed primarily by laboratory or physical measurement) were associated with a lower specificity than the other conditions. Sensitivity varied markedly and was lowest for "other heart disease" and "stroke". For diabetes and hypertension, inclusion criteria calling for more than one diagnosis reduced the accuracy of case identification, whereas increasing the number of years of data increased accuracy of identification. For diabetes and hypertension, self-reports were fairly accurate in detecting "true" past history of the illness based on physician diagnosis recorded on insurance claims. This study demonstrates the feasibility of linking a large health survey with administrative data and the validity of self-reports in estimating the prevalence of chronic diseases, especially diabetes and hypertension. A linked data set offers unusual opportunities for epidemiologic and health services research in a defined population.
Publisher: Elsevier BV
Date: 10-2018
Publisher: Royal College of Psychiatrists
Date: 02-2006
Abstract: Previous studies of people convicted of homicide have used different definitions of mental disorder. To estimate the rate of mental disorder in people convicted of homicide to examine the relationship between definitions, verdict and outcome in court. A national clinical survey of people convicted of homicide ( n =1594) in England and Wales (1996–1999). Rates of mental disorder were estimated based on: lifetime diagnosis, mental illness at the time of the offence, contact with psychiatric services, diminished responsibility verdict and hospital disposal. Of the 1594, 545 (34%) had a mental disorder: most had not attended psychiatric services 85 (5%) had schizophrenia (lifetime) 164 (10%) had symptoms of mental illness at the time of the offence 149 (9%) received a diminished responsibility verdict and 111 (7%) a hospital disposal – both were associated with severe mental illness and symptoms of psychosis. The findings suggest an association between schizophrenia and conviction for homicide. Most perpetrators with a history of mental disorder were not acutely ill or under mental healthcare at the time of the offence. Some perpetrators receive prison sentences despite having severe mental illness.
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.PSYCHRES.2010.03.013
Abstract: In iduals with first episode psychosis (FEP) experience high rates of premature mortality, in particular due to suicide. The study aims were to: a) Estimate the rate of sudden death among young people with FEP during an 8-10 year period following commencement of treatment b) Examine and describe the socio-demographic and clinical characteristics associated with sudden death and c) Examine the timing of death in relation to psychiatric treatment.This was a cohort study. The s le comprised 661 patients accepted into treatment at the Early Psychosis Prevention and Intervention Centre between 1/1/1998 and 31/12/2000. Demographic and clinical data were collected by examination of the medical files. Mortality data were collected via a search of the National Coroners Information System the Victorian State Coroner's office and clinical files. Nineteen patients died and just over two thirds of deaths were classified as intentional self-harm or suicide. Death was associated with male gender, previous suicide attempt and greater symptom severity at last contact. People with FEP are at increased risk of premature death, in particular suicide. A previous suicide attempt was very common amongst those who died, suggesting that future research could focus upon the development of interventions for young people with FEP who engage in suicidal behaviour.
Publisher: MDPI AG
Date: 03-04-2020
Abstract: Online social networking interventions have potential to support young people who experience suicidal thoughts by specifically addressing interpersonal risk factors for suicide, but may also pose a risk of harm. This uncontrolled, single-group pilot study aimed to evaluate the safety, feasibility, and acceptability of an enhanced online social networking intervention (“Affinity”) among a s le of young people who experienced active suicidal ideation, and to explore potential changes in clinical outcomes and the therapeutic targets of the intervention. Twenty young people with current or recent suicidal ideation who were receiving treatment for depression at a tertiary-level mental health service were given access to Affinity for two months. Participants were assessed at baseline and 8-week follow-up 90 percent reported clinical suicidal ideation at baseline. A priori criteria related to feasibility, safety and acceptability were satisfied. In terms of potential clinical effects, significant and reliable pre-post improvements were found on self-report outcomes including suicidal ideation. This study provides initial world-first evidence to support the use of an online intervention incorporating social networking as an adjunct to treatment for young people who experience suicidal ideation. The effectiveness of Affinity needs to be evaluated in a randomised controlled trial.
Publisher: International Journal of Wellbeing
Date: 08-06-2017
DOI: 10.5502/IJW.V7I1.484
Publisher: Oxford University Press (OUP)
Date: 15-03-2013
DOI: 10.1093/IJE/DYT021
Abstract: Certain sites have gained notoriety as 'hotspots' for suicide by jumping. Structural interventions (e.g. barriers and safety nets) have been installed at some of these sites. In idual studies examining the effectiveness of these interventions have been underpowered. We conducted a meta-analysis, pooling data from nine studies. Following the interventions, there was an 86% reduction in jumping suicides per year at the sites in question (95% CI 79% to 91%). There was a 44% increase in jumping suicides per year at nearby sites (95% CI 15% to 81%), but the net gain was a 28% reduction in all jumping suicides per year in the study cities (95% CI 13% to 40%). Structural interventions at 'hotspots' avert suicide at these sites. Some increases in suicide are evident at neighbouring sites, but there is an overall gain in terms of a reduction in all suicides by jumping.
Publisher: Informa UK Limited
Date: 30-11-2019
DOI: 10.1080/10410236.2017.1405484
Abstract: Suicide prevention media c aigns are gaining traction as a means of combatting suicide. The current review set out to synthesize information about the effectiveness of these c aigns. We searched four electronic databases for studies that provided evidence on the effectiveness of media c aigns. We focused on studies that described an evaluation of the effectiveness of an entire c aign or a public service announcement explicitly aimed at suicide prevention. We identified 20 studies of varying quality. Studies that looked at whether c aign exposure leads to improved knowledge and awareness of suicide found support for this. Most studies that considered whether c aign materials can achieve improvements in attitudes toward suicide also found this to be the case, although there were some exceptions. Some studies found that media c aigns could boost help-seeking, whereas others suggested that they made no difference or only had an impact when particular sources of help or particular types of help-seeking were considered. Relatively few studies had sufficient statistical power to examine whether media c aigns had an impact on the ultimate behavioral outcome of suicides, but those that did demonstrated significant reductions. Our review indicates that media c aigns should be considered in the suite of interventions that might be used to prevent suicide. Evidence for their effectiveness is still amassing, but there are strong suggestions that they can achieve positive results in terms of certain suicide-related outcomes. Care should be taken to ensure that c aign developers get the messaging of c aigns right, and further work is needed to determine which messages work and which ones do not, and how effective messages should be disseminated. There is an onus on those developing and delivering c aigns to evaluate them carefully and to share the findings with others. There is a need for evaluations that employ rigorous designs assessing the most pertinent outcomes. These evaluations should explore the nature of given c aigns in detail - in particular the messaging contained within them - in order to tease out which messages work well and which do not. They should also take into account the reach of the c aign, in order to determine whether it would be reasonable to expect that they might have their desired effect.
Publisher: American Psychiatric Association Publishing
Date: 11-2006
DOI: 10.1176/PS.2006.57.11.1648
Abstract: Few studies have described rates of schizophrenia in a national s le of homicide perpetrators. This study aimed to describe this group's social and clinical characteristics, mental state features, offense details, and outcome in court. Analyses used a national clinical survey that collected data on people convicted of homicide in England and Wales (1996-1999). Data were collected for those with schizophrenia or other delusional disorders from psychiatric reports and questionnaires. Of the 1,594 people convicted of homicide, 85 (5 percent) had schizophrenia. Of the 57 people with schizophrenia for whom data were available, 32 (56 percent) had been ill for less than 12 months, and in the month before the offense, 32 (56 percent) had shown a change in the quality, intensity, or conviction of or emotional response to their delusional beliefs. Twenty-four (28 percent) had no previous contact with psychiatric services. Regular assessment of delusions may help to detect an increased risk of violence, including homicide. More intensive care should be available for patients with a history of schizophrenia and previous violence.
