Is Case Management Effective for Long-Lasting Suicide Prevention?

Crisis ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 194-201 ◽  
Author(s):  
Liang-Jen Wang ◽  
Ya-Wen Wu ◽  
Chih-Ken Chen
Keyword(s):  
Case Management ◽  
Suicide Prevention ◽  
Suicide Attempts ◽  
Suicide Survivors ◽  
Suicide Rates ◽  
Study Results ◽  
Long Term Follow Up ◽  
Self Harm ◽  
Prevention Center ◽  
Management Services

Abstract. Background: Case management services have been implemented in suicide prevention programs. Aims: To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. Method: The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Results: Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Conclusion: Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.

Near-Fatal Self-Harm Among Canadian Adolescents

2021 ◽  
pp. 070674372110586
Author(s):  
Rachel HB Mitchell ◽  
Cornelius Ani ◽  
Claude Cyr ◽  
James Irvine ◽  
Ari R Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Prevention ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Case Definition ◽  
Surveillance Program ◽  
Female Age ◽  
Prevention Interventions ◽  
Working Age ◽  
Self Harm

Objective To evaluate the clinical features of Canadian adolescents admitted to the intensive care unit (ICU) for medically serious self-harm. Methods 2700 Canadian paediatricians were surveyed monthly over two years (January 2017 to December 2018) through the Canadian Paediatric Surveillance Program to ascertain data from eligible cases. Results Ninety-three cases (73 female; age 15.2 ± 1.5) met the case definition. Four provinces reported the majority of cases: Quebec (n = 27), Ontario (n = 26), Alberta (n = 21), and British Columbia (n = 8). There were 10 deaths, 9 by hanging. Overdose and hanging were the most frequently reported methods of self-harm (74.2% and 19.4%, respectively). Overdose was more common in females (80.8% females vs. 50% males; χ2 = 7.8 (1), p = .005), whereas hanging was more common in males (35% males vs. 15.1% females, χ2 = 3.9 (1), p = .04). More females than males had a past psychiatric diagnosis (79% vs. 58%; χ2 = 4.1 (1), p = .06), a previous suicide attempt (55.9% vs. 29.4%, χ2 = 3.8 (1), p = .05), and prior use of mental health service (69.7% vs. 27.8%, χ2 = 10.4 (1), p = .001). Family conflict was the most commonly identified precipitating factor (43%) of self-harm. Conclusions Among Canadian adolescents admitted to the ICU with medically serious self-harm, females demonstrate a higher rate of suicide attempts and prior mental health care engagement, whereas males are more likely to die by suicide. These findings are consistent with data from other adolescent samples, as well as data from working-age and older adults. Therefore, a sex-specific approach to suicide prevention is warranted as part of a national suicide prevention strategy; family conflict may be a specific target for suicide prevention interventions among adolescents.

scholarly journals The development and evaluation of an evidence-based suicide prevention strategy in Flanders (Belgium)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Dumon ◽  
G Portzky
Keyword(s):  
Suicide Prevention ◽  
Health Professionals ◽  
Suicide Attempts ◽  
Risk Groups ◽  
Prevention Strategy ◽  
Evidence Based ◽  
Online Help ◽  
Suicide Rates ◽  
The Government ◽  
Year 2000

Abstract Background Suicide rates in Belgium have been consistently high, with a current prevalence of 15.1 suicides per 100.000 inhabitants, which is 1.5 times higher than the European average. In Flanders (northern part of Belgium) more than 10.000 suicide attempts are being registered every year and studies show that 13 % of the population reports a lifetime history of suicidal thoughts. Since 2006 an extensive Suicide Prevention Strategy has been implemented in Flanders, aiming to decrease the Flemish suicide rate by 20% by 2020 (baseline year 2000). Methods The Suicide Prevention Strategy has been developed by a team of experts, involving multiple stakeholders and the lay public. The 'Flemish Centre of Expertise in Suicide Prevention' (VLESP) was launched by the government to coordinate and monitor the prevention campaigns, tools and interventions included in the strategy, and to study their effectiveness. Results The Suicide Prevention Strategy includes five key strategies namely: 1) mental health promotion, 2) providing helplines and online help, 3) educating health professionals and community facilitators, 4) developing programs targeting high risk groups, 5) developing and implementing targeted suicide prevention guidelines for health professionals and other key gatekeepers. A range of innovative suicide prevention tools and interventions, such as an e-learning course for health professionals, smartphone applications and group therapies for suicidal individuals, have been developed and positively evaluated. In 2017 (in comparison with the year 2000) suicide rates in men decreased with 27% and suicide rates in women with 26%. For suicide attempts, a decrease of 19% was noted. Conclusions Suicide prevention is a public health priority in Flanders. A combination of evidence-based tools and interventions have been developed and assessed in the past years, resulting in a decrease in suicide rates.

