Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland

2001 ◽  
Vol 31 (7) ◽  
pp. 1181-1191 ◽  
Author(s):  
WEN-HUNG KUO ◽  
J. J. GALLO ◽  
A. Y. TIEN
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Disorders ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
Community Sample ◽  
Suicide Behaviour

Background. Utilizing a prospectively designed community sample, we set out to estimate the rate of newly-incident suicidal ideation and attempts (non-fatal suicide behaviour) in a community sample, to evaluate antecedent sociodemographic characteristics and psychiatric disorders, and to assess use of mental health services in relation to non-fatal suicide behaviour.Method. Prospectively-gathered data was utilized from 3481 continuing participants in the 13-year follow-up of the Baltimore sample of the NIMH Epidemiologic Catchment Area survey interviewed in 1981, 1982 and 1993/6.Results. The incidence of suicide attempts was estimated at 148·8 per 100000 person-years and ideation at 419·9 per 100000 person-years. Persons in the youngest age group, in the lowest socio-economic status, and previously married persons were at increased risk for non-fatal suicide behaviour during the follow-up interval. Persons who reported suicidal ideation at baseline were more likely to report having attempted suicide at follow-up (RR = 6·09, 95% CI 2·58–14·36). Psychiatric disorders, especially depression and substance abuse, were associated with new-onset of non-fatal suicidal behaviour. While persons who reported newly-incident suicidal behaviour were more likely to report use of mental health services, few said that suicidal ideation or attempts were the reason for the visits.Conclusions. Suicidal ideation is a common and important antecedent to suicide attempts and deserves more attention in community and general medical settings.

Suicidal Ideation and Behaviours among University Students in Australia

1995 ◽  
Vol 29 (3) ◽  
pp. 473-479 ◽  
Author(s):  
Robert Schweitzer ◽  
John McLean ◽  
Michael Klayich
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
University Students ◽  
Undergraduate Students ◽  
Living Arrangements ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Demographic Variables

Objective: The aim of the study was to investigate the prevalence and demographic correlates of suicidal ideation and behaviours among university students in Australia and the utilisation of mental health services by this population. Method: Suicidal ideation and behaviours and demographic variables were assessed in a population of 1,678 undergraduate students by use of a modified Suicide Ideation Scale (SIS) and questionnaire. Results: Sixty two percent of students surveyed showed some suicidal ideation and 6.6% reported one or more suicide attempts. Over half of the group who reported suicide attempts did not use any type of mental health services. Suicidal ideation was found to be highly correlated with previous use of mental health services. In examining the relationship between suicidal ideation (SI) and demographic variables, SI was not significantly different for gender or parental marital status but was related to living arrangements, racial groups, religious affiliation and father's education. Conclusions: The results suggest that a higher proportion of students reported suicidal ideation and behaviours than that documented in related studies undertaken in the USA. While these findings draw attention to a higher level of suicidal ideation in students who utilise mental health assistance, more than half of those who reported suicide attempts did not use any kind of mental health service. The study has particular implications for detecting and assisting young people with a high suicide risk within the university environment.

An examination of suicidal behaviour among veterans receiving mental-health appointments in person versus clinical video telehealth

2020 ◽  
pp. 1357633X2094204
Author(s):  
Sasha M Rojas ◽  
Marilyn L Piccirillo ◽  
Russell A McCann ◽  
Mark A Reger ◽  
Bradford Felker
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Treatment Modality ◽  
Improvement Project ◽  
National Leader ◽  
Suicide Behaviour ◽  
Va Health Care System ◽  
Observation Period

Introduction The US Department of Veterans Affairs (VA) is a national leader in the implementation of clinical video telehealth (CVT) services. Despite the growth of mental-health services offered via CVT, it is unclear to what extent these services are offered and accessed by veterans with previous suicidal behaviour. Methods The current quality improvement project examined this question within a local VA health-care system using data from suicide behaviour reports (SBRs), the Veteran Health Administration’s official reporting and surveillance system. The frequency of SBRs was compared during two different time points among veterans who received individual mental-health appointments in person only or via CVT during the 2017 calendar year. Among veterans with a SBR, time in days elapsed from their first mental-health appointment to a SBR was examined as a function of treatment modality. Results Results indicated veterans who received in-person treatment only were more likely to present with a SBR six months prior to their first mental-health appointment compared to those who received CVT during the observation period. There were no differences in SBRs during the 12 months after the first appointment or the time from the first appointment to the SBR as a function of treatment modality used. Discussion Although veterans who received in-person mental-health services were more likely to have had a SBR six months prior to treatment, suicide risk throughout the observation period did not differ between groups. Clinical implications that arise from these findings are described in the discussion.