Publisher: Elsevier BV
Date: 2020
Publisher: Elsevier BV
Date: 2016
Publisher: SAGE Publications
Date: 10-2011
DOI: 10.3109/00048674.2011.595687
Abstract: Objectives: Understanding the characteristics of suicide attempts in people undergoing treatment for first episode psychosis (FEP) may have implications for risk management at a service level and local suicide prevention strategies. Although studies have focused on identifying in idual-level risk factors for suicide attempts in this patient group, none have yet conducted an in-depth profile of suicide attempts. The aim of the present study was to examine the characteristics of suicide attempts in young people during the initial 18 months of treatment for FEP. Method: A retrospective medical record audit study of a cohort of patients accepted for treatment at a specialist FEP service between 1/12/2002 and 30/11/2005. Results: Of 607 patients, 73 (12%) attempted suicide during treatment. Of these 73, most (72.6%) attempted suicide on one occasion. The majority of attempts (85.3%) occurred when patients were treated as outpatients and were in regular contact with the service. Suicide attempts tended to be impulsive (77.6%), triggered by interpersonal conflict or distress due to psychotic symptoms. Two thirds involved self-poisoning, usually by overdose of prescribed medications. All inpatient suicide attempts were by hanging or strangulation. In iduals infrequently sought help immediately before or after the attempt if help-seeking occurred, informal sources of support were contacted. Conclusions: To reduce the number of suicide attempts among in iduals treated for FEP, psychiatric services could consider: restricting the amount of medication prescribed per purchase in idualised suicide risk management plans for all newly admitted patients, including those who do not appear to be at risk stringent reviews of inpatient psychiatric units for potential ligature points providing information and psycho-education for significant others in recognition and response to suicide risk fostering patients' problem solving and conflict resolution skills and regular risk assessment and close monitoring of patients, particularly during the high risk period of 3 months after a suicide attempt.
Publisher: Elsevier BV
Date: 11-2015
Publisher: Hogrefe Publishing Group
Date: 2020
DOI: 10.1027/0227-5910/A000602
Abstract: Abstract. Background: Many organizations provide support to people affected by suicide-related behavior, for ex le, those bereaved by suicide, those who have attempted suicide, and their informal carers. However, evidence regarding how well used, and acceptable, these resources are is lacking. Aims: To investigate the views about and experiences with support and resources of people with lived experience of suicide bereavement, suicide attempt, or caring. Method: The study was conducted in Queensland, Australia. In total, 175 people completed the survey. Data were analyzed using SPSS Statistics 22. Results: Participants found resources helpful and user-friendly, but many had never searched for support, did not know it was available, or felt no better after using it. Respondents who had attempted suicide were more likely to look for resources, but less likely to feel better after using them and endorsed more barriers to accessing support. Limitations: This study used a convenience s le of in iduals living in Queensland, was biased toward help-seeking populations, and included mostly women, and therefore it was not representative. Conclusion: Support and resources that are more flexible and accessible, and are offered in a more proactive manner could improve the user experiences of people affected by suicide-related behavior.
Publisher: JMIR Publications Inc.
Date: 22-11-2022
Abstract: oung people are more likely to be affected by suicide contagion, and there are concerns about the role social media plays in the development and maintenance of suicide clusters or in facilitating imitative suicidal behavior. However, social media also presents an opportunity to provide real-time and age-appropriate suicide prevention information, which could be an important component of suicide postvention activities. his study aimed to test an intervention designed to equip young people to communicate safely online about suicide (#chatsafe) with a s le of young people who had recently been exposed to a suicide or suicide attempt, with a view to determining the role social media can play as part of a postvention response. s le of 266 young people from Australia, aged 16 to 25 years, were recruited to participate in the study. They were eligible if they had been exposed to a suicide or knew of a suicide attempt in the past 2 years. All participants received the #chatsafe intervention, which comprised 6 pieces of social media content that were sent to them weekly via direct message through Instagram, Facebook, or Snapchat. Participants were assessed on a range of outcome measures (social media use, willingness to intervene against suicide, internet self-efficacy, confidence, and safety when communicating about suicide on social media platforms) at baseline, immediately after the intervention, and at 4-week follow-up. fter the 6-week #chatsafe intervention, participants reported substantial improvements in their willingness to intervene against suicide online, their internet self-efficacy, and their perceived confidence and safety when communicating about suicide online. Overall, the participants reported that it was appropriate to receive the #chatsafe intervention via social media, and no iatrogenic effects were recorded. he findings suggest that it is safe and acceptable to disseminate suicide prevention information entirely via social media among young people who have recently been exposed to a suicide or suicide attempt. Interventions such as #chatsafe could potentially mitigate the risk of distress and future suicidal behavior in young people by improving the quality and safety of online communication about suicide and, as such, can be an important component of delivering a postvention response to young people.
Publisher: Springer Science and Business Media LLC
Date: 27-05-2014
Publisher: BMJ
Date: 23-07-2015
Publisher: Hogrefe Publishing Group
Date: 05-2013
DOI: 10.1027/0227-5910/A000168
Abstract: Background: Suicide, in particular among young people, is a major public health problem, although little is known regarding effective interventions for managing and preventing suicide-related behavior. Aims: To review the empirical literature pertaining to suicide postvention, prevention, and early intervention, specifically in school settings. Method: MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials (CCRCT) as well as citation lists of relevant articles using terms related to suicide and schools were searched in July 2011. School-based programs targeting suicide, attempted suicide, suicidal ideation, and self-harm where intent is not specified were included. No exclusion was placed on trial design. All studies had to include a suicide-related outcome. Results: A total of 412 potentially relevant studies were identified, 43 of which met the inclusion criteria, as well as three secondary publications: 15 universal awareness programs, 23 selective interventions, 3 targeted interventions, and 2 postvention trials. Limitations: Overall, the evidence was limited and h ered by methodological concerns, particularly a lack of RCTs. Conclusions: The most promising interventions for schools appear to be gatekeeper training and screening programs. However, more research is needed.
Publisher: Elsevier BV
Date: 06-2018
Abstract: The Victorian Suicide Register (VSR) is a state-based suicide surveillance system that contains detailed information on people who die by suicide and the circumstances surrounding their death. In this paper, we provide an overview of the VSR and then describe the evaluation, which used the Centres for Disease Control and Prevention guidelines for surveillance system evaluation as a framework. The evaluation drew on three data sources to assess whether the VSR: i) embodies the attributes of a good public health surveillance system and ii) can be used to inform community-based suicide prevention efforts. There was a high level of acceptability and enthusiasm for having an accessible data collection that can stimulate local action on suicide prevention planning. One of the key challenges identified was data quality, particularly around those data collected in the course of death investigations that are not designed for surveillance purposes. The VSR fills an important gap in the sustained and systematic collection of comprehensive information on suicide, with some key challenges identified. Implications for public health: Findings from the evaluation provide important strategic information for national and international jurisdictions seeking to establish their own suicide registers.
Publisher: Hogrefe Publishing Group
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 02-03-2022
DOI: 10.1186/S13063-022-06072-8
Abstract: Suicide is the leading cause of death among young Australians, accounting for one-third of all deaths in those under 25. Schools are a logical setting for youth suicide prevention activities, with universal, selective and indicated approaches all demonstrating efficacy. Given that international best practice recommends suicide prevention programmes combine these approaches, and that to date this has not been done in school settings, this study aims to evaluate a suicide prevention programme incorporating universal, selective and indicated components in schools. This study is a trial of a multimodal suicide prevention programme for young people. The programme involves delivering universal psychoeducation (safeTALK) to all students, screening them for suicide risk, and delivering internet-based Cognitive Behavioural Therapy (Reframe IT) to those students identified as being at high risk for suicide. The programme will be trialled in secondary schools in Melbourne, Australia, and target year 10 students (15 and 16 year-olds). safeTALK and screening will be evaluated using a single group pre-test ost-test case series, and Reframe IT will be evaluated in a Randomised Controlled Trial. The primary outcome is change in suicidal ideation other outcomes include help-seeking behaviour and intentions, and suicide knowledge and stigma. The programme’s cost-effectiveness will also be evaluated. This study is the first to evaluate a suicide prevention programme comprising universal, selective and indicated components in Australian schools. If the programme is found to be efficacious and cost-effective, it could be more widely disseminated in schools and may ultimately lead to reduced rates of suicide and suicidal behaviour in school students across the region.
Publisher: Informa UK Limited
Date: 31-10-2001
Publisher: MDPI AG
Date: 26-05-2022
Abstract: The ongoing COVID-19 pandemic has impacted the mental health of populations and highlighted the limitations of mental health care systems. As the trajectory of the pandemic and the economic recovery are still uncertain, decision tools are needed to help evaluate the best interventions to improve mental health outcomes. We developed a system dynamics model that captures causal relationships among population, demographics, post-secondary education, health services, COVID-19 impact, and mental health outcomes. The study was conducted in the Australian state of Victoria. The model was calibrated using historical data and was stratified by age group and by geographic remoteness. Findings demonstrate that the most effective intervention combination includes economic, social, and health sector initiatives. Assertive post-suicide attempt care is the most impactful health sector intervention, but delaying implementation reduces the potency of its impact. Some evidence-based interventions, such as population-wide community awareness c aigns, are projected to worsen mental health outcomes when implemented on their own. Systems modelling offers a powerful decision-support tool to test alternative strategies for improving mental health outcomes in the Victorian context.
