A decision support tool to inform local suicide prevention activity in Greater Western Sydney (Australia)

2018 ◽  
Vol 52 (10) ◽  
pp. 983-993 ◽  
Author(s):  
Andrew Page ◽  
Jo-An Atkinson ◽  
William Campos ◽  
Mark Heffernan ◽  
Shahana Ferdousi ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Support ◽  
Suicide Prevention ◽  
Attempted Suicide ◽  
Decision Support Tool ◽  
Support Tool ◽  
Health Network ◽  
Primary Health ◽  
Prevention Activities ◽  
Sydney Australia

Objectives: This study describes the development of a decision support tool to identify the combination of suicide prevention activities and service priorities likely to deliver the greatest reductions in suicidal behaviour in Western Sydney (Australia) over the period 2018–2028. Methods: A dynamic simulation model for the WentWest – Western Sydney Primary Health Network population-catchment was developed in partnership with primary health network stakeholders based on defined pathways to mental health care and suicidal behaviour, and which represented the current incidence of suicide and attempted suicide in Western Sydney. A series of scenarios relating to potential suicide prevention activities and service priorities identified by primary health network stakeholders were investigated to identify the combination of interventions associated with the largest reductions in the forecast number of attempted suicide and suicide cases for a 10-year follow-up period. Results: The largest number of cases averted for both suicide and attempted suicide was associated with (1) post-suicide attempt assertive aftercare (6.1% for both attempted suicide and suicide), (2) improved community support and reductions in psychological distress in the community (5.1% for attempted suicide and 14.8% for suicide), and (3) reductions in the proportion of those lost to services following a mental health service contact (10.5% for both attempted suicide and suicide). In combination, these interventions were forecast to avert approximately 29.7% of attempted suicides and 37.1% of suicides in the primary health network catchment over the 10-year period. Conclusion: This study demonstrates the utility of dynamic simulation models, co-designed with multi-disciplinary stakeholder groups, to capture and analyse complex mental health and suicide prevention regional planning problems. The model can be used by WentWest – Western Sydney Primary Health Network as a decision support tool to guide the commissioning of future service activity, and more efficiently frame the monitoring and evaluation of interventions as they are implemented in Western Sydney.

scholarly journals Risk of Suicide and Self-harm in Kids: The Development of an Algorithm to Identify High-Risk Individuals Within the Children’s Mental Health System

2020 ◽  
Vol 51 (6) ◽  
pp. 913-924 ◽  
Author(s):  
Shannon L. Stewart ◽  
Angela Celebre ◽  
John P. Hirdes ◽  
Jeffrey W. Poss
Keyword(s):  
Mental Health ◽  
Decision Support ◽  
Additional Data ◽  
Strong Predictor ◽  
Signs And Symptoms ◽  
Decision Support Tool ◽  
Support Tool ◽  
Increased Risk ◽  
Support Tools ◽  
Self Harm

Abstract Suicide is the second leading cause of death in adolescents within Canada. While several risk factors have been found to be associated with increased risk, appropriate decision-support tools are needed to identify children who are at highest risk for suicide and self-harm. The aim of the present study was to develop and validate a methodology for identifying children at heightened risk for self-harm and suicide. Ontario data based on the interRAI Child and Youth Mental Health Screener (ChYMH-S) were analyzed to develop a decision-support algorithm to identify young persons at risk for suicide or self-harm. The algorithm was validated with additional data from 59 agencies and found to be a strong predictor of suicidal ideation and self-harm. The RiSsK algorithm provides a psychometrically sound decision-support tool that may be used to identify children and youth who exhibit signs and symptoms noted to increase the likelihood of suicide and self-harm.

scholarly journals The Practical Approach to Care Kit (PACK) guide: developing a clinical decision support tool to simplify, standardise and strengthen primary healthcare delivery

2018 ◽  
Vol 3 (Suppl 5) ◽  
pp. e000962 ◽  
Author(s):  
Ruth Cornick ◽  
Sandy Picken ◽  
Camilla Wattrus ◽  
Ajibola Awotiwon ◽  
Emma Carkeek ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Practical Approach ◽  
Support Tool ◽  
Clinical Guidance ◽  
Primary Health ◽  
Clinical Decision Support Tool

For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.

scholarly journals A five-step approach for developing and implementing a Rural Primary Health Care Model for Dementia: a community–academic partnership

2019 ◽  
Vol 20 ◽  
Author(s):  
Debra Morgan ◽  
Julie Kosteniuk ◽  
Dallas Seitz ◽  
Megan E. O’Connell ◽  
Andrew Kirk ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Decision Support ◽  
Needs Assessment ◽  
Decision Support Tool ◽  
Evidence Based ◽  
Dementia Diagnosis ◽  
Support Tool ◽  
Primary Health ◽  
Team Based Care

