Building the foundation for comprehensive suicide prevention – based on intention and planning in a social–ecological context

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796019000659 ◽

2019 ◽

Vol 29 ◽

Author(s):

Eric D. Caine

Keyword(s):

Suicide Prevention ◽

Implementation Strategies ◽

Premature Mortality ◽

Key Populations ◽

Clinical Services ◽

Ecological Context ◽

Primary Interest ◽

Social Ecological ◽

Prevention Programmes ◽

Shared Culture

Abstract National suicide prevention programmes that have been successful in reducing rates or keeping them low have been intentional, with collective alignment of local, regional and national priorities. Prevention efforts must begin well before individuals become suicidal, complementing readily available clinical services that address the needs of acutely distressed persons. These efforts, which focus on the antecedent risks and vulnerabilities of key populations, have the potential to diminish premature mortality from multiple causes, even as reducing suicide is the outcome of primary interest. In this commentary, I consider four key challenges that must be confronted in order to develop effective, broadly reaching systemic strategies that, at once, can be adapted locally while being implemented nationally – challenges that are framed in a social–ecological context. They involve defining the scope of the problem, meeting essential data needs, developing and modelling measurable implementation strategies and building prevention efforts based on shared culture and values.

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Achieving Social and Ecological Outcomes in Collaborative Environmental Governance: Good Examples from Swedish Moose Management

Sustainability ◽

10.3390/su13042329 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2329

Author(s):

Sabrina Dressel ◽

Annelie Sjölander-Lindqvist ◽

Maria Johansson ◽

Göran Ericsson ◽

Camilla Sandström

Keyword(s):

Social Learning ◽

Environmental Governance ◽

Collaborative Governance ◽

Theory Of Change ◽

Ecological Context ◽

Discretionary Power ◽

Structured Interviews ◽

Resource Governance ◽

Social Ecological ◽

The Social

Collaborative governance approaches have been suggested as strategies to handle wicked environmental problems. Evaluations have found promising examples of effective natural resource governance, but also highlighted the importance of social-ecological context and institutional design. The aim of this study was to identify factors that contribute to the achievement of social and ecological sustainability within Swedish moose (Alces alces) management. In 2012, a multi-level collaborative governance regime was implemented to decrease conflicts among stakeholders. We carried out semi-structured interviews with six ‘good examples’ (i.e., Moose Management Groups that showed positive social and ecological outcomes). We found that ‘good examples’ collectively identified existing knowledge gaps and management challenges and used their discretionary power to develop procedural arrangements that are adapted to the social-ecological context, their theory of change, and attributes of local actors. This contributed to the creation of bridging social capital and principled engagement across governance levels. Thus, our results indicate the existence of higher-order social learning as well as a positive feedback from within-level collaboration dynamics to between-level collaboration. Furthermore, our study illustrates the importance of institutional flexibility to utilize the existing knowledge across stakeholder groups and to allow for adaptations based on the social learning process.

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Information and communication technology-based interventions for suicide prevention implemented in clinical settings: A scoping review protocol

10.31219/osf.io/7csgp ◽

2021 ◽

Author(s):

Hwayeon Danielle Shin ◽

Juveria Zaheer ◽

Terri Rodak ◽

John Torous ◽

Gillian Strudwick

Keyword(s):

Information And Communication Technology ◽

Suicide Prevention ◽

Communication Technology ◽

Scoping Review ◽

Implementation Strategies ◽

Mobile App ◽

Barriers And Facilitators ◽

Clinical Settings ◽

Scoping Reviews ◽

Information And Communication

IntroductionThere is a surplus of Information and Communication Technology (ICT)-based interventions for suicide prevention. However, it is unclear which of these ICT-based interventions for suicide prevention have been implemented in clinical settings. Furthermore, evidence shows that implementation strategies have often been mismatched to existing barriers. In response, the authors recognize the critical need for prospectively assessing the barriers and facilitators and then strategically developing implementation strategies. This review is part of a multi-phase project to develop and test tailored implementation strategies for mobile app-based suicide prevention in clinical settings. The overall objective of this scoping review is to identify and characterize ICT-based interventions for all levels of suicide prevention in clinical settings. Additionally, this review will identify and characterize the barriers and facilitators to implementing these ICT-based interventions as well as reported measures and outcomes. The findings will directly inform the subsequent phase to maximize implementation and inform future efforts for implementing other types of ICT-based interventions related to suicide prevention in clinical settings.Methods and analysis This review will adhere to the methods described by the Joanna Briggs Institute for conducting scoping reviews. The reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews checklist. The following databases will be searched: Medline, PsycInfo, Embase, CINAHL, Web of Science, and LISTA. Two reviewers will independently screen the articles and extract data using a standardised data collection tool. Then, authors will characterize extracted data using frameworks, typology, and taxonomies to address the proposed review questions. Ethics and disseminationEthics approval is not required for this scoping review. Authors will share the results in a peer-reviewed, open access publication, and conference presentations. Furthermore, the findings will be shared with relevant health organizations through lay language summaries and informal presentations.