Family, Health, and Poverty Factors Impacting Suicide Attempts in Cambodian Women

Crisis ◽  
2019 ◽  
Vol 40 (2) ◽  
pp. 141-145
Author(s):  
Desiree M. Seponski ◽  
Charity M. Somo ◽  
Sovandara Kao ◽  
Cindy J. Lahar ◽  
Sareth Khann ◽  
...  
Keyword(s):  
Data Collection ◽  
Suicide Attempt ◽  
Suicide Prevention ◽  
Emotional Distress ◽  
Family Conflict ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Family Health ◽  
Life Saving ◽  
Study Results

Abstract. Background: Our recent report demonstrates that 5.5% of Cambodian women have previously attempted suicide. Despite these high rates and critical need for intervention, research on suicide attempts in Cambodia is lacking, and life-saving information on suicide prevention is therefore unknown. Aims: This study explores factors impacting Cambodian women suicide attempts. Method: A total of 1,801 women participated in the large national survey during which 100 of these women (5.5%) reported at least one suicide attempt. Of the 100 participants 76 provided qualitative reasons for the suicide attempts. Only the 76 who provided the reasons for suicide attempt were included for analysis in this study. Results: Four major themes emerged: (1) family conflict, (2) emotional distress, (3) poverty, and (4) illness. Family conflict, emotional distress, poverty, and illness were all interrelated with each other; for example, women without money were unable to pay for treatment of otherwise treatable illnesses. Limitations: Owing to the nature of the data collection, member checking could not be conducted. Conclusion: Cumulative and intertwined personal, interpersonal, and contextual-level factors impacting suicide attempts included emotional distress, illness, family conflict, and poverty. Findings highlight points of intervention at individual, familial, and contextual levels to prevent suicide.

scholarly journals Global systematic review of the effects of suicide prevention interventions in Indigenous peoples

2020 ◽  
pp. jech-2019-212368
Author(s):  
Stuart Leske ◽  
Elise Paul ◽  
Mandy Gibson ◽  
Brock Little ◽  
Mark Wenitong ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Indigenous Peoples ◽  
Randomised Controlled Trials ◽  
Suicide Attempts ◽  
Risk Of Bias ◽  
Indigenous Populations ◽  
Controlled Trials ◽  
Prevention Interventions ◽  
Self Harm ◽  
Randomised Controlled

ObjectiveSuicide rates are often higher in Indigenous than in non-Indigenous peoples. This systematic review assessed the effects of suicide prevention interventions on suicide-related outcomes in Indigenous populations worldwide.MethodsWe searched CINAHL, Embase, PubMed, PsycINFO, ProQuest Dissertations & Theses and Web of Science from database inception to April 2020. Eligible were English language, empirical and peer-reviewed studies presenting original data assessing the primary outcomes of suicides and suicide attempts and secondary outcomes of suicidal ideation, intentional self-harm, suicide or intentional self-harm risk, composite measures of suicidality or reasons for life in experimental and quasi-experimental interventions with Indigenous populations worldwide. We assessed the risk of bias with the Cochrane Risk of Bias Tool and the Risk of Bias Assessment for Non-randomised Studies.FindingsWe included 24 studies from Australia, Canada, New Zealand and the USA, comprising 14 before–after studies, 4 randomised controlled trials (RCTs), 3 non-randomised controlled trials, 2 interrupted time-series designs and 1 cohort study. Suicides decreased in four and suicide attempts in six before–after studies. No studies had a low risk of bias. There was insufficient evidence to confirm the effectiveness of any one suicide prevention intervention due to shortage of studies, risk of bias, and population and intervention heterogeneity. Review limitations include language bias, no grey literature search and data availability bias.ConclusionFor the primary outcomes of suicides and suicide attempts, the limited available evidence supports multilevel, multicomponent interventions. However, there are limited RCTs and controlled studies.

scholarly journals Prevention of Suicidal Behavior in Prisons

Crisis ◽  
2016 ◽  
Vol 37 (5) ◽  
pp. 323-334 ◽  
Author(s):  
Lisa Marzano ◽  
Keith Hawton ◽  
Adrienne Rivlin ◽  
E. Naomi Smith ◽  
Mary Piper ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Psychiatric Morbidity ◽  
Clinical Factors ◽  
Factors Associated ◽  
Self Harm ◽  
Specific Factors

