scholarly journals The bounds of suicide talk: Implications for qualitative suicide research

Author(s):  
Patti Ranahan ◽  
Veronica Keefe

Following the implementation of a provincial suicide prevention gatekeeper training initiative in western Canada between 2015 and 2018, we conducted a focused ethnography designed to capture the post-initiative context within one small community. Analyses of our field observations and interviews with community members suggest suicide prevention work is represented in multiple informal or coordinated actions to generate innovative pathways to provoke open conversations about suicide. Simultaneously, suicide talk is constrained and managed to limit vulnerability and exposure and adhere to community privacy norms. Further, parameters around suicide talk may be employed in efforts to construct the community and mental health care in livable ways. As the research process paralleled existing representations of suicide prevention work in the community, this paper explores our entanglement in the bounds of suicide talk during phases of recruitment, data collection and knowledge translation activities.

Information ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 170
Author(s):  
Tineke Broer

Digital and networking technologies are increasingly used to predict who is at risk of attempting suicide. Such digitalized suicide prevention within and beyond mental health care raises ethical, social and legal issues for a range of actors involved. Here, I will draw on key literature to explore what issues (might) arise in relation to digitalized suicide prevention practices. I will start by reviewing some of the initiatives that are already implemented, and address some of the issues associated with these and with potential future initiatives. Rather than addressing the breadth of issues, however, I will then zoom in on two key issues: first, the duty of care and the duty to report, and how these two legal and professional standards may change within and through digitalized suicide prevention; and secondly a more philosophical exploration of how digitalized suicide prevention may alter human subjectivity. To end with the by now famous adagio, digitalized suicide prevention is neither good nor bad, nor is it neutral, and I will argue that we need sustained academic and social conversation about who can and should be involved in digitalized suicide prevention practices and, indeed, in what ways it can and should (not) happen.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Tilini Gunatillake ◽  
Cade Shadbolt ◽  
Daniel Gould ◽  
Michelle Lam ◽  
Marion Glanville Hearst ◽  
...  

Plain English summary Involving consumers and community members in the research process is an important step towards developing and delivering effective, person-centered health care. The National Health and Medical Research Council have provided recommendations for involving consumers and community members in research; however, definitive actions to implement these are not well defined. To address this, an established research centre in Melbourne, Australia, has developed a consumer and community involvement framework to incorporate the national recommendations into their research program. This paper describes the framework the research centre has employed, in the hope that other researchers can adapt this approach and learnings to their own research practices. The framework described in this paper aims to foster partnerships between consumers, community members and researchers, and in doing so, encourages consumers to be actively involved in research to help improve future outcomes for those living with musculoskeletal conditions. Simultaneously, the framework encourages researchers to value the consumer voice in their research to ensure they yield meaningful research outcomes for those living with musculoskeletal conditions. Abstract Background The value of involving consumers and community members in every stage of the research process is gaining recognition as an important consideration in the wider research landscape. The National Health and Medical Research Council (NHMRC) has provided general recommendations for involving consumers and community members in research, although the translation of these recommendations into tangible actions has not yet been well defined. In light of these recommendations, many research institutions are now seeking to incorporate the voices of consumers and community members in their research practices. Methods The consumer and community involvement framework described in this paper incorporates the NHMRC’s recommendations to produce a four-tiered model where consumer participants nominate their level of involvement depending on their research interests and preferred level of commitment. In ascending order, the tiers are: Consumer Subscriber, Document Reviewer, Research Buddy and Consumer Advocate. The success of this framework depends upon the implementation of effective governance and access to appropriate infrastructure. A Consumer and Community Advisory Group and a designated Consumer and Community Liaison Officer will take responsibility for ensuring appropriate interactions between consumers, researchers, and the research center’s executive team. The framework aims to apply suitable support structures in place to manage expectations and minimize barriers to effective involvement, whilst ensuring that consumer contributions are appropriately valued and incorporated in the research. Discussion Involving consumers and community members in the research process is an important step towards developing and delivering effective, person-centered health care. While consumer and community involvement offer researchers invaluable perspectives on their research program, it provides an opportunity for consumers and community members to be actively involved in health research and improve the health and wellbeing for those living with health conditions.


2020 ◽  
Vol 30 (14) ◽  
pp. 2343-2350
Author(s):  
Candice M. Waddell ◽  
Rachel V. Herron ◽  
Jason Gobeil ◽  
Frank Tacan ◽  
Margaret De Jager ◽  
...  

