Prioritizing suicide prevention guideline recommendations in specialist mental healthcare: a Delphi study

ObjectivePhysical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health.DesignSemistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements.Setting and participantsAcademic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included.Main outcome measuresAgreement in research priorities on a five-point scale.ResultsSeventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important.ConclusionsThis is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this.

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Multiple outcome measures and mixed methods for evaluating the effectiveness of theory-based behaviour-change interventions: A case study targeting health professionals' adoption of a national suicide prevention guideline

Psychology Health & Medicine ◽

10.1080/13548506.2011.554561 ◽

2011 ◽

Vol 16 (3) ◽

pp. 291-303 ◽

Cited By ~ 5

Author(s):

A. Hanbury ◽

L.M. Wallace ◽

M. Clark

Keyword(s):

Mixed Methods ◽

Suicide Prevention ◽

Outcome Measures ◽

Behaviour Change ◽

Health Professionals ◽

Behaviour Change Interventions ◽

Prevention Guideline ◽

Multiple Outcome

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Identification of Research Priorities For Suicide Prevention In Nepal: A Delphi Study

10.21203/rs.3.rs-1029224/v1 ◽

2021 ◽

Author(s):

Elisha Joshi ◽

Santosh Bhatta ◽

Sunil Kumar Joshi ◽

Julie Mytton

Keyword(s):

Lived Experience ◽

Suicide Prevention ◽

Delphi Study ◽

Research Priorities ◽

Expert Consensus ◽

Psychiatric Nurses ◽

Health Concern ◽

Consensus Method ◽

Significant Public Health ◽

Research Questions

Abstract Background: Suicide is a significant public health concern in Nepal and there is a need for an evidence-based suicide prevention programme to facilitate stakeholders working towards suicide prevention in Nepal. Collaborative research between stakeholders focussing on shared priorities can help to prevent and control suicide. Hence, we aimed to develop a consensus list of research priorities for suicide prevention in Nepal. Methods: The Delphi expert consensus method was used to elicit the prioritized research questions for suicide prevention in Nepal. Participants comprised suicide prevention experts (psychologists, psychiatrists, psychiatric nurses, researchers and advocates) and people with lived experience. Three rounds of Delphi were conducted; round 1: constituted one to one interview involving open-ended questions used to generate research questions; round 2: ranking of the research questions using a 5-point Likert scale, and round 3: re-ranking of research questions in light of individual and group responses.Results: 42 participants participated in round 1 followed by 38 in round 2 and 39 in round 3. 522 research questions were generated through round 1 which were grouped together and reduced to 33 research questions sent for ranking in round 2. Using a cut off of at least 70% of the panel ranking questions as ‘very important’ or ‘important’, 22 questions were retained. These research questions were sent for re-rating in round 3 generating a final list of prioritized research questions.Conclusions: This is the first expert consensus study to identify the top research priorities for suicide prevention in Nepal and used experts in suicide prevention and those with lived experience. A consensus was reached regarding the research needed to improve suicide data quality, assess the burden and identify factors associated with suicide. A priority-driven approach to suicide prevention research may ensure that the research endeavour provides the most useful information for those whose day-t- day work involves trying to prevent suicide.

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Patient safety priorities in mental healthcare in Switzerland: a modified Delphi study

BMJ Open ◽

10.1136/bmjopen-2016-011494 ◽

2016 ◽

Vol 6 (8) ◽

pp. e011494 ◽

Cited By ~ 2

Author(s):

Anna C Mascherek ◽

David L B Schwappach

Keyword(s):

Patient Safety ◽

Delphi Study ◽

Mental Healthcare ◽

Modified Delphi

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Indicators for routine monitoring of effective mental healthcare coverage in low- and middle-income settings: a Delphi study

Health Policy and Planning ◽

10.1093/heapol/czw040 ◽

2016 ◽

Vol 31 (8) ◽

pp. 1100-1106 ◽

Cited By ~ 20

Author(s):

Mark J D Jordans ◽

Dan Chisholm ◽

Maya Semrau ◽

Nawaraj Upadhaya ◽

Jibril Abdulmalik ◽

...

Keyword(s):

Delphi Study ◽

Mental Healthcare ◽

Middle Income ◽

Routine Monitoring ◽

Healthcare Coverage ◽

Low And Middle Income

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Peer support programs for people experiencing suicidality – A systematic scoping review of current literature

10.21203/rs.2.16656/v1 ◽

2019 ◽

Author(s):

MARISA SCHLICHTHORST ◽

Ingrid Ozols ◽

Lennart Reifels ◽

Amy Morgan

Keyword(s):