Transdiagnostic versus Diagnosis-Specific Group Cognitive Behavioral Therapy for Anxiety Disorders and Depression: A Randomized Controlled Trial

2021 ◽  
pp. 1-14
Author(s):  
Nina Reinholt ◽  
Morten Hvenegaard ◽  
Anne Bryde Christensen ◽  
Anita Eskildsen ◽  
Carsten Hjorthøj ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
Major Depressive ◽  
Outpatient Mental Health ◽  
End Of Treatment

<b><i>Introduction:</i></b> The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments. <b><i>Objective:</i></b> This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services. <b><i>Methods:</i></b> In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. The primary test was non-inferiority, using a priori criteria, on the World Health Organisation 5 Well-Being Index (WHO-5) at the end of the treatment. Secondary outcomes were functioning and symptoms. We assessed outcomes at baseline, end-of-treatment, and at a 6-month follow-up. A modified per-protocol analysis was performed. <b><i>Results:</i></b> At end-of-treatment, WHO-5 mean scores for patients in UP (<i>n</i> = 148) were non-inferior to those of patients in dCBT (<i>n</i> = 143; mean difference –2.94; 95% CI –8.10 to 2.21). Results were inconclusive for the WHO-5 at the 6-month follow-up. Results for secondary outcomes were non-inferior at end-of-treatment and the 6-month follow-up. Client satisfaction and rates of attrition, response, remission, and deterioration were similar across conditions. <b><i>Conclusions:</i></b> This RCT demonstrated non-inferior acute-phase outcomes of group-delivered UP compared with dCBT for major depressive disorder, social anxiety disorder, panic disorder, and agoraphobia in outpatient mental health services. The long-term effects of UP on well-being need further investigation. If study findings are replicated, UP should be considered a viable alternative to dCBT for common anxiety disorders and depression in outpatient mental health services.

Simple versus Complex Conduct Disorders: Identification and Phenomenology

1994 ◽  
Vol 19 (4) ◽  
pp. 306-312 ◽  
Author(s):  
Mary Margaret Kerr ◽  
Steven R. Forness ◽  
Kenneth A. Kavale ◽  
Bryan H. King ◽  
Connie Kasari
Keyword(s):  
Mental Health ◽  
Special Education ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Disorders ◽  
Disruptive Behavior ◽  
Mental Health Treatment ◽  
Conduct Disorders ◽  
Health Treatment ◽  
Versus Complex

Children with conduct disorders are among the most frequent referrals for psychiatric or other mental health treatment; yet the diagnosis of conduct disorders is also frequently seen as a reason to exclude children or youth from special education and related mental health services. This article highlights the possibility that associated with conduct disorders or its symptoms may be a variety of other psychiatric disorders requiring very different interventions. Extrapolation of symptoms from classroom inattention or disruptive behavior and estimated prevalence are discussed.

scholarly journals The impact of strengthening mental health services to prevent suicidal behaviour

2018 ◽  
Vol 53 (7) ◽  
pp. 642-650 ◽  
Author(s):  
Jo-An Atkinson ◽  
Andrew Page ◽  
Mark Heffernan ◽  
Geoff McDonnell ◽  
Ante Prodan ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Attempted Suicide ◽  
Service Capacity ◽  
Forecast Period ◽  
Hospital Staffing

Objective: Successive suicide prevention frameworks and action plans in Australia and internationally have called for improvements to mental health services and enhancement of workforce capacity. However, there is debate regarding the priorities for resource allocation and the optimal combination of mental health services to best prevent suicidal behaviour. This study investigates the potential impacts of service capacity improvements on the incidence of suicidal behaviour in the Australian context. Methods: A system dynamics model was developed to investigate the optimal combination of (1) secondary (acute) mental health service capacity, (2) non-secondary (non-acute) mental health service capacity and (3) resources to re-engage those lost to services on the incidence of suicidal behaviour over the period 2018–2028 for the Greater Western Sydney (Australia) population catchment. The model captured population and behavioural dynamics and mental health service referral pathways and was validated using population survey and administrative data, evidence syntheses and an expert stakeholder group. Results: Findings suggest that 28% of attempted suicide and 29% of suicides could be averted over the forecast period based on a combination of increases in (1) hospital staffing (with training in trauma-informed care), (2) non-secondary health service capacity, (3) expansion of mental health assessment capacity and (4) re-engagement of at least 45% of individuals lost to services. Reduction in the number of available psychiatric beds by 15% had no substantial impact on the incidence of attempted suicide and suicide over the forecast period. Conclusion: This study suggests that more than one-quarter of suicides and attempted suicides in the Greater Western Sydney population catchment could potentially be averted with a combination of increases to hospital staffing and non-secondary (non-acute) mental health care. Reductions in tertiary care services (e.g. psychiatric hospital beds) in combination with these increases would not adversely affect subsequent incidence of suicidal behaviour.

