Prevention of suicide and treatment following self-harm

2020 ◽  
pp. 1303-1314
Author(s):  
Keith Hawton ◽  
Kate E. A. Saunders ◽  
Alexandra Pitman
Keyword(s):  
High Risk ◽  
Suicide Prevention ◽  
Help Seeking ◽  
Population Level ◽  
Risk Groups ◽  
Evidence Base ◽  
Targeted Prevention ◽  
Prevention Interventions ◽  
Physical Health Problems ◽  
Self Harm

Suicide prevention strategies generally combine broad population or universal approaches with complementary high-risk or targeted prevention interventions, with evidence favouring greater impacts of population strategies. This chapter summarizes the evidence supporting a range of approaches to suicide prevention at the population level (restricting access to means of suicide, limiting the effects of suicide suggestion, influencing media portrayals of suicidal behaviour, using psychoeducation to improve help-seeking, primary care training, school interventions, telephone/Internet support services, lay training in gatekeeping) and for high-risk groups (risk management for specific psychiatric disorders, optimizing psychotropic medication, service delivery reform, enhanced support for specific high-risk groups—people with substance misuse and physical health problems, people who self-harm, people in specific occupational groups, prisoners, and people bereaved by suicide). Particular attention is given to evaluating the evidence base for interventions for people who self-harm. The chapter concludes that a comprehensive multi-sectoral approach is required for suicide prevention, tailored to specific local epidemiological patterns.

scholarly journals Australia's National Suicide Prevention Strategy: the next chapter

2006 ◽  
Vol 30 (3) ◽  
pp. 271 ◽  
Author(s):  
Jo Robinson ◽  
Patrick McGorry ◽  
Meredith G Harris ◽  
Jane Pirkis ◽  
Philip Burgess ◽  
...  
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Suicide Prevention ◽  
Risk Groups ◽  
Evidence Base ◽  
Prevention Strategy ◽  
People With Mental Illness ◽  
Prevention Activities ◽  
The Impact

Australia?s National Suicide Prevention Strategy (NSPS) is about to move into a new funding phase. In this context this paper considers the emphasis of the NSPS since its inception in 1999. Certain high-risk groups (particularly people with mental illness and people who have selfharmed) have been relatively neglected, and some promising approaches (particularly selective and indicated interventions) have been under-emphasised. This balance should be redressed and the opportunity should be taken to build the evidence-base regarding suicide prevention. Such steps have the potential to maximise the impact of suicide prevention activities in Australia.

scholarly journals Rates of violence in patients classified as high risk by structured risk assessment instruments

2014 ◽  
Vol 204 (3) ◽  
pp. 180-187 ◽  
Author(s):  
Jay P. Singh ◽  
Seena Fazel ◽  
Ralitza Gueorguieva ◽  
Alec Buchanan
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Groups ◽  
Evidence Base ◽  
Assessment Tools ◽  
Current Evidence ◽  
Assessment Instruments ◽  
Individual Liberty ◽  
Current Evidence Base ◽  
Study Heterogeneity

BackgroundRates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies.AimsTo analyse the variation in rates of violence in individuals identified as high risk by SRAIs.MethodA systematic search of databases (1995–2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity.ResultsInformation was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study.ConclusionsAfter controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety.

After Teen Suicide: Issues for Pediatricians Who Are Asked to Consult to Schools

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 982-987 ◽  
Author(s):  
Richard S. Adler ◽  
Michael S. Jellinek
Keyword(s):  
High Risk ◽  
Suicide Prevention ◽  
Risk Groups ◽  
School Community ◽  
Ongoing Task ◽  
It Impacts

Every suicide is a unique tragedy. This article has attempted to provide a framework for understanding suicide as it impacts on the scmunity.ool community. Given this background, we have listed 10 frequent dilemmas faced by pediatricians (and others) who consult to schools. The central themes of the approach offered are to avoid inadvertently glorifying suicide, target high-risk groups for interventions, and consider suicide prevention as part of the broad, ongoing task of providing a caning environment for adolescents in which the collaboration of the school community is essential.

Suicide Prevention Public Service Announcements

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Andrea Wiglesworth ◽  
Josephine P. Abate ◽  
Bonnie Klimes-Dougan
Keyword(s):  
High Risk ◽  
Suicide Prevention ◽  
Public Service ◽  
Help Seeking ◽  
Internal Validity ◽  
Public Service Announcements ◽  
Prevention Messages ◽  
Adult Participants ◽  
Written Recall ◽  
Main Message

Abstract. Background: Suicide prevention public service announcements (PSAs) help to disseminate information about suicide and help-seeking options. However, little is known about how individuals at risk for suicide recall PSAs. Aims: The current project assessed which features of suicide prevention PSAs are recalled by young adult participants and whether there are differences between those who are at low or high risk for suicide. Method: Participants ( N = 140) viewed a simulated suicide prevention billboard that consisted of a main message, help-seeking message, and graphical features. Participants provided written recollections of the billboard features approximately 15 min post-viewing, which were coded and analyzed. Results: High-risk participants were significantly less likely than low-risk participants to include a description of the help-seeking message in their written recall. Few group differences were noted in the recall of the main message or graphical features. Limitations: Recall was limited to short-term recall based on a single exposure. Efforts to enhance internal validity (e.g., measurement of suicide risk) and external validity (e.g., a balanced sample regarding sex and race) are recommended. Conclusions: Results suggest that new tactics may need to be considered when developing suicide prevention messages, including crafting help-seeking messages that are more easily committed to memory for target audiences.

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.

Prevention of depression: psychological and social measures

1995 ◽  
Vol 1 (4) ◽  
pp. 94-101 ◽  
Author(s):  
Jan Scott
Keyword(s):  
High Risk ◽  
Help Seeking ◽  
Depressive Disorders ◽  
Psychosocial Interventions ◽  
Risk Groups ◽  
Prevalence Rates ◽  
Help Seeking Behaviour ◽  
Incidence Prevalence

The role of pharmacotherapy in the management of depressive disorders is well-established and frequently reviewed. This paper focuses on the prospects for reducing the incidence, prevalence and morbidity of depression through psychosocial interventions. A central requirement in prevention is a knowledge of the epidemiology of the disorder being investigated. This data can be used to identify high-risk groups. By comparing the number of known cases with population levels of morbidity, it allows comment on help-seeking behaviour and accessibility of services. Also, differences in incidence and prevalence rates give some indication of the chronicity of the disorder.

scholarly journals Making the case for investing in suicide prevention interventions: estimating the economic impact of suicide and non-fatal self harm events

2010 ◽  
Vol 16 (Supplement 1) ◽  
pp. A257-A258 ◽  
Author(s):  
D. McDaid ◽  
E. Bonin ◽  
A. Park ◽  
U. Hegerl ◽  
E. Arensman ◽  
...  
Keyword(s):  
Economic Impact ◽  
Suicide Prevention ◽  
Prevention Interventions ◽  
Self Harm

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.

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