Publisher: MDPI AG
Date: 07-07-2022
Abstract: Young people experience high rates of suicidal ideation, self-harm, suicide attempt and death due to suicide. As a result of increasing globalisation, young people are increasingly mobile and can migrate from one country to another seeking educational and employment opportunities. With a growing number of young migrants, it is important to understand the prevalence of suicidal behaviour among this population group. We systematically searched Medline, Embase, and PsycINFO from inception until 31 March 2022. Eligible studies were those providing data on suicidal ideation, self-harm, suicide attempt, and death due to suicide. Seventeen studies were included in the review, some of which provided data on multiple outcomes of interest. Twelve studies provided data on suicidal ideation, five provided data on self-harm, eight provided data on suicide attempt, and one study had data on suicide death among young migrants. The quality of the included studies was varied and limited. The studies included in this review commonly reported that young migrants experience higher rates of self-harm and suicide attempt, but no major differences in suicidal ideation and suicide death compared to non-migrant young people. However, the limited number of studies focused on suicidal behaviour among young migrants highlights the need for further high-quality studies to capture accurate information. This will enable the development of policies and interventions that reduce the risk of suicidal behaviour among young migrants.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2010
Publisher: Public Library of Science (PLoS)
Date: 31-03-2020
Publisher: MDPI AG
Date: 10-05-2018
Publisher: MDPI AG
Date: 12-03-2021
Abstract: Many young people who engage in self-harm do not seek help from health services. For those that do, emergency departments (EDs) are a key point of contact. Substantial gaps remain in current knowledge related to young consumers’ experiences and views on optimal treatment of self-harm in the ED. In this study, semi-structured interviews were conducted with thirteen young people (Mage = 21.2 years), who were engaged with care at headspace early intervention centers and had presented to an ED with a self-inflicted physical injury. Participants were asked to describe their experience in the ED and the care they received. Data were analyzed thematically. Three inter-related themes were identified: 1. The ED was experienced through a lens of significant distress, 2. The ED environment and processes were counter-therapeutic, and 3. Staff were perceived to be disinterested, dismissive, and lacking in knowledge. The study highlights the overwhelmingly negative nature of participants’ experiences, and presents recommendations for service and practice improvements, such as the provision of staff training and increased aftercare.
Publisher: Hindawi Limited
Date: 11-2001
DOI: 10.1046/J.0966-0410.2001.00331.X
Abstract: Alongside mental health policies emphasising the need to focus on people experiencing serious, long-term problems, recent general healthcare policy is leading to the development in the UK of a primary care-led National Health Service. While most primary care-led mental health initiatives have focused on supporting general practitioners (GPs) in managing milder depression and anxiety, this article describes an evaluation comparing primary care-based and secondary care-based services for people with serious long-term problems. A survey of service users was carried out at three points in time using three measures: the Camberwell Assessment of Need, the Verona Satisfaction with Services Scales and the Lancashire Quality of Life Profile. Staff views were sought at two time intervals and carers' views were obtained towards the end of the 2-year study period. The results indicate that both services reduced overall needs and the users' need for information. The primary care service also reduced the need for help with psychotic symptoms whereas the secondary care service reduced users' need for help with benefits and occupation. There were no major differences in terms of satisfaction or quality of life. Primary care-based services therefore appear to have the potential to be as effective as more traditional secondary care services. However, a more comprehensive range of services is required to address the whole spectrum of needs, a conclusion supported by the views of staff and carers.
Publisher: Elsevier BV
Date: 06-2014
Publisher: Wiley
Date: 08-2006
DOI: 10.1111/J.1360-0443.2006.01483.X
Abstract: The annual number of homicide convictions in England and Wales is increasing. Previous studies have highlighted the aetiological role of alcohol and drugs in homicide. To examine rates of alcohol and drug misuse and dependence in people convicted of homicide the role of alcohol and drugs in the offence the social and clinical characteristics of alcohol- and drug-related homicides and the social and clinical characteristics of patients with dual diagnosis who commit homicide. A national clinical survey based on a 3-year (1996-9) consecutive s le of people convicted of homicide in England and Wales. Information on rates of alcohol and drug misuse/dependence, the role of alcohol and drugs in the offence and social and clinical characteristics of perpetrators were collected from psychiatric reports prepared for the court in homicide convictions. Detailed clinical information was gathered from questionnaires completed by mental health teams for those in contact with mental health services. Of the 1594 homicide perpetrators, more than one-third (42%) occurred in people with a history of alcohol misuse or dependence and 40% in people with a history of drug misuse or dependence. Alcohol or drug misuse played a contributory role in two-fifths of homicides. Alcohol played a major role in 52 (6%) and a minor role in 364 (39%) homicides. Drugs played a major role in six (1%) and a minor role in 138 (14%) homicides. Forty-two homicides (17%) were committed by patients with severe mental illness and substance misuse. Alcohol- and drug-related homicides were generally associated with male perpetrators who had a history of violence, personality disorders, mental health service contact and with stranger victims. Substance misuse contributes to the majority of homicides in England and Wales. A public health approach to homicide would highlight alcohol and drugs before severe mental illness.
Publisher: Cambridge University Press (CUP)
Date: 2020
DOI: 10.1017/S2045796020000645
Abstract: There is currently no gold-standard definition or method for identifying suicide clusters, resulting in considerable heterogeneity in the types of suicide clusters that are detected. This study sought to identify the characteristics, mechanisms and parameters of suicide clusters using three cluster detection methods. Specifically, the study aimed to: (1) determine the overlap in suicide clusters among each method, (2) compare the spatial and temporal parameters associated with different suicide clusters and (3) identify the demographic characteristics and rates of exposure to suicide among cluster and non-cluster members. Suicide data were obtained from the National Coronial Information System. N = 3027 Australians, aged 10–24 who died by suicide in 2006–2015 were included. Suicide clusters were determined using: (1) poisson scan statistics, (2) a systematic search of coronial inquests and (3) descriptive network analysis. These methods were chosen to operationalise three different definitions of suicide clusters, namely clusters that are: (1) statistically significant, (2) perceived to be significant and (3) characterised by social links among three or more suicide descendants. For each method, the demographic characteristics and rates of exposure to suicide were identified, in addition to the maximum duration of suicide clusters, the geospatial overlap between suicide clusters, and the overlap of in idual cluster members. Eight suicide clusters (69 suicides) were identified from the scan statistic, seven (40 suicides) from coronial inquests and 11 (37 suicides) from the descriptive network analysis. Of the eight clusters detected using the scan statistic, two overlapped with clusters detected using the descriptive network analysis and one with clusters identified from coronial inquests. Of the seven clusters from coronial inquests, four overlapped with clusters from the descriptive network analysis and one with clusters from the scan statistic. Overall, 9.2% (12 suicides) of in iduals were identified by more than one method. Prior exposure to suicide was 10.1% ( N = 7) in clusters from the scan statistic, 32.5% ( N = 13) in clusters from coronial inquest and 56.8% ( N = 21) in clusters from the descriptive network analysis. Each method identified markedly different suicide clusters. Evidence of social links between cluster members typically involved clusters detected using the descriptive network analysis. However, these data were limited to the availability information collected as part of the police and coroner investigation. Communities tasked with detecting and responding to suicide clusters may benefit from using the spatial and temporal parameters revealed in descriptive studies to inform analyses of suicide clusters using inferential methods.
Publisher: SAGE Publications
Date: 08-07-2214
Abstract: To provide guidance for the organisation and delivery of clinical services and the clinical management of patients who deliberately self-harm, based on scientific evidence supplemented by expert clinical consensus and expressed as recommendations. Articles and information were sourced from search engines including PubMed, EMBASE, MEDLINE and PsycINFO for several systematic reviews, which were supplemented by literature known to the deliberate self-harm working group, and from published systematic reviews and guidelines for deliberate self-harm. Information was reviewed by members of the deliberate self-harm working group, and findings were then formulated into consensus-based recommendations and clinical guidance. The guidelines were subjected to successive consultation and external review involving expert and clinical advisors, the public, key stakeholders, professional bodies and specialist groups with interest and expertise in deliberate self-harm. The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for deliberate self-harm provide up-to-date guidance and advice regarding the management of deliberate self-harm patients, which is informed by evidence and clinical experience. The clinical practice guidelines for deliberate self-harm is intended for clinical use and service development by psychiatrists, psychologists, physicians and others with an interest in mental health care. The clinical practice guidelines for deliberate self-harm address self-harm within specific population sub-groups and provide up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus.
