Preventing Elderly Suicide Through Primary Care by Community-Based Screening for Depression in Rural Japan

Crisis ◽  
2006 ◽  
Vol 27 (2) ◽  
pp. 58-65 ◽  
Author(s):  
Hirofumi Oyama ◽  
Masahiro Goto ◽  
Motoi Fujita ◽  
Hiroshi Shibuya ◽  
Tomoe Sakashita
Keyword(s):  
Primary Care ◽  
Suicide Rate ◽  
Suicide Risk ◽  
Community Intervention ◽  
Reference Group ◽  
The Elderly ◽  
Community Based Interventions ◽  
Community Based ◽  
Intervention Area ◽  
Elderly Suicide

Depression is a major cause of suicide among the elderly. Few previous community-based interventions against depression have reduced the suicide rate. This study aims to evaluate outcomes of a community-based program to prevent suicide among the elderly using a quasi-experimental design with a neighboring reference group. The program, including depression screening with follow-up and health education through primary care and public health nursing, was implemented for 10 years in Matsudai town, a rural area of Japan (population 6,015; suicide rate per 105 [≥65-year-olds] for males 290.6, and for females 361.3). Changes in the suicide risk were estimated by the incidence rate ratio (IRR). The female risk of completing suicide in the intervention area was reduced by 70% (age-adjusted IRR: 0.30; 95% CI: 0.14-0.67), while there was no change in the risk for males in the intervention area nor for males or females in the reference area (Kawanishi town: population 9,425; elderly suicide rate for males 212.2, females 151.9). A ratio of the female IRR in the intervention area to that in its prefecture was also estimated at 0.45 (95% CI: 0.19-0.97), showing that the reduction of suicide risk in the intervention area was greater than the historical trend. A community intervention against suicide using management of depression with nonpsychiatric, primary health care would be effective for elderly females, but not males.

scholarly journals Reducing unscheduled hospital care for adults with diabetes following a hypoglycaemic event: which community-based interventions are most effective? A systematic review

2021 ◽  
Author(s):  
Aoife Watson ◽  
Donna McConnell ◽  
Vivien Coates
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Integrated Care ◽  
Hospital Care ◽  
Hospital Admissions ◽  
Community Based Interventions ◽  
Community Based ◽  
Integrated Care Pathways ◽  
Effective Community ◽  
Balance Of Care

Abstract Aim To determine which community-based interventions are most effective at reducing unscheduled hospital care for hypoglycaemic events in adults with diabetes. Methods Medline Ovid, CINAHL Plus and ProQuest Health and Medical Collection were searched using both key search terms and medical subject heading terms (MeSH) to identify potentially relevant studies. Eligible studies were those that involved a community-based intervention to reduce unscheduled admissions in adults with diabetes. Papers were initially screened by the primary researcher and then a secondary reviewer. Relevant data were then extracted from papers that met the inclusion criteria. Results The search produced 2226 results, with 1360 duplicates. Of the remaining 866 papers, 198 were deemed appropriate based on titles, 90 were excluded following abstract review. A total of 108 full papers were screened with 19 full papers included in the review. The sample size of the 19 papers ranged from n = 25 to n = 104,000. The average ages within the studies ranged from 41 to 74 years with females comprising 57% of the participants. The following community-based interventions were identified that explored reducing unscheduled hospital care in people with diabetes; telemedicine, education, integrated care pathways, enhanced primary care and care management teams. Conclusions This systematic review shows that a range of community-based interventions, requiring different levels of infrastructure, are effective in reducing unscheduled hospital care for hypoglycaemia in people with diabetes. Investment in effective community-based interventions such as integrated care and patient education must be a priority to shift the balance of care from secondary to primary care, thereby reducing hospital admissions.

scholarly journals The 4-Level Approach: Prevention of Suicidal Behaviour Through Community-Based Intervention

2021 ◽  
Vol 12 ◽  
Author(s):  
Ulrich Hegerl ◽  
Ines Heinz ◽  
Ainslie O'Connor ◽  
Hannah Reich
Keyword(s):  
Public Health ◽  
Primary Care ◽  
High Risk ◽  
Suicidal Behaviour ◽  
Lessons Learned ◽  
Community Based Interventions ◽  
Community Based ◽  
Four Levels ◽  
The Many ◽  
Different Levels

Due to the many different factors contributing to diagnostic and therapeutic deficits concerning depression and the risk of suicidal behaviour, community-based interventions combining different measures are considered the most efficient way to address these important areas of public health. The network of the European Alliance Against Depression has implemented in more than 120 regions within and outside of Europe community-based 4-level-interventions that combine activities at four levels: (i) primary care, (ii) general public, (iii) community facilitators and gatekeepers (e.g., police, journalists, caregivers, pharmacists, and teachers), and (iv) patients, individuals at high risk and their relatives. This review will discuss lessons learned from these broad implementation activities. These include targeting depression and suicidal behaviour within one approach; being simultaneously active on the four different levels; promoting bottom-up initiatives; and avoiding any cooperation with the pharmaceutical industry for reasons of credibility.