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Let's talk about suicide: Primary prevention programmes focusing on youth, elderly and media

European Psychiatry ◽

10.1016/s0924-9338(11)73354-5 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1650-1650

Author(s):

A. Tančič Grum ◽

V. Poštuvan ◽

S. Roškar

Keyword(s):

School Counselors ◽

Suicide Prevention ◽

Suicide Rate ◽

Elderly Population ◽

Risk Groups ◽

Family Doctors ◽

Suicidal Person ◽

Prevention Programmes ◽

Practical Guidelines ◽

Very High

IntroductionSlovenia is a country with a very high suicide rate. Unfortunately, there is a lack of primary suicide prevention programmes.ObjectivesOur main objective was to develop suicide prevention programmes, which would decrease suicide rate in Slovenia. We would achieve that by increasing awareness and knowledge of different professionals, who address or come in contact with the most vulnerable risk groups.MethodsFirstly we identified school counselors, family doctors and media as professionals to target. School counselors have an important gatekeeper’s role in youth suicide prevention and family doctors are of a similar importance for elderly population. Besides, media has a significant influence on any at-risk person regarding suicide prevention. Secondly, we prepared manuals with practical guidelines: for school counselors - how to recognize and deal with suicidal youth, for family doctors - how to recognize and treat depression and suicidal behavior among elderly, and for media representatives - how to responsibly report about suicide. Lastly, we performed 1-day workshops for all gatekeepers’ groups covering the contents of the manuals.ResultsAll the initiatives received highly positive expert-reviews and a lot of encouraging feedbacks from participants. An evaluation with pre-post questionnaire showed that participants’ feelings of competency in dealing with suicidal person have improved after the involvement in programmes’ workshops and reading the manuals.ConclusionsExperiences showed that primary suicide prevention programmes are highly appreciated and we believe that is necessary to continue and deepen the work in this area also in the future.

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Suicide

Landmark Papers in Psychiatry ◽

10.1093/med/9780198836506.003.0022 ◽

2020 ◽

pp. 363-380

Author(s):

Danuta Wasserman ◽

Marcus Sokolowski ◽

Vladimir Carli

Keyword(s):

Suicide Prevention ◽

Cause Of Death ◽

Suicidal Behaviour ◽

Physician Education ◽

Future Research ◽

Evidence Based ◽

Prevention Strategies ◽

Iatrogenic Effects ◽

School Based ◽

Prevention Programmes

Suicide is a leading cause of death and is preventable. This chapter identifies landmark papers from three areas within the field of suicide prevention that are important for trainees, experienced clinicians, and policymakers alike. Firstly, it reviews papers on evidence-based suicide prevention strategies. Physician education, pharmacological and psychotherapy treatments, school-based suicide prevention programmes, and means of suicide restriction are found to be effective in preventing suicidal behaviours. Suicide prevention strategies that require further research on efficacy are identified, along with directions for future research. Secondly, several papers are analysed providing evidence that talking about suicide does not cause iatrogenic effects. Suicide research and prevention should not be hindered due to unsubstantiated concerns. Lastly, a paper discussing the genetics of suicidal behaviour provides an understanding of the diathesis of suicide. These landmark papers highlight the importance of suicide prevention and inform future research.

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Analysing regional unemployment rates, GDP per capita and financial support for regional suicide prevention programme on suicide mortality in Japan using governmental statistical data

BMJ Open ◽

10.1136/bmjopen-2020-037537 ◽

2020 ◽

Vol 10 (8) ◽

pp. e037537

Author(s):

Motohiro Okada ◽

Toshiki Hasegawa ◽

Ryo Kato ◽

Takashi Shiroyama

Keyword(s):