Publisher: Cambridge University Press
Date: 19-02-2009
Publisher: MDPI AG
Date: 11-08-2020
DOI: 10.3390/PSYCHIATRYINT1010002
Abstract: School-based youth-specific suicide prevention and early intervention initiatives are presently underdeveloped. The current study conducted a pilot evaluation of a multi-modal suicide prevention training program for school-based social workers, ‘Management of Youth Suicidality Training for Schools’ (MYSTS). The program comprised a two-day workshop and six fortnightly post-workshop webinar online consultations. Participants were 36 social workers (years’ experience M = 11.23, SD = 8.29) employed by the Department of Education in Tasmania, Australia. Outcomes were self-rated confidence, competence, and knowledge of self-harm in young people, and attitudes toward suicide prevention and suicide-related behaviors. Exploratory quantitative results indicated significant improvements with large effect sizes for participants’ self-reported competence (d = 1.33), and confidence (d = 1.29) to identify and respond therapeutically to youth suicidality following the workshop. Confidence remained significantly higher than baseline following the online consultations (d = 0.90). Qualitative analysis of online supervision consultations indicated key themes of accessibility, communication and information sharing, and clinical management. Participants endorsed the MYSTS package as well-presented, with relevant topics, and effective learning activities. This study highlights the need for continued supervisory or implementation support to practitioners following suicide prevention training initiatives and suggests web-based teleconference technology as a feasible strategy for this. Further evaluation of the MYSTS package, including a suitable comparison or control condition, is indicated.
Publisher: Frontiers Media SA
Date: 10-01-2020
Publisher: Wiley
Date: 03-2018
DOI: 10.1111/IMJ.13717
Abstract: This review will provide an overview of the prevalence of, and risk factors for, depression and suicide in medical practitioners. It will also discuss the barriers to accessing appropriate care and potential interventions for this population.
Publisher: JMIR Publications Inc.
Date: 15-04-2021
Abstract: orrection to article
Publisher: Cambridge University Press (CUP)
Date: 28-05-2008
DOI: 10.1017/S0033291708003644
Abstract: Few controlled studies have specifically investigated aspects of mental health care in relation to suicide risk among recently discharged psychiatric patients. We aimed to identify risk factors, including variation in healthcare received, for suicide within 3 months of discharge. We conducted a national population-based case-control study of 238 psychiatric patients dying by suicide within 3 months of hospital discharge, matched on date of discharge to 238 living controls. Forty-three per cent of suicides occurred within a month of discharge, 47% of whom died before their first follow-up appointment. The first week and the first day after discharge were particular high-risk periods. Risk factors for suicide included a history of self-harm, a primary diagnosis of affective disorder, recent last contact with services and expressing clinical symptoms at last contact with staff. Suicide cases were more likely to have initiated their own discharge and to have missed their last appointment with services. Patients who were detained for compulsory treatment at last admission, or who were subject to enhanced levels of aftercare, were less likely to die by suicide. The weeks after discharge from psychiatric care represent a critical period for suicide risk. Measures that could reduce risk include intensive and early community follow-up. Assessment of risk should include established risk factors as well as current mental state and there should be clear follow-up procedures for those who have self-discharged. Recent detention under the Mental Health Act and current use of enhanced levels of aftercare may be protective.
Publisher: JMIR Publications Inc.
Date: 17-11-2022
Abstract: uicide is the leading cause of death among Australians. One commonly cited explanation is the impact of social media, in particular, the ways in which young people use social media to communicate about their own experiences and their exposure to suicide-related content posted by others. Guidelines designed to assist mainstream media to safely report about suicide are widespread. Until recently, no guidelines existed that targeted social media or young people. In response, we developed the #chatsafe guidelines and a supporting social media c aign, which together make up the #chatsafe intervention. The intervention was tested in a pilot study with positive results. However, the study was limited by the lack of a control group. he aim of this study is to assess the impact of the #chatsafe social media intervention on young people’s safety and confidence when communicating on the web about suicide. he study employs a pragmatic, parallel, superiority randomized controlled design. It will be conducted in accordance with the Consolidated Standards of Reporting Trials statement over 18 months. Participants will be 400 young people aged 16-25 years (200 per arm). Participants will be recruited via social media advertising and assessed at 3 time points: time 1—baseline time 2—8-week postintervention commencement and time 3—4-week postintervention. They will be asked to complete a weekly survey to monitor safety and evaluate each piece of social media content. The intervention comprises an 8-week social media c aign including social media posts shared on public Instagram profiles. The intervention group will receive the #chatsafe suicide prevention content and the control group will receive sexual health content. Both groups will receive 24 pieces of content delivered to their mobile phones via text message. The primary outcome is safety when communicating on the web about suicide, as measured via the purpose-designed #chatsafe online safety questionnaire. Additional outcomes include willingness to intervene against suicide, internet self-efficacy, safety, and acceptability. he study was funded in November 2020, approved by the University of Melbourne Human Research Ethics Committee on October 7, 2022, and prospectively registered with the Australian New Zealand Clinical Trials registry. Trial recruitment began in November 2022 and study completion is anticipated by June 2024. his will be the first randomized controlled trial internationally to test the impact of a social media intervention designed to equip young people to communicate safely on the web about suicide. Given the rising rates of youth suicide in Australia and the acceptability of social media among young people, incorporating social media–based interventions into the suicide prevention landscape is an obvious next step. This intervention, if effective, could also be extended internationally, thereby improving web-based safety for young people not just in Australia but globally. ustralian New Zealand Clinical Trials Registry ACTRN12622001397707 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384318 ERR1-10.2196/44300
Publisher: Springer Science and Business Media LLC
Date: 17-01-2007
DOI: 10.1007/S00127-006-0150-3
Abstract: Several studies have compared the residential mobility of in iduals with schizophrenia to mobility of in iduals with other mental disorders or with no mental disorders. Little research has been undertaken to describe differences between single (i.e., infrequent) and multiple (i.e., frequent) movers with schizophrenia, and the association between frequency of mobility and health and health service use. The data source is population-based administrative records from the province of Manitoba, Canada. Hospital separations and physicians claims are linked to health registration files to identify a cohort with diagnosed schizophrenia and track changes in residential postal code over time. Single movers (N = 736), who had only one postal code change in a 2.5-year observation period, are compared to multiple movers (N = 252), who had two or more postal code changes. Differences in demographic, socioeconomic, and geographic characteristics, measures of health service use, and the prevalence of several chronic diseases were examined using chi(2) tests, logistic regression, and generalized linear regression. Multiple movers were significantly more likely to be young, live in socioeconomically disadvantaged neighborhoods, and reside in the urban core. The prevalence of a co-occurring substance use disorder and arthritis was higher for multiple than single movers. Use of acute and ambulatory care for schizophrenia, other mental disorders, as well as physical disorders was generally higher for multiple than single movers. Frequency of mobility should be considered in the development of needs-based funding plans and service delivery interventions. Other opportunities to use record-linkage techniques to examine residential mobility are considered.
Publisher: Hogrefe Publishing Group
Date: 09-2017
DOI: 10.1027/0227-5910/A000471
Abstract: Abstract. Background: Bereavement by suicide is associated with a number of consequences including poor mental health outcomes and increased suicide risk. Despite this, the bereaved by suicide may be reluctant to seek help from friends, family, and professionals. Internet forums and social networking sites are a popular avenue of support for the bereaved, but to date there is a lack of research into their use and efficacy. Aims: To survey users of suicide bereavement Internet forums and Facebook groups regarding their help-seeking behaviors, use of forums, and perceived benefits and limitations of such use. Method: This study employed a cross-sectional design in which users of suicide bereavement Internet forums and Facebook groups completed an anonymous online survey. Results: Participants were 222 users of suicide bereavement Internet forums. Most participants (93.2%) had sought face-to-face help from sources other than Internet forums, but were more likely to seek help in the near future from informal rather than formal sources. Forums were perceived as highly beneficial and there were few limitations. Limitations: The generalizability of these results to other internet forums may be limited. Additionally, we were not able to examine differences between forums in terms of quality or user-reported efficacy. Finally, the data reflects the subjective views of forum users, which may differ from the views of moderators or experts. Conclusion: Internet forums, including Facebook groups, appear to be a useful adjunct to face-to-face help-seeking for supporting those who have been bereaved by suicide.
