scholarly journals Smartphone-based safety planning and self-monitoring for suicidal patients: Rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study

2018 ◽  
Vol 13 ◽  
pp. 16-23 ◽  
Author(s):  
Chani Nuij ◽  
Wouter van Ballegooijen ◽  
Jeroen Ruwaard ◽  
Derek de Beurs ◽  
Jan Mokkenstorm ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Study Protocol ◽  
Research Study ◽  
Safety Planning ◽  
Continuous Assessment ◽  
Self Monitoring ◽  
Suicidal Patients

scholarly journals Smartphone-Based Safety Planning and Self-Monitoring for Suicidal Patients: A Conceptual Basis for the CASPAR (Continuous Assessment for Suicide Prevention and Research) Study

2017 ◽  
Author(s):  
Chani Nuij ◽  
Wouter Van Ballegooijen ◽  
Jeroen Ruwaard ◽  
Derek de Beurs ◽  
Rory C. O'Connor ◽  
...  
Keyword(s):  
Real Time ◽  
Suicide Prevention ◽  
Health Care Professionals ◽  
Suicidal Behaviour ◽  
Safety Planning ◽  
Management Skills ◽  
Continuous Assessment ◽  
Self Monitoring ◽  
Prevention Interventions ◽  
Suicidal Crisis

Suicidal behaviour remains difficult to predict and prevent, even for experienced mental health care professionals. The known distal risk factors for suicidal behaviour are not sufficiently specific to fully understand the complex dynamic processes that precede a suicide attempt. Real-time mobile monitoring data can be used to analyse proximal risk mechanisms within the suicidal process. At the same time smartphone-based safety planning and self-monitoring may enhance a patient’s self-management skills thereby increasing their capacity to respond to a suicidal crisis and to become more aware of crisis symptoms. The current paper describes the theoretical and conceptual rationale for the CASPAR study which applies an innovative approach to the study of suicidal processes. It uses basic science approaches to inform the implementation of an innovative suicide prevention intervention. We aim to develop and implement mobile safety plan in conjunction with real-time monitoring in order to both directly implement suicide prevention interventions and to study the ongoing dynamics of individual suicidal behaviour by applying network analysis.

scholarly journals Study protocol for Post Pregnancy Family Planning Choices, an operations research study examining the effectiveness of interventions in the public and private sectors in Indonesia and Kenya

2020 ◽  
Vol 4 ◽  
pp. 89
Author(s):  
Elaine Charurat ◽  
Sara Kennedy ◽  
Siti Qomariyah ◽  
Anne Schuster ◽  
Megan Christofield ◽  
...  
Keyword(s):  
Family Planning ◽  
Study Protocol ◽  
Operations Research ◽  
Research Study ◽  
Scale Up ◽  
Unmet Need ◽  
Study Data ◽  
Multiple Time ◽  
Public And Private ◽  
The Public

Background: Global evidence suggests many postpartum and postabortion women have an unmet need for family planning (FP) after delivery or receiving care following loss of a pregnancy. Post Pregnancy Family Planning Choices, an operations research study, aims to examine the effectiveness of a package of postpregnancy FP interventions, inclusive of postpartum and postabortion FP. The interventions are being implemented in selected public and private facilities in Indonesia and Kenya and focus on quality FP counseling and service provision prior to discharge. This manuscript presents the study protocol, documenting how the study team intends to determine key factors that influence uptake of postpregnancy FP. Methods: This is a multi-country, quasi-experimental operations research study in Brebes and Batang Districts of Indonesia and Meru and Kilifi Counties of Kenya. Quantitative and qualitative data is collected from multiple data sources and participants through interviews and assessments at multiple time points. Participants include health facilities; antenatal, postpartum, and postabortion clients; and key informants at national, subnational, facility, and community levels. Quantitative study data is collected and managed through the use of REDCap (Research Electronic Data Capture). Once data are thoroughly cleaned and reviewed, regression models and multilevel analyses will explore quantitative data. Qualitative study data is collected using audio recordings and transcribed to Microsoft Word, then analyzed using ATLAS.ti. Qualitative datasets will be analyzed using grounded theory methods. Discussion: The ultimate goals of the study are to generate and disseminate actionable evidence of positive drivers, barriers, and activities that do not yield results with regard to increasing postpregnancy FP programmatic activities, and to institutionalize postpregnancy FP in the public and private sectors in Indonesia and Kenya. We hope these learnings and experience will contribute to global efforts to advance and scale up postpregnancy FP in similar settings beyond these two countries. Trial registration: ClinicalTrials.gov NCT03333473

