Introduction

Author(s):  
Phillip Kleespies

This book is about behavioral emergencies and the association between interpersonal victimization and subsequent suicidality and/or risk for violence toward others. Section I focuses on the differences between behavioral crises and behavioral emergencies and presents an integrative approach to crisis intervention and emergency intervention. Section II discusses the evaluation of suicide risk, risk of violence, and risk of interpersonal victimization in children and adolescents. Sections III and IV explore behavioral emergencies with adults and the elderly, while Section V deals with certain conditions or behaviors that may either need to be differentiated from a behavioral emergency, or understood as relevant to possibly heightening risk. Section VI describes treatments for patients with recurrent or ongoing risks, and Section VII is devoted to legal, ethical, and psychological risks faced by clinicians who work with patients who might be at risk to themselves or others.

Author(s):  
Phillip M. Kleespies

In this chapter, the author discusses two ways in which the area of behavioral emergencies can be viewed as integrative. First, evidence is presented demonstrating how the three major behavioral emergencies (i.e., risks of interpersonal victimization, suicide, and violence) overlap and are interrelated in certain respects. For example, data indicate that those who have been victims of violence have an increased risk of becoming perpetrators of violence and/or victims of suicidal behavior. Second, the author distinguishes between the concepts of crisis and emergency, and then discusses how crises often precede the development of behavioral emergencies, and how crisis intervention techniques can be used to avert a developing emergency. The chapter concludes with a discussion of the decision making involved in determining whether a patient at risk can be treated as an outpatient in crisis or needs to be hospitalized because of imminent risk of suicide or violence.


Crisis ◽  
2019 ◽  
Vol 40 (5) ◽  
pp. 326-332
Author(s):  
Ivonne Andrea Florez ◽  
Devon LoParo ◽  
Nakia Valentine ◽  
Dorian A. Lamis

Abstract. Background: Early identification and appropriate referral services are priorities to prevent suicide. Aims: The aim of this study was to describe patterns of identification and referrals among three behavioral health centers and determine whether youth demographic factors and type of training received by providers were associated with identification and referral patterns. Method: The Early Identification Referral Forms were used to gather the data of interest among 820 youth aged 10–24 years who were screened for suicide risk (females = 53.8%). Descriptive statistics and binary logistic regressions were conducted to examine significant associations. Results: Significant associations between gender, race, and age and screening positive for suicide were found. Age and race were significantly associated with different patterns of referrals and/or services received by youths. For providers, being trained in Counseling on Access to Lethal Means was positively associated with number of referrals to inpatient services. Limitations: The correlational nature of the study and lack of information about suicide risk and comorbidity of psychiatric symptoms limit the implications of the findings. Conclusion: The results highlight the importance of considering demographic factors when identifying and referring youth at risk to ensure standard yet culturally appropriate procedures to prevent suicide.


2021 ◽  
Vol 214 (7) ◽  
pp. 335
Author(s):  
Nicholas Leedman ◽  
Murray Princehorn ◽  
Nicholas Gottardo ◽  
Claire Franklin ◽  
Rebecca D'Souza ◽  
...  

2007 ◽  
Vol 55 (3) ◽  
pp. 237-253 ◽  
Author(s):  
Karolina E. Krysinska ◽  
Diego De Leo

Development of information technology has created new opportunities and challenges in suicide prevention, research, and clinical practice. This article presents an overview of the wide range of telecommunication-based suicide prevention approaches. Interventions using the Internet, telephone, and videoconferencing are discussed, including crisis intervention, referral, and support, suicide risk assessment, psychotherapy for individuals at risk, and online-based suicide prevention training and education. Research regarding effectiveness of telecommunication-based suicide prevention in various demographic and clinical populations is reviewed, as well as concerns regarding this type of intervention. Future areas of research and development in the use of telecommunication media in prevention of suicide are discussed.


10.2196/17758 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17758 ◽  
Author(s):  
Diana Ramírez-Cifuentes ◽  
Ana Freire ◽  
Ricardo Baeza-Yates ◽  
Joaquim Puntí ◽  
Pilar Medina-Bravo ◽  
...  