Publisher: BMJ
Date: 27-03-2019
DOI: 10.1136/EBMENTAL-2019-300082
Abstract: A growing body of work suggests that medical students may be particularly at risk of mental ill health, suicidal ideation and behaviour, resulting in recent calls to develop interventions to prevent these outcomes. However, few reviews have synthesised the current evidence base regarding the effectiveness of these interventions and provided guidance to improve future intervention efforts. The authors conducted a systematic review to identify studies of any design reporting the effectiveness of any universal intervention to address these outcomes in medical students. Embase, MEDLINE and PsycINFO databases were searched from their respective start dates until 1 December 2017. Data from 39 studies were included. Most investigated the effectiveness of relatively brief interventions designed to reduce stress most commonly using mindfulness-based or guided meditation approaches. Only one implemented an intervention specifically designed to address suicidal ideation none investigated the effectiveness of an intervention specifically designed to address suicidal behaviour. Five investigated the effects of curriculum-level changes. Overall, there was limited evidence of an effect for these programmes at both the postintervention and longest follow-up assessment on depression, anxiety and stress. Relatively brief, in idually focused, mindfulness-based interventions may be effective in reducing levels of anxiety, depression and stress in medical students in the short term. Effects on suicidal ideation and behaviour, however, remain to be determined. There has been a significant lack of attention on organisational-level stressors associated with medical education and training.
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.SCHRES.2012.06.022
Abstract: Suicide-related behaviors (suicide attempts and suicides) are common in the early phase of psychotic disorders. Studies have examined risk factors among baseline and historical (i.e., past) variables, yet little is known about recent characteristics that increase suicide risk during treatment for first-episode psychosis (FEP). This study had two aims: first, to determine the relative importance of baseline, past, and recent variables to the prediction of suicide-related behaviors in patients with FEP second, to identify recent characteristics that exert most influence on suicide risk levels and which could become foci of preventive interventions. This was a case-control study of 180 patients from a cohort entering a specialist FEP service between 1/12/2002 and 30/11/2005. Data for 72 cases and 108 matched controls were obtained via medical record audit. Multivariate logistic regression models assessed the contribution of baseline, past, and recent domains. Suicide attempt or suicide during treatment was the outcome variable. The strongest risk factors for suicide-related behaviors were: baseline depressive symptoms, baseline suicidal ideation/intent, past negative events, past non-suicidal self-injurious behavior, recent negative events, recent depressive symptoms, and recent non-suicidal self-injurious behavior. However, when these were entered into a hierarchical logistic regression model, only recent non-suicidal self-injurious behavior (AOR=72.96, p<0.001), and recent negative events (AOR=1.90, p=0.003) remained significant predictors. The final model accurately classified 75.5% of cases and 89.2% of controls, and explained 72.0% of variance in the suicide attempt status. Since recent negative events and recent non-suicidal self-injurious behavior were the strongest predictors of suicide-related behaviors during treatment for FEP, psychiatric services could consider incorporating psychosocial interventions addressing affect regulation, interpersonal effectiveness, stress management and problem solving, alongside case management and pharmacotherapy, to help to reduce the rates of suicide attempts and suicides in first-episode patients.
Publisher: Hogrefe Publishing Group
Date: 2007
Abstract: Abstract. Suicidal behavior is associated with negative outcomes, including completed suicide. This study examined the prevalence of suicidal behavior in a s le of referrals to a youth psychiatric service and investigated the stability of suicidality over 2 years. Of the 140 people (mean age 17.8) who were referred to a youth psychiatric service, 82 who were accepted for treatment (RA group) and 58 who were not accepted (RNA group) were assessed 57% reported considering suicide and 39% reported attempting suicide in the 12 months prior to referral. Participants who reported suicidal ideation were significantly more likely than nonsuicidal participants to have multiple Axis I diagnoses and lower levels of functioning. At the 2-year follow-up there was a significant reduction in suicidality in the RA group, but not in the RNA group. In conclusion, suicidality is prevalent among young people referred to psychiatric services. Even brief contact with services results in a reduction in suicidality over 2 years.
Publisher: MDPI AG
Date: 31-03-2017
Publisher: MDPI AG
Date: 07-04-2022
Abstract: Suicide clusters involve an excessive number of suicides, suicide attempts, or both, that occur close in space or time or involve social links between cluster members. Although suicide clusters are rare, evidence documenting the implementation of suicide cluster response activities in communities is required yet remains limited. In this study, we identified the core components of existing suicide cluster response frameworks through a search of the grey literature and conducted an international survey to assess the implementation of the core components by stakeholders with experience responding to a suicide cluster. The following six core components were identified from five cluster response frameworks and were incorporated into a survey assessing stakeholders’ experiences of responding to a suicide cluster: (1) Preparing for a suicide cluster (2) Routine monitoring of suicide, suicide attempts, and cluster detection (3) Coordination with the media and monitoring social media (4) Identifying and supporting in iduals at risk (5) Promoting help-seeking and building community resilience and (6) Long-term follow-up and evaluation. Twenty-six stakeholders completed the online survey. Many of the core components were implemented by stakeholders. However, gaps in practice were reported in terms of cluster surveillance, monitoring of referral uptake among bereaved in iduals, and long-term evaluation. Barriers to implementation included the perceived availability and suitability of mental health services, and availability of long-term funding. Strategic policy and planning that addresses the practice-based experiences of communities has the potential to facilitate a more coordinated and timely response to suicide clusters.
Publisher: Springer Science and Business Media LLC
Date: 28-10-2019
DOI: 10.1186/S12889-019-7742-9
Abstract: Australian mortality statistics suggest that young female suicides have increased since 2004 in comparison to young males, a pattern documented across other Western high-income countries. This may indicate a need for more targeted and multifaceted youth suicide prevention efforts. However, sex-based time trends are yet to be tested empirically within a comprehensive Australian s le. The aim of this study was to examine changes over time in sex-based rates and characteristics of all suicides among young people in Australia (2004–2014). National Coronial Information System and Australian Bureau of Statistics data provided annual suicide counts and rates for 10–24-year-olds in Australia (2004–2014), stratified by sex, age group, Indigenous status and methods. Negative binomial regressions estimated time trends in population-stratified rates, and multinomial logistic regressions estimated time trends by major suicide methods (i.e., hanging, drug poisoning). Between 2004 and 2014, 3709 young Australians aged 10–24 years died by suicide. Whilst, overall, youth suicide rates did not increase significantly in Australia between 2004 and 2014, there was a significant increase in suicide rates for females (incident rate ratio [IRR] 1.03, 95% confidence interval [CI] 1.01 to 1.06), but not males. Rates were consistently higher among Aboriginal/Torres Strait Islander youth, males, and in older (20–24-years) as compared to younger (15–19 years) age groups. Overall, the odds of using hanging as a method of suicide increased over time among both males and females, whilst the odds of using drug-poisoning did not change over this period. We showed that suicide rates among young females, but not young males, increased over the study period. Patterns were observed in the use of major suicide methods with hanging the most frequently used method among both sexes and more likely among younger and Aboriginal/Torres Strait Islander groups. Findings highlight the need to broaden current conceptualizations of youth suicide to one increasingly involving young females, and strengthen the case for a multifaceted prevention approach that capitalize on young females’ greater help-seeking propensity.
Publisher: Wiley
Date: 08-2008
Publisher: MDPI AG
Date: 26-03-2022
Abstract: Suicidal ideation is prevalent in adolescents and is a marker for subsequent psychiatric vulnerability and symptom severity. Literature shows that blended care (integrating online and offline components in a treatment process) could improve the effectiveness and adherence of interventions targeting suicidal ideation in adolescents, but the evidence is inconclusive. Thus, we will test the effectiveness of a blended intervention to reduce suicidal ideation (primary outcome) in school settings using a single-blind two-armed cluster randomized controlled trial (cRCT). The internet-based component corresponds to the Reframe-IT, a program encompassing eight online sessions based on cognitive-behavioral therapy (CBT) principles. The face-to-face intervention will be delivered through four CBT sessions. Additionally, we will assess the effect of the intervention on the following secondary outcomes: suicidal attempts, depressive symptoms, hopelessness, emotional regulation, and problem-solving skills. Primary and secondary outcomes will be assessed at post-intervention, 3-month, 6-month, and 12-month follow-up. Finally, we will explore the mediation role of cognitive, emotional, and behavioral correlates of suicide on the effect of the intervention. Results will inform whether the intervention can reduce suicide among school adolescents and be implemented on a large scale in Chile.