Peer Support ◽

Suicide Prevention ◽

Scoping Review ◽

Meta Analysis ◽

Grey Literature ◽

Mental Healthcare ◽

Support Programs ◽

Research Knowledge ◽

Definition Of ◽

Clinical Trials Registry

Abstract Background Peer-led support models have gained increasing popularity in mental healthcare. Yet little is known about the types of peer support programs that exist in suicide prevention and whether these are effective in improving the health and wellbeing of people at risk of suicide.Method We conducted a systematic scoping review, involving a search of three academic (Medline, PsycINFO, Embase), and selected grey literature databases (Google Scholar, WHO Clinical Trials Registry) for publications between 2000 and 2019. We also contacted suicide prevention experts and relevant internet sites to identify peer support programs that exist but have not been evaluated. The screening of records followed a systematic two-stage process in alignment with PRISMA guidelines.Results We identified 8 records accounting for 7 programs focused on peer-led support programs in suicide prevention. These programs employed a range of different designs and included a variety of settings (schools, communities, rural and online). Only 4 of these 7 programs contained data on the effectiveness of the program, and this evaluation data was descriptive on all accounts but showed promising results. With the small number of eligible programs in this review our findings are limited and must be interpreted with caution.Conclusions Despite the increased focus of policymakers on the importance of peer support programs in suicide prevention, our scoping review confirms an evidence gap in research knowledge regarding design, implementation, and effectiveness of programs. More rigour is required in reporting peer support initiatives to clarify the underlying definition of peer support and to enhance our understanding of the types of current peer support programs available to those experiencing suicidality. Further, we need formal and high-quality evaluations of peer support suicide prevention programs to better understand their effectiveness on participant health across different settings and delivery modalities and to allow for comprehensive systematic reviews and meta-analysis in future.

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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 ◽

10.1136/bmjopen-2018-024398 ◽

2018 ◽

Vol 8 (8) ◽

pp. e024398 ◽

Cited By ~ 3

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.

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Importance of Messages for a Suicide Prevention Media Campaign

Crisis ◽

10.1027/0227-5910/a000517 ◽

2018 ◽

Vol 39 (6) ◽

pp. 438-450 ◽

Cited By ~ 9

Author(s):

Angela Nicholas ◽

Alyssia Rossetto ◽

Anthony Jorm ◽

Jane Pirkis ◽

Nicola Reavley

Keyword(s):

Lived Experience ◽

Suicide Prevention ◽

Delphi Study ◽

Online Survey ◽

Family Members ◽

Population Level ◽

Survey Method ◽

Media Campaign ◽

Prevention Messages ◽

Prevention Campaign

Abstract. Background: A suicide prevention media campaign aimed at family members and friends may be one useful population-level suicide prevention strategy for Australia. However, currently there is limited evidence of what messages would be acceptable and appropriate for inclusion. Aims: This expert consensus study aimed to identify messages that experts with lived experience of suicide risk and suicide prevention professionals believed were most important to include in such a suicide prevention campaign. Method: Using an online survey method, 127 participants with lived experience (lived experience group) and 33 suicide prevention professionals (suicide prevention professionals group) rated 55 statements, drawn from an earlier Delphi study, from very low priority to very high priority for inclusion in a suicide prevention campaign. Results: There was significant agreement within and between the two participant groups on the most highly rated messages for inclusion. The mostly highly rated messages were that family members or friends should ask directly about suicidal thoughts and intentions, listen to responses without judgment, and tell the person at risk that they care and want to help. Limitations: We restricted ratings to just one round and may therefore have limited the level of consensus achieved. Use of a predefined set of suicide prevention messages might also have prevented us from identifying other important messages. Lived experience participants were drawn from one source and this might bias their responses through exposure to common suicide prevention messages that influence their points of view. Conclusion: There is substantial agreement between professionals and people with lived experience on the most important messages to include in a suicide prevention campaign. These most highly rated messages could be adopted in a suicide prevention media campaign.

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Characteristics of and trends in subgroups of prisoner suicides in England and Wales

Psychological Medicine ◽

10.1017/s0033291711000705 ◽

2011 ◽

Vol 41 (11) ◽

pp. 2275-2285 ◽

Cited By ~ 20

Author(s):

N. Humber ◽

M. Piper ◽

L. Appleby ◽

J. Shaw

Keyword(s):

Mental Health ◽

Suicide Prevention ◽

Drug Dependence ◽

Policy Development ◽

Case Series ◽

Mental Healthcare ◽

Service Level ◽

Treatment Needs ◽

England And Wales ◽

History Of

BackgroundThe suicide rate is higher in prisoners compared with the general population. The aim was to describe the characteristics of and longitudinal trends in prisoner suicides in England and Wales.MethodA case series was ascertained from the Safer Custody and Offender Policy Group at the Ministry of Justice and included a 9-year (1999–2007) national census of prisoner suicides. Questionnaires were completed by prison staff on sociodemographic, custodial, clinical and service-level characteristics of the suicides.ResultsThere was a fall in the number of prison suicides and a decline in the proportion of young prisoner (18–20 years) suicides over time. Females were over-represented. Upward trends were found in prisoners with a history of violence and with previous mental health service contact. A downward trend was found in those with a primary psychiatric diagnosis of drug dependence. Drug dependence was found to be significant in explaining suicides within the first week of custody.ConclusionsThe findings provide an important insight to aid a target set in the National Suicide Prevention Strategy in England to reduce suicides in the prisoner population by 20% and highlight an important area for policy development in mental health services. Examining trends identified subgroups that may require improved mental healthcare and recognized those that appeared to be having their treatment needs more adequately met. Evidence suggests that targeted suicide prevention strategies for subgroups of prisoners are required.

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