Abstract. Background: Worldwide, prisoners are at high risk of suicide. Research on near-lethal suicide attempts can provide important insights into risk and protective factors, and inform suicide prevention initiatives in prison. Aims: To synthesize findings of research on near-lethal attempts in prisons, and consider their implications for suicide prevention policies and practice, in the context of other research in custody and other settings. Method: We searched two bibliographic indexes for studies in any language on near-lethal and severe self-harm in prisoners, supplemented by targeted searches over the period 2000–2014. We extracted information on risk factors descriptively. Data were not meta-analyzed owing to heterogeneity of samples and methods. Results: We identified eight studies reporting associations between prisoner near-lethal attempts and specific factors. The latter included historical, prison-related, and clinical factors, including psychiatric morbidity and comorbidity, trauma, social isolation, and bullying. These factors were also identified as important in prisoners' own accounts of what may have contributed to their attempts (presented in four studies). Conclusion: Factors associated with prisoners' severe suicide attempts include a range of potentially modifiable clinical, psychosocial, and environmental factors. We make recommendations to address these factors in order to improve detection, management, and prevention of suicide risk in prisoners.

scholarly journals Feasibility and impact of data-driven learning within the suicide prevention action network of thirteen specialist mental healthcare institutions (SUPRANET Care) in the Netherlands: a study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e024398 ◽  
Author(s):  
Kim Setkowski ◽  
Jan Mokkenstorm ◽  
Anton JLM van Balkom ◽  
Gerdien Franx ◽  
Inge Verbeek- van Noord ◽  
...  
Keyword(s):  
Intensive Care ◽  
The Netherlands ◽  
Suicide Prevention ◽  
Data Protection ◽  
Suicide Attempts ◽  
Human Subjects ◽  
Mental Healthcare ◽  
Suicide Rates ◽  
Action Network ◽  
The Impact

IntroductionImprovement of the quality and safety of care is associated with lower suicide rates among mental healthcare patients. In The Netherlands, about 40% of all people that die by suicide is in specialist mental healthcare. Unfortunately, the degree of implementation of suicide prevention policies and best practices within Dutch mental healthcare services is variable. Sharing and comparing outcome and performance data in confidential networks of professionals working in different organisations can be effective in reducing practice variability within and across organisations and improving quality of care.Methods and analysisUsing formats of professional networks to improve surgical care (Dutch Initiative for Clinical Auditing) and somatic intensive care (National Intensive Care Evaluation), 113 Suicide Prevention has taken the lead in the formation of a Suicide Prevention Action Network (SUPRANET Care), with at present 13 large Dutch specialist mental health institutions. Data on suicide, suicide attempts and their determinants as well as consumer care policies and practices are collected biannually, after consensus rounds in which key professionals define what data are relevant to collect, how it is operationalised, retrieved and will be analysed. To evaluate the impact of SUPRANET Care, standardised suicide rates will be calculated adjusted for confounding factors. Second, the extent to which suicide attempts are being registered will be analysed with the suicide attempt data. Finally, professionals’ knowledge, attitude and adherence to suicide prevention guidelines will be measured with an extended version of the Professionals In Training to STOP suicide survey.Ethics and disseminationThis study has been approved by the Central Committee on Research Involving Human Subjects, The Netherlands. This study does not fall under the scope of the Medical Research Involving Human Subjects Act (WMO) or the General Data Protection Regulation as stated by the Dutch Data Protection Authority because data are collected on an aggregated level.

scholarly journals Exploring Lived Experiences of Adolescents Presenting with Self-Harm and Their Views about Suicide Prevention Strategies: A Qualitative Approach

2021 ◽  
Vol 18 (9) ◽  
pp. 4694
Author(s):  
Anum Naz ◽  
Amna Naureen ◽  
Tayyeba Kiran ◽  
Omair Husain ◽  
Ayesha Minhas ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Lived Experiences ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Therapeutic Interventions ◽  
Global Public Health ◽  
Prevention Strategies ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Self Harm

Suicide is a serious global public health problem and the third leading cause of death in those 15–35 years old. Self-harm is the major predictor of future suicide attempts and completed suicide yet remains poorly understood. There is limited evidence on effective interventions for adolescents who present with self-harm. To identify and develop acceptable preventive and therapeutic interventions it is essential to understand the factors that contribute to self-harm and suicide in young people, in the context of their emotions, interpersonal difficulties, available support and prevention strategies. This qualitative study aimed at exploring the lived experiences of adolescents presenting with self-harm and their views about potential prevention strategies. Semi-structured interviews with 16 adolescents (12–18 years) presenting with a self-harm episode in a public hospital in Pakistan. A topic guide was developed to facilitate the interviews. The following themes emerged using the framework analysis; predisposing factors (interpersonal conflicts, emotional crisis etc.), regret and realization that self-harm is not the only option, perceived impact of self-harm, and suggestions for suicide prevention strategies (sharing, distraction techniques, involvement of family). This study may help in refining a contextual and culturally based explanatory model of self-harm in adolescents and in informing development of culturally acceptable interventions.