scholarly journals Are we training psychiatrists to develop skills in intellectual disability psychiatry? Current European context and future directions

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Marisa Casanova Dias ◽  
Bhathika Perera ◽  
Florian Riese ◽  
Livia De Picker ◽  
Mariana Pinto da Costa ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Psychiatric Disorders ◽  
Psychiatric Training ◽  
Future Directions ◽  
Education And Health ◽  
People With Intellectual Disabilities

Abstract The majority of people with intellectual disabilities (ID) and psychiatric disorders access mainstream mental health services across Europe. However, only 56% of countries provide postgraduate psychiatric training in ID according to a survey across 42 European countries. We explore the challenges of ID training and make recommendations for education and health policymakers.

A Twelve Month Follow-Up Study of Psychogeriatric Admissions to Mental Health Services and Geriatric Service Hospitals

1970 ◽  
Vol 4 (3) ◽  
pp. 131-136 ◽  
Author(s):  
P. W. Burvill
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Western Australia ◽  
Hospital Admissions ◽  
Public Health Department ◽  
Home Setting ◽  
Geriatric Service ◽  
Psychogeriatric Patients

Eighty-five (100 per cent) consecutive psychogeriatric patients admitted to the Public Health Department Geriatric Service of Western Australia and eighty (94 per cent) of the original 85 psychogeriatric patients admitted to the Mental Health Services of Western Australia were re-examined by the author 12 months after admission. Twenty-five Geriatric Service patients had died, 19 were alive in the community, and 41 alive in hospital; the corresponding Mental Health Services figures were 15, 33 and 32. Differences in movement pattern and outcome between the two services, and between mental hospital admissions in the United Kingdom and Western Australia, were documented. There was a considerable number of repeated transfers from one hospital or nursing home setting to another during the 12 months among those patients living in hospital at follow-up, and to a less extent among those who died. Outcome of the patients was related to a number of factors for each service.

Unemployment and the rate of new contacts with mental health services in South London

2016 ◽  
Vol 33 (S1) ◽  
pp. S173-S174
Author(s):  
V. Bhavsar ◽  
M. Hotopf ◽  
J. Boydell ◽  
S. Hatch ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Survey Data ◽  
Survival Data ◽  
Illicit Drugs ◽  
Suicide Attempts ◽  
Mental Health Problems ◽  
Cox Regression ◽  
First Contact

IntroductionUnemployment is a risk factor for later development of mental health problems, but characterisation of this in real world clinical data is limited. This study aimed to investigate the association between employment status and time-to-first-contact with mental health services using survey data linked to electronic health records(EHR).MethodsSELCoH (n = 1698, 2008–2010) was a representative population survey of South East London, with a 71.9% household participation rate. Anonymised survey data for participants was linked with EHR, generating survival data for time-to-first-contact. Cox regression was used to assess associations between unemployment and time to first contact with mental health services.ResultsThe rate in the unemployed was 22.84 contacts per 1000 person-years, and in those not unemployed, it was 10 contacts per 1000 person-years. The crude (age-adjusted) hazard ratio (HR) for unemployment was 3.09 (95% CI: 1.66–5.75). The HR for contact for unemployment, after adjusting for age, gender, ethnicity and education, was 2.8 (95% CI: 1.44–5.47). On addition of symptoms of common mental disorder, post-traumatic stress, psychosis and suicide attempts, to the model, unemployed participants remained at elevated risk (HR:2.65, 95% CI: 1.33–5.27). Finally, illicit drugs and alcohol had minimal influence on estimates, giving a fully-adjusted estimate for the association between unemployment and rate of contact of 2.6 (95% CI: 1.31–5.14).ConclusionsUnemployment was associated with a greater than two-fold increase in risk of accessing mental health care for the first time within the observation time, after adjustment for sociodemographic confounders, psychopathology, and substance use. Explanations for this association could include unobserved confounding, health behaviours associated with unemployment or effects of unemployment on stress processing.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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