Publisher: Cambridge University Press (CUP)
Date: 17-10-2017
DOI: 10.1017/JGC.2017.10
Abstract: Suicide-related behaviours are relatively common among school-aged young people, and schools are an appropriate setting for activities that aim to prevent and assist recovery after suicide. headspace School Support is a specialist service that assists Australian secondary schools to be prepared for and recover from suicide. Through the responses of secondary school personnel to two surveys, this study explored awareness of and need for such services ( n = 214), and satisfaction with and impacts of the service ( n = 359). Findings indicate that most schools are aware of headspace School Support and regard specialised suicide support as needed. Most respondents indicated that the service increased their perceived knowledge, skills, and capacity in managing suicide issues, and reported satisfaction was high. Continued availability of suicide support to secondary schools is warranted.
Publisher: Springer Science and Business Media LLC
Date: 13-05-2020
DOI: 10.1186/S12910-020-00479-1
Abstract: People who are at elevated risk of suicide stand to benefit from internet-based interventions however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention. This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data. The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees. There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them (i.e., those who prefer anonymity). Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area.
Publisher: MDPI AG
Date: 14-04-2021
Abstract: Background: Suicide is the leading cause of death among young people in Australia. Media c aigns have the potential to reach a broad audience, change attitudes and behaviours, and, ultimately, help prevent suicide. Little is known about the type of content or format suicide prevention media message should take to help prevent suicide among young people. Objective: the objective of this study was to involve young people aged 18 to 24 years in developing three suicide prevention public service announcement (PSAs) targeting young people at risk of suicide appropriate for testing in a randomised controlled trial (RCT). Method: fifteen young people attended at least one of four workshops in Melbourne, Australia. The workshops focused on exploring the appropriateness of three key suicide prevention media PSAs: “Talk to someone”, “Find what works for you”, and “Life can get better”. Young people also provided input into message content, format, and design. Results: participants perceived that all three suicide prevention PSAs were useful and helpful. Participants were concerned that the PSAs may not be suitable for nonwestern cultural groups, could trivialise psychological suffering, and that the actions they promoted could seem distant or unattainable to young people at risk. The featuring of young people, especially young people with hopeful narratives of how they overcame a suicidal crisis, was considered to be an important characteristic of suicide prevention PSAs targeting young people. Conclusions: Developing suicide prevention PSAs with young people is rare but essential to better understand young people’s needs and improve the quality of suicide prevention media PSAs. Further research is needed to evaluate the impact of suicide prevention PSAs developed by young people, for young people.
Publisher: SAGE Publications
Date: 09-1997
DOI: 10.1177/070674379704200707
Abstract: To determine the accuracy of data contained in Manitoba's Mental Health Management Information System (MHMIS) as compared with client charts and to determine which factors influence completeness and accuracy. Data on diagnosis, open date and close date, demographic information, and contact information were obtained from client charts and compared with data extracted from the MHMIS. Semistructured interviews were conducted with in iduals who contribute data to the MHMIS. Data on required demographic variables, primary diagnosis, and open and close dates are highly similar in the 2 sources. The correlation between data sources on the number of client contacts is also good. This study establishes the reliability of MHMIS data. MHMIS data, in combination with hospital abstracts and physician claims data, provide the information needed to serve as a psychiatric case register (PCR) and can be used for psychiatric epidemiology as well as for planning, monitoring, and evaluating mental health services.
Publisher: MDPI AG
Date: 15-12-2020
Abstract: The prevention of suicide and suicide-related behaviour are key policy priorities in Australia and internationally. The World Health Organization has recommended that member states develop self-harm surveillance systems as part of their suicide prevention efforts. This is also a priority under Australia’s Fifth National Mental Health and Suicide Prevention Plan. The aim of this paper is to describe the development of a state-based self-harm monitoring system in Victoria, Australia. In this system, data on all self-harm presentations are collected from eight hospital emergency departments in Victoria. A natural language processing classifier that uses machine learning to identify episodes of self-harm is currently being developed. This uses the free-text triage case notes, together with certain structured data fields, contained within the metadata of the incoming records. Post-processing is undertaken to identify primary mechanism of injury, substances consumed (including alcohol, illicit drugs and pharmaceutical preparations) and presence of psychiatric disorders. This system will ultimately leverage routinely collected data in combination with advanced artificial intelligence methods to support robust community-wide monitoring of self-harm. Once fully operational, this system will provide accurate and timely information on all presentations to participating emergency departments for self-harm, thereby providing a useful indicator for Australia’s suicide prevention efforts.
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670802607162
Abstract: Objectives: Studies investigating suicidal behaviour in psychosis rarely focus on incidence cohorts of first-episode patients. This is important, because patients who refuse study participation have higher rates of comorbid substance use disorders and longer duration of untreated psychosis as well as worse course illness, variables potentially linked to higher prevalence of suicidal behaviour. The aims of the present study were therefore to examine the prevalence and predictors of suicide and suicide attempt before and during the first 18–24months of treatment. Method: A retrospective file audit of 661 patients was carried out. Results: Six patients (0.9%) died by suicide, 93 (14.3%) attempted suicide prior to entry, and 57 (8.7%) did so during treatment. Predictors of suicide attempt were: previous attempt (odds ratio (OR)=45.54, 95% confidence interval (CI)=9.46–219.15), sexual abuse (OR=8.46, 95%CI=1.88–38.03), comorbid polysubstance (OR=13.63, 95%CI=2.58–71.99), greater insight (OR=0.17, 95%CI=0.06–0.49), lower baseline Global Assessment of Functioning Scale and Scale of Occupational and Functional Assessment score (OR=0.96, 95%CI=0.62–0.91 OR=0.98, 95%CI=0.95–0.99), and longer time in treatment (OR=1.05, 95%CI=1.03–1.08). Conclusions: The prevalence of suicidal behaviour was high, indicating that suicidal behaviour in incidence populations is higher than in non-epidemiological cohorts of first-episode patients. The rate of repetition of suicide attempt among the s le, however, was lower than expected, suggesting that specialist services can play a role in reducing suicide risk.
Publisher: Royal College of Psychiatrists
Date: 08-2003
Abstract: Information on suicide by psychiatric patients from ethnic minority groups is scarce. To establish the number of patients from ethnic minorities who kill themselves to describe their suicide methods, and their social and clinical characteristics. A national clinical survey was based on a 4-year s le of suicides in England and Wales. Detailed data were collected on those who had been in contact with mental health services in the year before death. In total 282 patients from ethnic minorities died by suicide – 6% of all patient suicides. The most common method of suicide was hanging violent methods were more common than in White patient suicides. Schizophrenia was the most common diagnosis. Ethnic minority patients were more likely to have been unemployed than White patients and to have had a history of violence and recent non-compliance. In around half, this was the first episode of self-harm. Black Caribbean patients had the highest rates of schizophrenia (74%), unemployment, living alone, previous violence and drug misuse. In order to reduce the number of suicides byethnicminority patients, services should address the complex health and social needs of people with severe mental illness.
Publisher: Springer Science and Business Media LLC
Date: 10-01-2020
DOI: 10.1186/S13033-019-0335-2
Abstract: Despite continuous research over the past 20 years in Australia there is still limited understanding of what works and what does not work in suicide prevention and where to invest research efforts that will help to expand this knowledge base. There is a recursive relationship between research activities, knowledge gain and the development of strategy and action plans as these in turn guide future decisions on research funding. In this context, the first step to continuous improvement in knowledge is to better understand where research has been invested in the past until now and where it has not. We conducted a study that collected data over two periods. The first data collection was done in 2006 for the period of 1999 to 2006 and the second data collection was in 2017 for the period from 2010 to 2017. This allowed us to examine changes in published suicide-related journal articles, and grants/fellowships funded between the two periods. Published articles and grants/fellowships were classified according to a pre-determined framework. The number of suicide-related articles and grants/fellowships increased over the two periods. We noted shifts in the types of research that were funded and published, and in the emphasis that was given to different types of suicidal behavior, suicide methods, and settings. Research target groups showed a trend towards increasing ersification. Our findings help to identify current research priorities and inform where future priorities for suicide-related research in Australia lie by linking findings to other external data sources (population risk data, stakeholder consultations, national strategies and action plan documents).