AbstractAimThis study is aimed at developing a Rural Primary Health Care (PHC) Model for delivering comprehensive PHC for dementia in rural settings and addressing the gap in knowledge about disseminating and implementing evidence-based dementia care in a rural PHC context.BackgroundLimited access to specialists and services in rural areas leads to increased responsibility for dementia diagnosis and management in PHC, yet a gap exists in evidence-based best practices for rural dementia care.MethodsElements of the Rural PHC Model for Dementia were based on seven principles of effective PHC for dementia identified from published research and organized into three domains: team-based care, decision support, and specialist-to-provider support. Since 2013 the researchers have collaborated with a rural PHC team in a community of 1000 people in the Canadian province of Saskatchewan to operationalize these elements in ways that were feasible in the local context. The five-step approach included: building relationships; conducting a problem analysis/needs assessment; identifying core and adaptable elements of a decision support tool embedded in the model and resolving applicability issues; implementing and adapting the intervention with local stakeholders; and sustaining the model while incrementally scaling up.ResultsDeveloping and sustaining relationships at regional and PHC team levels was critical. A comprehensive needs assessment identified challenges related to all domains of the Rural PHC Model. An existing decision support tool for dementia diagnosis and management was adapted and embedded in the team’s electronic medical record. Strategies for operationalizing other model elements included integrating team-based care co-ordination into the decision support tool and family-centered case conferences. Research team specialists provided educational sessions on topics identified by the PHC team. This paper provides an example of a community-based process for adapting evidence-based practice principles to a real-world setting.

scholarly journals Risk of Injury to Others: The Development of an Algorithm to Identify Children and Youth at High-Risk of Aggressive Behaviours

2022 ◽  
Vol 12 ◽  
Author(s):  
Shannon L. Stewart ◽  
Angela Celebre ◽  
John P. Hirdes ◽  
Jeffrey W. Poss
Keyword(s):  
Mental Health ◽  
Decision Support ◽  
Youth Violence ◽  
Strong Predictor ◽  
Premature Mortality ◽  
Decision Support Tool ◽  
Children And Youth ◽  
Support Tool ◽  
Increased Risk ◽  
Aggressive Behaviours

Youth violence is considered one of the most preventable causes of morbidity and premature mortality. Various risk factors have previously been identified, however, there is presently a crucial need to develop effective decision-support tools in order to identify children and youth at increased risk for violence. The current study utilised data collected from the interRAI Child and Youth Mental Health Screener (ChYMH-S), within the province of Ontario, to develop and validate a methodology for the purpose of identifying young persons who were at greater risk of harm to others. Additional data from 59 mental health agencies validated the algorithm, and it was found to be a strong predictor of harmful behaviour toward others. The RIO algorithm provides a valuable decision-support tool with strong psychometric properties that may be used to identify young persons who exhibit signs or symptoms associated with increased likelihood of harm toward others, in order to provide early intervention efforts for these vulnerable youth, thereby reducing the likelihood of future aggressive behaviours.

Preventing Suicide in Prisons, Part II

Crisis ◽  
2007 ◽  
Vol 28 (3) ◽  
pp. 122-130 ◽  
Author(s):  
Marc S. Daigle ◽  
Anasseril E. Daniel ◽  
Greg E. Dear ◽  
Patrick Frottier ◽  
Lindsay M. Hayes ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Prevention ◽  
Mental Health Professionals ◽  
Task Force ◽  
International Association ◽  
Correctional Officers ◽  
Community Services ◽  
Correctional Systems ◽  
Prevention Activities ◽  
Prison Systems

Abstract. The International Association for Suicide Prevention created a Task Force on Suicide in Prisons to better disseminate the information in this domain. One of its objectives was to summarize suicide-prevention activities in the prison systems. This study of the Task Force uncovered many differences between countries, although mental health professionals remain central in all suicide prevention activities. Inmate peer-support and correctional officers also play critical roles in suicide prevention but there is great variation in the involvement of outside community workers. These differences could be explained by the availability of resources, by the structure of the correctional and community services, but mainly by the different paradigms about suicide prevention. While there is a common and traditional paradigm that suicide prevention services are mainly offered to individuals by mental health services, correctional systems differ in the way they include (or not) other partners of suicide prevention: correctional officers, other employees, peer inmates, chaplains/priests, and community workers. Circumstances, history, and national cultures may explain such diversity but they might also depend on the basic way we think about suicide prevention at both individual and environmental levels.

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