Background Suicide risk assessment usually involves an interaction between doctors and patients. However, a significant number of people with mental disorders receive no treatment for their condition due to the limited access to mental health care facilities; the reduced availability of clinicians; the lack of awareness; and stigma, neglect, and discrimination surrounding mental disorders. In contrast, internet access and social media usage have increased significantly, providing experts and patients with a means of communication that may contribute to the development of methods to detect mental health issues among social media users. Objective This paper aimed to describe an approach for the suicide risk assessment of Spanish-speaking users on social media. We aimed to explore behavioral, relational, and multimodal data extracted from multiple social platforms and develop machine learning models to detect users at risk. Methods We characterized users based on their writings, posting patterns, relations with other users, and images posted. We also evaluated statistical and deep learning approaches to handle multimodal data for the detection of users with signs of suicidal ideation (suicidal ideation risk group). Our methods were evaluated over a dataset of 252 users annotated by clinicians. To evaluate the performance of our models, we distinguished 2 control groups: users who make use of suicide-related vocabulary (focused control group) and generic random users (generic control group). Results We identified significant statistical differences between the textual and behavioral attributes of each of the control groups compared with the suicidal ideation risk group. At a 95% CI, when comparing the suicidal ideation risk group and the focused control group, the number of friends (P=.04) and median tweet length (P=.04) were significantly different. The median number of friends for a focused control user (median 578.5) was higher than that for a user at risk (median 372.0). Similarly, the median tweet length was higher for focused control users, with 16 words against 13 words of suicidal ideation risk users. Our findings also show that the combination of textual, visual, relational, and behavioral data outperforms the accuracy of using each modality separately. We defined text-based baseline models based on bag of words and word embeddings, which were outperformed by our models, obtaining an increase in accuracy of up to 8% when distinguishing users at risk from both types of control users. Conclusions The types of attributes analyzed are significant for detecting users at risk, and their combination outperforms the results provided by generic, exclusively text-based baseline models. After evaluating the contribution of image-based predictive models, we believe that our results can be improved by enhancing the models based on textual and relational features. These methods can be extended and applied to different use cases related to other mental disorders.


e-GIGI ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 217
Author(s):  
Dwita N. Halim ◽  
Vonny N. S. Wowor ◽  
Dinar A. Wicaksono

Abstract: Tooth loss which is often found among elderly may cause problems in mastication. Chewing efficiency may decrease if the elderly do not replace the function of the missing teeth by using dentures. This can further affect their nutritional intake and nutritional status. This study was aimed to explore scientific information regarding differences in elderly nutritional status of removable denture wearers and non-denture wearers. This was a literature review study by searching data on three databases, namely Pubmed, ScienceDirect, and Google Scholar using keywords and a combination of boolean operators. After being selected based on inclusion and exclusion criteria, a critical appraisal was performed, and 10 literatures were obtained consisting of cross-sectional, cohort, and randomized controlled trial design studies. The results showed that the percentage of the elderly with normal nutritional status was higher in denture wearers than in non-denture wearers. There was an increase in nutritional status based on MNA and MNA-SF scores in the elderly after wearing removable dentures. Among elderly, the nutritional status of denture wearers was relatively at risk of malnutrition, while of non-denture wearers was at risk of malnutrition and experienced malnutrition. In conclusion, risk of malnutrition and the occurrence of malnutrition are greater in non-denture wearer elderly.Keywords: nutritional status; elderly; tooth loss; denture wearers; removable dentures  Abstrak: Kehilangan gigi yang banyak ditemukan pada lansia dapat menyebabkan timbulnya gangguan dalam pengunyahan. Efisiensi kunyah dapat menurun bila lansia tidak menggantikan fungsi gigi asli yang hilang dengan menggunakan gigi tiruan. Hal tersebut dapat berpengaruh terhadap asupan nutrisi dan status gizi lansia. Penelitian ini bertujuan untuk menelaah mengenai perbedaan status gizi pada lansia pengguna dan bukan pengguna gigi tiruan lepasan. Jenis penelitian ialah suatu literature review dengan pencarian data pada tiga database yaitu Pubmed, ScienceDirect, dan Google Scholar menggunakan kata kunci dan kombinasi boolean operator. Setelah diseleksi berdasarkan kriteria inklusi dan eksklusi, dilakukan critical appraisal, dan didapatkan 10 literatur dengan desain studi cross sectional, cohort, dan randomized controlled trial. Hasil penelitian mendapatkan persentase lansia dengan status gizi normal lebih besar ditemukan pada lansia pengguna gigi tiruan daripada lansia bukan pengguna gigi tiruan. Terdapat peningkatan status gizi berdasarkan skor MNA dan MNA-SF pada lansia setelah pemakaian gigi tiruan lepasan. Status gizi lansia pengguna gigi tiruan relatif berisiko malnutrisi, sedangkan pada lansia bukan pengguna gigi tiruan berisiko malnutrisi dan mengalami malnutrisi. Simpulan penelitian ini ialah risiko malnutrisi dan terjadinya malnutrisi lebih besar ditemukan pada lansia bukan pengguna gigi tiruan.Kata kunci: status gizi, lansia; kehilangan gigi; pengguna gigi tiruan; gigi tiruan lepasan


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