Sociodemographic and clinical profile in elderly suicide victims: 34 autopsy case studies

2017 ◽  
Vol 41 (S1) ◽  
pp. s887-s887
Author(s):  
S. Ellouze ◽  
I. Baati ◽  
W. Ben Amar ◽  
D. Trigui ◽  
W. Abbes ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Suicide Risk ◽  
Public Health Problem ◽  
The Elderly ◽  
University Hospital ◽  
Major Public Health Problem ◽  
Treatment Of Depression ◽  
Competing Interest ◽  
Elderly Suicide

IntroductionThe elderly suicide is a major public health problem that is gaining more and more ground, given the aging population problem. This has rarely been the subject of forensic studies in Tunisia.ObjectivesTo identify the sociodemographic and clinical characteristics of elderly suicide victims over 60 years and to determine what factors might increase suicide risk in this population.MethodsWe conducted a retrospective study on suicide victims aged 60 and over, autopsied in forensic medicine department of the Habib Bourguiba university hospital in Sfax (Tunisia), on a 10-year period (January 2006–December 2015).ResultsWe identified 34 cases with an average age of 66 years. The sex ratio was 2.77. Suicide victims were alone in 38.2% of cases. They were inactive professionally in 32.4% of cases. Almost half of them (44.1%) had a psychiatric history, 40% of depressed pace, 26.7% of bipolar disorder and 13.3% of schizophrenia.Three main factors were identified as precipitating the passage to suicidal act: family conflicts (26.5%), financial difficulties (11.8%) and loss of autonomy (5.9%).Suicide methods were hanging (50%), immolation and drug intoxication (11.8%), hit by train and poisoning (8.8%), jumping from height (5.9%) and drowning (2.9%). In 55.8% of cases, suicide took place at home.ConclusionElderly suicide seems to be a huge but largely preventable public health problem. Its prevention is essentially based on the identification of risk situations and the detection and treatment of depression: major suicide risk factor in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Low testosterone levels in aging men may mediate the observed increase in suicide in this age group

2017 ◽  
Vol 16 (1) ◽  
pp. 123-123 ◽  
Author(s):  
Timothy R. Rice ◽  
Leo Sher
Keyword(s):  
Suicide Risk ◽  
The Elderly ◽  
Older Men ◽  
Protective Effects ◽  
Aging Men ◽  
Low Testosterone ◽  
Reward Pathways ◽  
Elderly Suicide ◽  
Mixed Age

Abstract This short communication suggests that there may be biological in addition to psychosocial reasons underlying the rise in suicide among older men. Testosterone, the major male sex hormone, has attracted interest as a putative biological mediator of suicide risk, but observational data have been mixed. Age stratification may reveal that high levels of testosterone in adolescents and young adults but low levels in the elderly may mediate suicide risk. A putative age-testosterone-suicide differential may be mediated by divergent central nervous system architecture between adolescents and the elderly. Whereas the prefrontal and prefontal-limbic connectivity underdevelopment observed in adolescents may render vulnerability to testosterone-mediated increases in impulsivity as a risk factor for suicide, declining function of dopaminergic striato-thalamic reward pathways in the aging cohort may render older men vulnerable to the loss of testosterone’s protective effects against anhedonia, thereby increasing suicide risk through a different biological pathway. Further research is needed regarding the role of hypotestosteronemia in elderly suicide.