Suicide Prevention ◽

Financial Support ◽

Gdp Per Capita ◽

Prevention Programme ◽

Suicide Mortality ◽

Intervention Model ◽

Unemployment Rates ◽

Female Suicide ◽

Prevention Programmes ◽

Per Capita

ObjectivesTo explore the mechanisms of reduced suicide mortality in Japan, which decreased from 25.7 to 16.5 per 100 000 people following the comprehensive suicide prevention programme from 2009 to 2018, the present study determined the relationship between regional suicide mortality, socioeconomic data (GDP per capita, unemployment rates) and financial support for regional suicide prevention programmes.Design and settingStepwise multiple regression analysis was used to determine the effects of regional GDP per capita, unemployment rates and implementation amount of financial support for regional suicide prevention programmes (Emergency Fund to Enhance Community-Based Suicide Countermeasures—EFECBSC) on age and gender disaggregated suicide mortalities in Japan between 2009 and 2018. Data on each prefecture’s complete unemployment rates, GDP per capita and implementation amount of EFECBSC sub-divisions were derived from an official Japanese governmental database.ResultsBoth prefectural enlightenment and intervention model programmes were found to lead to a decrease in male suicide mortality, but were less effective in reducing female suicide mortality. Municipal enlightenment and intervention model programmes were also less effective in reducing suicide mortality. Municipal development programmes for listener and leader led to a greater decrease in suicide mortality for both men and women compared with such programmes at the prefectural level. Contrary to our expectations, reduced complete unemployment rate only reduced suicide mortality in the older male population without affecting female suicide mortality.ConclusionThe study findings suggest an inverse relationship between financial support and suicide mortality in Japan. Furthermore, independent factors in the reduction of suicide mortality rates provide important information for planning evidence-based and cost-effective regional suicide prevention programmes.

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College suicide prevention programmes are most effective when they incorporate students’ sense of coherence and connectedness in their design

Evidence-Based Nursing ◽

10.1136/ebnurs-2019-103173 ◽

2020 ◽

Vol 24 (1) ◽

pp. 8-8

Author(s):

Akhtar Ebrahimi Ghassemi

Keyword(s):

Suicide Prevention ◽

Sense Of Coherence ◽

Prevention Programmes

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The social–ecological context of media use and school success

Jornal de Pediatria ◽

10.1016/j.jped.2015.04.001 ◽

2015 ◽

Vol 91 (4) ◽

pp. 318-319 ◽

Cited By ~ 1

Author(s):

Jenny S. Radesky

Keyword(s):

School Success ◽

Media Use ◽

Ecological Context ◽

Social Ecological ◽

The Social

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Tackling wicked problems in strategic management with systems thinking

Strategic Organization ◽

10.1177/14761270211038635 ◽

2021 ◽

pp. 147612702110386

Author(s):

Sylvia Grewatsch ◽

Steve Kennedy ◽

Pratima (Tima) Bansal

Keyword(s):

Systems Thinking ◽

Evolutionary Dynamics ◽

Environmental Issues ◽

Wicked Problems ◽

Tipping Points ◽

Transformative Change ◽

Ecological Context ◽

Strategy Research ◽

Social Ecological ◽

Reductionist Approach

Strategy scholars are increasingly attempting to tackle complex global social and environmental issues (i.e. wicked problems); yet, many strategy scholars approach these wicked problems in the same way they approach business problems—by building causal models that seek to optimize some form of organizational success. Strategy scholars seek to reduce complexity, focusing on the significant variables that explain the salient outcomes. This approach to wicked problems, ironically, divorces firms from the very social-ecological context that makes the problem “wicked.” In this essay, we argue that strategy research into wicked problems can benefit from systems thinking, which deviates radically from the reductionist approach to analysis taken by many strategy scholars. We review some of the basic tenets of systems thinking and describe their differences from reductionist thinking. Furthermore, we ask strategy scholars to widen their theoretical lens by (1) investigating co-evolutionary dynamics rather than focusing primarily on static models, (2) advancing processual insights rather than favoring causal identification, and (3) recognizing tipping points and transformative change rather than assuming linear monotonic changes.

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Suicide prevention: the evidence on safer clinical care is now good and should be adopted internationally

International Psychiatry ◽

10.1192/s1749367600003015 ◽

2012 ◽

Vol 9 (2) ◽

pp. 27-29

Author(s):

Louis Appleby

Keyword(s):

Mental Health ◽

Suicide Prevention ◽

Clinical Care ◽

Public Consultation ◽

Health Policies ◽

Economic Downturn ◽

Clinical Services ◽

International Evidence ◽

Mental Health Patients ◽

Clinical Phenomenon

The global economic downturn seems to be associated with a rise in suicide rates in many countries but we should not assume that this is a social rather than a clinical phenomenon. Mental health patients may be particularly vulnerable to unemployment and other hardships and to cuts in the care they receive. There is now no shortage of evidence on how clinical services and health policies can reduce suicide, and in England a new suicide prevention strategy was recently launched for public consultation. What we lack is an effective forum where a rigorous examination of international evidence can take place, with the findings translated into actions.

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