Family, Health, and Poverty Factors Impacting Suicide Attempts in Cambodian Women

Crisis ◽  
2018 ◽  
pp. 1-5
Author(s):  
Desiree M. Seponski ◽  
Charity M. Somo ◽  
Sovandara Kao ◽  
Cindy J. Lahar ◽  
Sareth Khann ◽  
...  
Keyword(s):  
Data Collection ◽  
Suicide Attempt ◽  
Suicide Prevention ◽  
Emotional Distress ◽  
Family Conflict ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Family Health ◽  
Life Saving ◽  
Study Results

Abstract. Background: Our recent report demonstrates that 5.5% of Cambodian women have previously attempted suicide. Despite these high rates and critical need for intervention, research on suicide attempts in Cambodia is lacking, and life-saving information on suicide prevention is therefore unknown. Aims: This study explores factors impacting Cambodian women suicide attempts. Method: A total of 1,801 women participated in the large national survey during which 100 of these women (5.5%) reported at least one suicide attempt. Of the 100 participants 76 provided qualitative reasons for the suicide attempts. Only the 76 who provided the reasons for suicide attempt were included for analysis in this study. Results: Four major themes emerged: (1) family conflict, (2) emotional distress, (3) poverty, and (4) illness. Family conflict, emotional distress, poverty, and illness were all interrelated with each other; for example, women without money were unable to pay for treatment of otherwise treatable illnesses. Limitations: Owing to the nature of the data collection, member checking could not be conducted. Conclusion: Cumulative and intertwined personal, interpersonal, and contextual-level factors impacting suicide attempts included emotional distress, illness, family conflict, and poverty. Findings highlight points of intervention at individual, familial, and contextual levels to prevent suicide.

scholarly journals A systematic review of controlled studies of suicidal and self-harming behaviours in adolescents following bereavement by suicide

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254203
Author(s):  
Laura del Carpio ◽  
Sally Paul ◽  
Abigail Paterson ◽  
Susan Rasmussen
Keyword(s):  
Suicide Prevention ◽  
Suicide Attempts ◽  
Young Person ◽  
Suicide Mortality ◽  
Policy Makers ◽  
Parentally Bereaved ◽  
Suicide Bereavement ◽  
Newcastle Ottawa Scale ◽  
Self Harm ◽  
Ottawa Scale

Background Research suggests that being exposed to the suicide of others increases risk of subsequent suicidal or self-harming thoughts or behaviours. What is less clear is whether this applies to adolescents, and if the risk exceeds that following other causes of death, which has implications on suicide prevention approaches. This study aimed to systematically review the evidence on adolescent bereavement experiences by different causes to address this gap. Methods A comprehensive literature search using four databases (MEDLINE, PsycInfo, Web of Science, and Embase) identified 21 studies which measured suicidal or self-harm outcomes among bereaved adolescents aged between 12 to 18 years old. The literature was screened, data was extracted using pre-piloted forms, and risk of bias was assessed using versions of the Newcastle-Ottawa Scale; a proportion of papers were double extracted and assessed for bias. The review has been registered with PROSPERO (CRD42016051125). Results A narrative synthesis of the literature demonstrated divergent findings depending on the outcome being measured. Suicide bereavement appears to be strongly associated with suicide mortality among parentally bereaved youth, while self-harm or non-fatal suicide attempts (either presenting to hospital or self-reported) showed mixed evidence. Suicidal ideation was not uniquely associated with suicide bereavement. An exploration of circumstances surrounding the death, characteristics of the person who died, and characteristics of the young person across each outcome measure suggested that earlier experiences of loss, shorter timeframes following the death, and maternal death are associated with particularly elevated risk of suicidal outcomes. Conclusions Findings suggest that suicide loss is associated with subsequent suicide, and may be associated with non-fatal self-harm. A detailed account of the risk and protective factors surrounding suicide bereavement among young people is crucial to understand the pathways through which suicidal behaviours develop. Researchers, policy makers and practitioners with an interest in suicide prevention will benefit from clarity around the needs of young bereaved individuals.

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