Research continues to be a dirty word for many Indigenous people. Community-based participatory research (CBPR) is a means to disrupt power dynamics by engaging community members within the research process. However, the majority of relationships between researcher and participants within CBPR are structured within Western research paradigms and they often reproduce imbalances of power. The purpose of this article is to reflect on the process of CBPR within a research project focused on Indigenous men’s masculinity and mental health. In doing so, we aim to contribute to reflexive practice in CBPR and flatten research hierarchies to facilitate more equitable knowledge sharing. Our reflections highlight the importance of prioritizing healing, centering cultural protocols, negotiating language, and creating space for Indigenous research partners to lead. These critical lessons challenge Western researchers to ground their practices in Indigenous culture while they “sit outside the circle” to facilitate more equitable and engaged partnerships.


10.2196/17481 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17481
Author(s):  
Conor O'Grady ◽  
Ruth Melia ◽  
John Bogue ◽  
Mary O'Sullivan ◽  
Karen Young ◽  
...  

Background Suicide is a prominent cause of death worldwide, particularly among young people. It was the second leading cause of death among those aged 15-29 years globally in 2016. Treatment for patients with suicidal thoughts or behaviors often includes face-to-face psychological therapy with a mental health professional. These forms of interventions may involve maintaining and updating paper-based reports or worksheets in between sessions. Mobile technology can offer a way to support the implementation of evidence-based psychological techniques and the acquisition of protective coping skills. Objective This study aims to develop a mobile app to facilitate service users’ access to mental health support and safety planning. This process involved eliciting expert input from clinicians who are actively engaged in the provision of mental health care. Methods A survey was distributed to targeted health care professionals to determine what features should be prioritized in a new mobile app relating to suicide prevention. On the basis of the survey results, a clinical design group, comprising 6 members with experience in fields such as mobile health (mHealth), clinical psychology, and suicide prevention, was established. This group was supplemented with further input from additional clinicians who provided feedback over three focus group sessions. The sessions were centered on refining existing app components and evaluating new feature requests. This process was iterated through regular feedback until agreement was reached on the overall app design and functionality. Results A fully functional mobile app, known as the SafePlan app, was developed and tested with the input of clinicians through an iterative design process. The app’s core function is to provide an interactive safety plan to support users with suicidal thoughts or behaviors as an adjunct to face-to-face therapy. A diary component that facilitates the generalization of skills learned through dialectical behavior therapy was also implemented. Usability testing was carried out on the final prototype by students from a local secondary school, who are representative of the target user population in both age and technology experience. The students were asked to complete a system usability survey (SUS) at the end of this session. The mean overall SUS rating was 71.85 (SD 1.38). Conclusions The participatory process involving key stakeholders (clinicians, psychologists, and information technology specialists) has resulted in the creation of an mHealth intervention technology that has the potential to increase accessibility to this type of mental health service for the target population. The app has gone through the initial testing phase, and the relevant recommendations have been implemented, and it is now ready for trialing with both clinicians and their patients.


2021 ◽  
Author(s):  
Moturu S. Raju

In order to explore standardised approaches for preventive mental health care rather than treatment of diseases manifested, an action research was carried out on What are the unfulfilled needs of leprosy affected that are creating crisis situations and leading to mental health issues and a practicably affective process of counselling and the essential stages to be involved in carrying out in individual counselling of leprosy affected. The study was conducted in the counselling center of referral hospital of Gandhi Memorial Leprosy Foundation on 146 leprosy affected and counselling provided by trained counsellors in every monthly visit for MDT till declared RFT. Findings show the process of counselling practiced towards prevention of mental health problems may be illustrated as the following five essential stages viz. Rapport establishment, Identification of crisis situation, Diagnosis of Psycho-social problems and reasons thereof, Ascertaining of counselling needs, and Fulfilment of needs through counselling. Analysis shows the psychological problems are basically develop from cognition viz. lack of knowledge, lack of conviction, Lack of knowledge about Cure, Lack of conviction about known facts of cure, Fear of society/ family/ reactions/ deformities, loneliness- Lack of social support to the patient, possession of misconceptions of the patient or the family members or the community members who creates socio-behavioural problems which in turn cause psychological problems. Maintenance of mental health starts from identification of needs and fulfilment which otherwise need to mental problems. The study concludes that a systematic counselling along with leprosy treatment can be a successful method to prevent the mental health problems prior to reaching the stage of needing treatment.


2021 ◽  
Author(s):  
Selena Davis ◽  
Marcy Antonio ◽  
Mindy Smith ◽  
Paul Burgener ◽  
Danielle C. Lavallee ◽  
...  

BACKGROUND Patient-centred measurement (PCM) aims to improve overall quality of care through the collection and sharing of patients’ values and perspectives. Yet, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process. OBJECTIVE (i) test the feasibility of using patient-generated data (PGD) in team-based care; (ii) describe use of these data for team-based mental health care; and (iii) summarize patient and provider care experiences with PCM. METHODS We conducted a multi-methods exploratory study in a rural team-based primary care clinic using IKT to co-design, implement and evaluate use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were iteratively adjusted to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating use of PCM and patient portal in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation. RESULTS During co-design, a care workflow was developed for incorporating electronically-collected PGD from the patient portal into the electronic medical record (EMR), and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work and lack of portal/EMR integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding ongoing barriers to PCM use and quality improvement. CONCLUSIONS Although the culture towards PCM is changing, use of PCM during care was not successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are needed before PCM can be integrated into routine care.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
James O. E. Pittman ◽  
Laurie Lindamer ◽  
Niloofar Afari ◽  
Colin Depp ◽  
Miguel Villodas ◽  
...  