Publisher: MDPI AG
Date: 20-04-2022
Abstract: The gatekeeper training of parents is a promising approach for suicide prevention in young people, but little research has addressed the effectiveness of such training, especially using online delivery. This study aimed to evaluate the efficacy and acceptability of the delivery of an online suicide prevention training program, LivingWorks Start, to improve the capacity of parents to support young people at risk of suicide. The participants were 127 parents of young people aged 12–25 who completed the LivingWorks Start training and consented to participate in the evaluation. The participants completed online surveys before, after, and 3 months after training. The participants showed increases in perceived self-efficacy and formal help-seeking intentions, and reductions in suicide stigma, although stigma returned to the baseline three months post-training. Suicide literacy also increased, but only at the three-month follow-up. Most parents found the training acceptable, and did not find it upsetting. Prior mental health, suicide-related experiences, and pre-participation vulnerability were not predictive of finding the training distressing. Overall, the findings show that online gatekeeper training for parents can be beneficial, and is rarely associated with distress.
Publisher: JMIR Publications Inc.
Date: 11-09-2020
Abstract: eb-based interventions are a promising approach to support youth at risk of suicide, and those incorporating peer-to-peer social networking may have the added potential to target interpersonal states of perceived burdensomeness and thwarted belongingness. Owing to feasibility and safety concerns, including fear of contagion, this had not been tested until recently. In 2018, we conducted a pilot evaluation to test the feasibility, safety, and acceptability of a Moderated Online Social Therapy intervention, called Affinity, with a s le of young people with active suicidal ideation. he aim of this study is to report qualitative data collected from study participants regarding their experience of the web-based social network and the consequent safety features. ffinity is a closed website incorporating 3 key components: therapeutic content delivered via comics, peer-to-peer social networking, and moderation by peers and clinicians. Semistructured interviews were conducted with 17 young people who participated in the pilot study after 8 weeks of exposure to the intervention. Interview data from 2 young people who did not use Affinity were excluded from the analysis. The interviews were analyzed using thematic analysis, with the frequency of responses characterized using the consensual qualitative research method. The results are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. total of 4 overarching themes were identified: a safe and supportive environment, the importance of mutual experiences, difficulty engaging and connecting, and the pros and cons of banning discussions about suicide. Interestingly, although Affinity was perceived to be safe and free of judgment, concerns about negative evaluation and triggering others were significant barriers to posting on the social network. Participants generally supported the banning of conversations about suicide, although for some this was perceived to reinforce stigma or was associated with frustration and distress. he results not only support the safety and potential therapeutic benefit of the social networking aspect of Affinity but also highlight several implementation challenges. There is a need to carefully balance the need for stringent safety and design features while ensuring that the potential for therapeutic benefit is maximized. >
Publisher: Springer Science and Business Media LLC
Date: 03-02-2018
DOI: 10.1007/S00787-018-1111-6
Abstract: The repetition of hospital-treated self-harm by young people is common. However, little work has summarised the modifiable factors associated with this. A thorough understanding of those factors most strongly associated with repetition could guide the development of relevant clinical interventions. We systematically reviewed four databases (EMBASE, Medline, PubMed and PsycINFO) until 15 April 2016 to identify all observational studies of factors for the repetition of self-harm or suicide reattempts (together referred to as 'self-harm behaviour') in young people. We quantified the magnitude of association with odds ratios (OR) and 95% confidence intervals (CIs) and calculated the population attributable risk (PAR) and population preventable fraction (PPF) for modifiable factors to provide an indication of the potential impact in reducing subsequent self-harm behaviour in this population. Seventeen studies were included comprising 10,726 participants. Borderline personality disorder (OR 3.47, 95% CI 1.84-6.53 PAR 42.4%), any personality disorder (OR 2.54, 95% CI 1.71-3.78 PAR 16.3%), and any mood disorder (OR 2.16, 95% CI 1.09-4.29 PAR 42.2%) are important modifiable risk factors. Severity of hopelessness (OR 2.95, 95% CI 1.74-5.01), suicidal ideation (OR 2.01, 95% CI 1.43-2.81), and previous sexual abuse (OR 1.52, 95% CI 1.02-2.28 PAR 12.8%) are also associated with repetition of self-harm. We recommend that clinical services should focus on identifying key modifiable risk factors at the in idual patient level, whilst the reduction of exposure to child and adolescent sexual abuse would also be a useful goal for public health interventions.
Publisher: MDPI AG
Date: 22-05-2020
Abstract: Background: Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The “Coping with Self-Harm” booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. This paper presents qualitative analysis of interviews with parents about their experiences and psychoeducational needs when supporting a young person who engages in self harm. Methods: The qualitative study drew on semi-structured in idual and group interviews with parents (n = 19 participants) of young people who self-harm. Data were analysed using Thematic Analysis. Results: The analysis identified six themes: (1) the discovery of self-harm, (2) challenges in the parent-young person relationship, (3) parents’ need to understand self-harm, (4) parents’ emotional reactions to self-harm, (5) the importance of self-care and help-seeking among parents, and (6) the need for psychoeducational resources. Conclusion: The study highlights the need for support for parents and carers of young people who engage in self-harm, including development and adaptation of resources, such as the “Coping with Self-Harm” booklet, of which an Australian version has now been developed.
Publisher: Hogrefe Publishing Group
Date: 09-2017
DOI: 10.1027/0227-5910/A000465
Abstract: Abstract. Background: Universal education and awareness programs in schools are a promising suicide prevention intervention but to date no research has evaluated the iatrogenic effects of such programs. Aims: To evaluate the efficacy and acceptability of the safeTALK program for secondary school students and determine whether it is associated with any iatrogenic effects. Method: Participants were 129 students from the three main high schools in Alice Springs who attended the safeTALK training and consented to participate in the evaluation. Participants were assessed immediately before and immediately after the training using a purpose-designed survey. Follow-up questionnaires were administered online 4 weeks after completion of the training. Results: Participants demonstrated increases in knowledge about suicide, confidence in talking about issues related to suicide, willingness to talk about suicide, and likelihood of seeking help for suicidal thoughts. There was no evidence that the training induced suicidal thoughts or caused distress in fact both appeared to decrease following the training. Most participants did not find the training upsetting they reported the training to be worthwhile and most said that they would recommend it to a friend. Limitations: The lack of control group, use of non-validated measures, and relatively short follow-up period are limitations of this study. Conclusion: Universal suicide prevention workshops in schools can be beneficial and do not appear to be associated with iatrogenic effects.
Publisher: Hogrefe Publishing Group
Date: 09-2011
DOI: 10.1027/0227-5910/A000087
Abstract: Background: Programs designed to detect students at risk of depression and suicidality have shown success ( Shaffer et al., 2004 ). Aims: The current study sought to examine whether or not such a program was acceptable to participants and whether or not it caused distress. Methods: Participants were boys aged 14 to 16. Participants were assessed using an on-line questionnaire acceptability was measured via postal questionnaire. Results: Of 272 participants, 31 (11.4%) were considered at-risk 13 required ongoing support, 8 of whom had not previously sought help. Overall screening did not appear to cause significant undue distress, although some differences were evident between at-risk and not at-risk students. All participants found the program acceptable. Conclusions: When conducted carefully, early detection programs can be an effective and acceptable method of identifying at-risk adolescents.
Publisher: Springer Science and Business Media LLC
Date: 16-12-2009
Publisher: JMIR Publications Inc.
Date: 11-05-2020
DOI: 10.2196/17520
Abstract: Young people commonly use social media platforms to communicate about suicide. Although research indicates that this communication may be helpful, the potential for harm still exists. To facilitate safe communication about suicide on social media, we developed the #chatsafe guidelines, which we sought to implement via a national social media c aign in Australia. Population-wide suicide prevention c aigns have been shown to improve knowledge, awareness, and attitudes toward suicide. However, suicide prevention c aigns will be ineffective if they do not reach and resonate with their target audience. Co-designing suicide prevention c aigns with young people can increase the engagement and usefulness of these youth interventions. This study aimed to document key elements of the co-design process to evaluate young people’s experiences of the co-design process and to capture young people’s recommendations for the #chatsafe suicide prevention social media c aign. In total, 11 co-design workshops were conducted, with a total of 134 young people aged between 17 and 25 years. The workshops employed commonly used co-design strategies however, modifications were made to create a safe and comfortable environment, given the population and complexity and sensitivity of the subject matter. Young people’s experiences of the workshops were evaluated through a short survey at the end of each workshop. Recommendations for the c aign strategy were captured through a thematic analysis of the postworkshop discussions with facilitators. The majority of young people reported that the workshops were both safe (116/131, 88.5%) and enjoyable (126/131, 96.2%). They reported feeling better equipped to communicate safely about suicide on the web and feeling better able to identify and support others who may be at risk of suicide. Key recommendations for the c aign strategy were that young people wanted to see bite-sized sections of the guidelines come to life via shareable content such as short videos, animations, photographs, and images. They wanted to feel visible in c aign materials and wanted all materials to be fully inclusive and linked to resources and support services. This is the first study internationally to co-design a suicide prevention social media c aign in partnership with young people. The study demonstrates that it is feasible to safely engage young people in co-designing a suicide prevention intervention and that this process produces recommendations, which can usefully inform suicide prevention c aigns aimed at youth. The fact that young people felt better able to safely communicate about suicide on the web as a result of participation in the study augurs well for youth engagement with the national c aign, which was rolled out across Australia. If effective, the c aign has the potential to better prepare many young people to communicate safely about suicide on the web.