Landscape of Elderly Suicide in South Korea: Its Trend According to Age, Gender, and Educational Attainment

2018 ◽  
Vol 82 (2) ◽  
pp. 214-229 ◽  
Author(s):  
J. W. Kim ◽  
H. Y. Jung ◽  
D. Y. Won ◽  
Y. S. Shin ◽  
J. H. Noh ◽  
...  
Keyword(s):  
South Korea ◽  
Educational Attainment ◽  
Social Services ◽  
Suicide Rate ◽  
Cultural Context ◽  
Suicide Risk ◽  
Male Suicide ◽  
The Social ◽  
Elderly Suicide ◽  
Suicide Prevention Programs

South Korea has one of the highest suicide rates in the world, and the most alarming suicide rate is among its elders. This study aims to understand the social, historical, and cultural context of the Korean older adults and examine suicide trends based on that understanding. The results show that the suicide risk increases with age, the male suicide rate outweighs that of females, and the suicide rate decreases with educational attainment. In addition, several suggestions for reducing elderly suicide rate are addressed, including differentiating the existing social services for elders by age and expanding suicide prevention programs beyond schools to communities so that all people in need can access them.

SAFER brief community intervention: a primary suicide prevention strategy to improve firearm and medication storage behaviour

2020 ◽  
pp. injuryprev-2020-043902
Author(s):  
Jennifer Paige Stuber ◽  
Anne Massey ◽  
Morgan Meadows ◽  
Brett Bass ◽  
Ali Rowhani-Rahbar
Keyword(s):  
Suicide Prevention ◽  
Brief Intervention ◽  
Military Service ◽  
Community Intervention ◽  
Intervention Strategy ◽  
Elevated Risk ◽  
Community Based Interventions ◽  
Community Based ◽  
Safe Medication ◽  
Medication Storage

ObjectiveTo determine if a brief intervention, called Signpost, Assess, Facts, Emotion, Recommend (SAFER), designed to motivate changes in behaviour to secure firearms and medications to prevent future suicide is feasible to implement in community-based settings such as gun shows, acceptable to participants at higher risk for suicide including veterans and men in the middles years (35–64) and improves firearm and medication locking behaviours.Methods1175 people received SAFER over a 12-month period at 18 gun shows and community events in 2019 and completed a preassessment measuring firearms ownership, storage practices, knowledge about suicide as the leading type of firearm fatality and attitudes about suicide prevention. 372 responded to a brief postassessment using comparable measures.Results85% of participants reported keeping firearms at home. 43.7% reported current or prior military service. 53.2% were males between the ages of 35 and 64. Among those who responded to the postassessment, 61% of participants reported SAFER to be highly valuable. Safe firearms storage improved among participants who completed the preassessment and postassessment (51.2% pre, 66.0% post; p<0.01) as did safe medication storage (14.8% pre, 21.6% post; p=0.01). Knowledge that most firearm fatalities are suicides (33.4% pre, 45.8% post; p<0.01) also improved.ConclusionsIt is feasible, acceptable and effective to reach groups at elevated risk for suicide using a brief intervention strategy in unconventional settings. Community-based interventions to improve safe storage motivated by suicide prevention messaging should be prioritised because men in the middle years are less likely to use mental health services.

Community-based suicide prevention through group activity for the elderly successfully reduced the high suicide rate for females

2005 ◽  
Vol 59 (3) ◽  
pp. 337-344 ◽  
Author(s):  
HIROFUMI OYAMA ◽  
NAOKI WATANABE ◽  
YUTAKA ONO ◽  
TOMOE SAKASHITA ◽  
YUKA TAKENOSHITA ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Suicide Rate ◽  
The Elderly ◽  
Group Activity ◽  
Community Based ◽  
High Suicide Rate

Community Interventions: A Brief Overview and Their Application to the Obesity Epidemic

2007 ◽  
Vol 35 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Christina D. Economos ◽  
Sonya Irish-Hauser
Keyword(s):  
Ecological Model ◽  
Community Intervention ◽  
Economic Status ◽  
Community Interventions ◽  
Community Based Interventions ◽  
Community Based ◽  
Community Based Research ◽  
Research Perspective ◽  
Obesity Epidemic ◽  
Group Memberships

Defining community from a research perspective is difficult. Communities consist of environmental, social, and geographic components. In addition, race, ethnicity, socio-economic status (SES), and group memberships often play roles in community identity. Barry Wellman and Scot Wortley urge that to truly understand and influence a community, and most certainly to conduct research within communities, one must take into account the varied nature of relationships and networks and how they may work together synergistically to meet the needs of community members. Using the Social Ecological Model, with its delineation of multiple spheres of influence (individual-interpersonal-organizational-community-public policy), community-based research has attempted to reach this understanding. Although dramatic shifts have not yet been realized, many studies suggest improved health behaviors and healthy environments, which indicate a promising future for community intervention work. The discussion that follows reviews the theory and rationale for community-based interventions, the socialecological approach to understanding and studying obesity, and the progress and promise of community interventions.

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