Abstract Background Post-9/11 veterans who enroll in VA health care frequently present with suicidal ideation and/or recent suicidal behavior. Most of these veterans are not screened on their day of enrollment and their risk goes undetected. Screening for suicide risk, and associated mental health factors, can lead to early detection and referral to effective treatment, thereby decreasing suicide risk. eScreening is an innovative Gold Standard Practice with evidence to support its effectiveness and implementation potential in transition and care management (TCM) programs. We will evaluate the impact of eScreening to improve the rate and speed of suicide risk screening and referral to mental health care compared to current screening methods used by transition care managers. We will also evaluate the impact of an innovative, multicomponent implementation strategy (MCIS) on the reach, adoption, implementation, and sustained use of eScreening. Methods This is an eight-site 4-year, stepped-wedge, mixed-method, hybrid type-II implementation trial comparing eScreening to screening as usual while also evaluating the potential impact of the MCIS focusing on external facilitation and Lean/SixSigma rapid process improvement workshops in TCM. The aims will address: 1) whether using eScreening compared to oral and/or paper-based methods in TCM programs is associated with improved rates and speed of PTSD, depression, alcohol, and suicide screening & evaluation, and increased referral to mental health treatment; 2) whether and to what degree our MCIS is feasible, acceptable, and has the potential to impact adoption, implementation, and maintenance of eScreening; and 3) how contextual factors influence the implementation of eScreening between high- and low-eScreening adopting sites. We will use a mixed methods approach guided by the RE-AIM outcomes of the Practical Robust Implementation and Sustainability Model (PRISM). Data to address Aim 1 will be collected via medical record query while data for Aims 2 and 3 will be collected from TCM staff questionnaires and qualitative interviews. Discussion The results of this study will help identify best practices for screening in suicide prevention for Post-9/11 veterans enrolling in VA health care and will provide information on how best to implement technology-based screening into real-world clinical care programs. Trial registration ClinicalTrials.gov: NCT04506164; date registered: August 20, 2020; retrospectively registered


Author(s):  
Kristin Cleverley ◽  
Emma McCann ◽  
David O’Brien ◽  
Julia Davies ◽  
Kathryn Bennett ◽  
...  

AbstractYouth accessing mental health care often experience a disruption in care as they attempt to transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). Few studies have evaluated interventions seeking to improve the experience and outcomes of CAMHS–AMHS transitions, in part due to lack of consensus on what constitutes best practices in intervention success. As such, the aim of this study was to engage patients, caregivers, and clinicians to prioritize core components of successful CAMHS–AMHS transitions which can be used in the design or evaluation of transition interventions. As such, a Delphi study was conducted to determine core components of successful CAMHS–AMHS transitions. Guided by the principles of patient-oriented research, three balanced expert panels consisting of youth, caregivers, and clinicians ranked and provided feedback on the importance and feasibility of core components of CAMHS-AMHS transitions. Components endorsed as feasible or important with ≥ 70% agreement from any panel moved to the next round. As a result, a list of 26 core components of CAMHS–AMHS transitions has been refined which can be used in the design, implementation, or evaluation of interventions intended to improve transition experiences and outcomes for youth in mental health care. Youth and families were engaged in an expert advisory role throughout the research process, contributing their important perspectives to the design and implementation of this study, as well as interpretation of the findings.


2015 ◽  
Vol 27 (1) ◽  
pp. 20-44
Author(s):  
Maryke Woolf ◽  
Jason Bantjes ◽  
Ashraf Kagee

Youth suicidal behaviour poses a significant public health concern. Mental health care professionals working in schools have an important role to play in youth suicide prevention initiatives, although little is known of the experiences of this group of professionals in low and middle income countries (LMIC’s). The aim of this study was to explore the experiences of mental health professionals working in South African schools and to document their insights, attitudes and beliefs regarding youth suicidal behaviour. In-depth semi-structured interviews were conducted with seven school-based mental health care professionals and data were analysed using Thematic Analysis. Participants reported that they relied on a reactive strategy by responding to youths who were in crisis. They were challenged by a lack of support from faculty staff, a lack of access to resources, and heavy caseloads. Findings highlight the need for a proactive and collaborative approach to suicide prevention among mental health care professionals, teachers and parents in South African schools and improved training and supervision.


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