Szasz, suicide, and medical ethics

Thomas Szasz ◽  
2019 ◽  
pp. 55-64
Author(s):  
George J. Annas
Keyword(s):  
Mental Illness ◽  
Informed Consent ◽  
Suicide Prevention ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
The Subject ◽  
The Right ◽  
Suicidal Patients ◽  
Commit Suicide

Szasz objected to the medicalization of suicide, the legalization of suicide prevention, and especially the coercive role of psychiatry in this realm. He declared that, by medicalizing suicide, we banish the subject from discussion. What is meant by acceptable and unacceptable “suicide”? Who has a right to commit suicide? How does suicide implicate freedom? Does it reflect abortion jurisprudence? How do psychiatrists become suicide’s gatekeepers? Current phenomena (e.g., new physician-assisted suicide legislation) illuminate these and other issues (e.g., euthanasia, informed consent, informed refusal, the “right to die,”), all suggesting how Szasz would react to each. Suicide is legal, but is almost always considered a result of mental illness. Courts approve psychiatrists who want to commit “suicidal” patients involuntarily. Granting physicians prospective legal immunity for prescribing lethal drugs is, at best, a strange and tangential reaction to our inability to discuss suicide (and dying) rationally. Szasz got it right.

How to increase the role of social workers in suicide preventive interventions

2020 ◽  
Vol 32 (4) ◽  
pp. 186-195
Author(s):  
Joshua Levine ◽  
Leo Sher
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Social Work ◽  
Social Workers ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Preventive Interventions ◽  
Suicide Risk Factors ◽  
Suicidal Patients

AbstractObjective:Suicide is a serious public health issue that affects individuals, families and societies all over the world. International studies provide consistent evidence that the presence of psychiatrists in a region is associated with lesser suicide rates. However, many psychiatric patients including suicidal patients do not have access to psychiatrists. This indicates that mental health and non-mental health social workers need to be involved in suicide prevention efforts. This paper is the first comprehensive work that discusses how to increase the role of social workers in the area of suicide prevention.Methods:A review of the relevant literature.Results:Increasing the role of social workers in suicide prevention efforts may reduce suicide risk in groups and people at elevated risk for suicide, as well as the general population.Conclusion:Recommendations are provided for how the social work profession can improve upon suicide prevention while incorporating universal, selective and indicated suicide preventive interventions. Social work research efforts should focus on how to increase the role of social workers in suicide prevention and the management of suicidal patients. Social work education programmes should modify their curricula and increase their attention on suicide prevention. Mental health social workers need to educate the patient and their family on suicide risk factors. Furthermore, mental health and non-mental health social workers need to educate the general public on suicide risk factors.

Retrospective analysis of reported suicide deaths and attempts on veterans health administration campuses and inpatient units

2020 ◽  
pp. bmjqs-2020-011312
Author(s):  
Peter D Mills ◽  
Christina Soncrant ◽  
William Gunnar
Keyword(s):  
Mental Health ◽  
Suicide Prevention ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Residential Units ◽  
Anchor Points ◽  
Suicidal Patients ◽  
Inpatient Units

IntroductionSuicide is the 10th leading cause of death in the USA. Inpatient suicide is the fourth most common sentinel event reported to the Joint Commission. This study reviewed root cause analysis (RCA) reports of suicide events by hospital unit to provide suicide prevention recommendations for each area.MethodsThis is a retrospective analysis of reported suicide deaths and attempts in the US Veterans Health Administration (VHA) hospitals. We searched the VHA National Center for Patient Safety RCA database for suicide deaths and attempts on inpatient units, outpatient clinics and hospital grounds, between December 1999 and December 2018.ResultsWe found 847 RCA reports of suicide attempts (n=758) and deaths (n=89) in VHA hospitals, hanging accounted for 71% of deaths on mental health units and 50% of deaths on medical units. Overdose accounted for 55% of deaths and 68% of attempts in residential units and the only method resulting in death in emergency departments. In VHA community living centres, hanging, overdose and asphyxiation accounted for 64% of deaths. Gunshot accounted for 59% of deaths on hospital grounds and 100% of deaths in clinic areas. All inpatient locations cited issues in assessment and treatment of suicidal patients and environmental risk evaluation.ConclusionsInpatient mental health and medical units should remove anchor points for hanging where possible. On residential units and emergency departments, assessing suicide risk, conducting thorough contraband searches and maintaining observation of suicidal patients is critical. In community living centres, suicidal patients should be under supervision in an environment free of anchor points, medications and means of asphyxiation. Suicide prevention on hospital grounds and outpatient clinics can be achieved through the control of firearms.

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