Publisher: MDPI AG
Date: 29-12-2021
Abstract: Social media may play a role in the “contagion” mechanism thought to underpin suicide clusters. Our pilot case-control study presented a novel methodological approach to examining whether Facebook activity following cluster and non-cluster suicides differed. We used a scan statistic to identify suicide cluster cases occurring in spatiotemporal clusters and matched each case to 10 non-cluster control suicides. We identified the Facebook accounts of 3/48 cluster cases and 20/480 non-cluster controls and their respective friends-lists and retrieved 48 posthumous posts and replies (text segments) referring to the deceased for the former and 606 for the latter. We examined text segments for “putatively harmful” and “putatively protective” content (e.g., discussion of the suicide method vs. messages discouraging suicidal acts). We also used concept mapping, word-emotion association, and sentiment analysis and gauged user reactions to posts using the reactions-to-posts ratio. We found no “putatively harmful” or “putatively protective” content following any suicides. However, “family” and “son” concepts were more common for cluster cases and “xx”, “sorry” and “loss” concepts were more common for non-cluster controls, and there were twice as many surprise- and disgust-associated words for cluster cases. Posts pertaining to non-cluster controls were four times as receptive as those about cluster cases. We hope that the approach we have presented may help to guide future research to explain suicide clusters and social-media contagion.
Publisher: SAGE Publications
Date: 18-11-2017
Abstract: This paper provides a review of the rates of self-harm and repeated self-harm among young people. It describes some of the risk factors associated with these behaviours and summarises some of the barriers to delivering optimal treatment. The review concludes that there is an urgent need for the delivery of respectful and evidence-based practice to all young people who present with self-harm. In addition, improved monitoring of self-harm presentations to hospitals across Australia is required in order that robust data are collected and the impact of practice change can be reliably assessed.
Publisher: BMJ
Date: 09-2016
Publisher: JMIR Publications Inc.
Date: 26-09-2017
Abstract: ffective treatment of depression in young people is critical, given its prevalence, impacts, and link to suicide. Clinical practice guidelines point to the need for regular monitoring of depression symptom severity and the emergence of suicidal ideation to track treatment progress and guide intervention delivery. Yet, this is seldom integrated in clinical practice. he objective of this study was to address the gap between guidelines about monitoring and real-world practice by codesigning an app with young people that allows for self-monitoring of mood and communication of this monitoring with a clinician. e engaged young people aged 18 to 25 years who had experienced depression, suicidal ideation including those who self-harm, as well as clinicians in a codesign process. We used a human-centered codesign design studio methodology where young people designed the features of the app first in idually and then as a group. This resulted in a minimal viable product design, represented through low-fidelity hand-drawn wireframes. Clinicians were engaged throughout the process via focus groups. he app incorporated a mood monitoring feature with innovative design aspects that allowed customization, and was named a “well-being tracker” in response to the need for a positive approach to this function. Brief personalized interventions designed to support young people in the intervals between face-to-face appointments were embedded in the app and were immediately available via pop-ups generated by a back-end algorithm within the well-being tracker. Issues regarding the safe incorporation of alerts generated by the app into face-to-face clinical services were raised by clinicians (ie, responding in a timely manner) and will need to be addressed during the full implementation of the app into clinical services. he potential to improve outcomes for young people via technology-based enhancement to interventions is enormous. Enhancing communication between young people and their clinicians about symptoms and treatment progress and increasing access to timely and evidence-based interventions are desirable outcomes. To achieve positive outcomes for young people using technology- (app) based interventions, it is critical to understand and incorporate, in a meaningful way, the expectations and motivations of both young people and clinicians.
Publisher: Springer Science and Business Media LLC
Date: 07-04-2021
DOI: 10.1186/S12910-021-00609-3
Abstract: Suicide research aims to contribute to a better understanding of suicidal behaviour and its prevention. However, there are many ethical challenges in this research field, for ex le, regarding consent and potential risks to participants. While studies to-date have focused on the perspective of the researchers, this study aimed to investigate the views and experiences of members of Human Research Ethics Committees (HRECs) in dealing with suicide-related study applications. This qualitative study entailed a thematic analysis using an inductive approach. We conducted semi-structured interviews with a purposive s le (N = 15) of HREC Chairs or their delegates from Australian research-intensive universities. The interview guide included questions regarding the ethical concerns and challenges in suicide-related research raised by HREC members, how they dealt with those challenges and what advice they could give to researchers. The analysis identified four main themes: (1) HREC members’ experiences of reviewing suicide-related study applications, (2) HREC members’ perceptions of suicide, suicide research, and study participants, (3) Complexity in HREC members’ decision-making processes, and (4) HREC members’ relationships with researchers. Reliance on ethical guidelines and dialogue with researchers are crucial in the assessment of suicide-related study applications. Both researchers and HREC members may benefit from guidance and resources on how to conduct ethically sound suicide-related studies. Developing working relationships will be likely to help HRECs to facilitate high quality, ethical suicide-related research and researchers to conduct such research.
Publisher: Springer Science and Business Media LLC
Date: 24-02-2016
Publisher: Springer Science and Business Media LLC
Date: 25-05-2010
Publisher: Public Library of Science (PLoS)
Date: 02-08-2023
DOI: 10.1371/JOURNAL.PONE.0289494
Abstract: Young people use social media to communicate about self-harm and suicide and this is associated with both potential risks and protective effects. The #chatsafe guidelines were originally developed in 2018 to equip young people to communicate safely online about suicide. They were shown to be safe, acceptable, and beneficial however, they do not provide guidance on self-harm, and social media is constantly evolving. This study aimed to update the #chatsafe guidelines to reflect new evidence and current social media affordances, and to include guidance on self-harm. A Delphi expert consensus study was conducted, comprising six stages: 1) A systematic search of peer-reviewed and grey literature 2) A series of roundtables with key stakeholders including social media companies, policymakers, and young people 3) Questionnaire development 4) Expert panel formation 5) Data collection and analysis and 6) Guideline development. A total of 191 items were included in the new #chatsafe guidelines. These were organised into eight themes, which became the overarching sections of the guidelines: 1) General tips 2) Creating self-harm and suicide content 3) Consuming self-harm and suicide content 4) Livestreams of self-harm and suicide acts 4) Self-harm and suicide games, pacts, and hoaxes 6) Self-harm and suicide communities 7) Bereavement and communicating about someone who has died by suicide and 8) Guidance for influencers. The new guidelines include updated and new information on online communication about self-harm, livestreams, games, pacts, and hoaxes, as well as guidance for influencers. They will be disseminated via a national social media c aign and supported by a series of adult-facing resources. Given the acceptability of the original guidelines and the ubiquitous use of social media by young people, it is hoped that the new guidelines will be a useful resource for young people and adults alike, both in Australia and worldwide.
Publisher: Royal College of Psychiatrists
Date: 12-2003
Publisher: Royal College of Psychiatrists
Date: 03-2022
DOI: 10.1192/BJO.2022.35
Abstract: Emergency departments are often the point of entry to the healthcare system for people who self-harm, and these in iduals are at high risk of further self-harm and suicide in the post-discharge period. These settings therefore provide a critical opportunity for intervention. However, many studies have identified that the experiences of patients, carers and the emergency department staff themselves is often suboptimal. In this editorial we summarise one such study, by O'Keeffe and colleagues, and consider strategies for improving the experiences of patients and their carers when presenting to the emergency department. We also reiterate the need for wider systemic change in attitudes and approaches towards people who self-harm that are pervasive across the healthcare system and beyond.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: Australia
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2015
End Date: 2018
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2018
End Date: 2023
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2018
End Date: 2021
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2015
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2018
End Date: 2021
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2018
End Date: 2021
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 12-2021
End Date: 11-2024
Amount: $452,898.00
Funder: Australian Research Council
View Funded Activity