scholarly journals Reflections on a project to prevent suicide and self-harm among prisoners identified as high risk in two prisons in Northern England

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Paul Biddle ◽  
Wendy Dyer ◽  
Richard Hand ◽  
Charlitta Strinati
Keyword(s):  
High Risk ◽  
Self Harm

The Direct and Indirect Self-Harm Inventory (DISH): A new measure for assessing high-risk and self-harm behaviors among military veterans.

2017 ◽  
Vol 18 (3) ◽  
pp. 208-214 ◽  
Author(s):  
Jonathan D. Green ◽  
Christina Hatgis ◽  
Jaclyn C. Kearns ◽  
Matthew K. Nock ◽  
Brian P. Marx
Keyword(s):  
High Risk ◽  
Military Veterans ◽  
Self Harm

scholarly journals Predicting suicidal behaviours using clinical instruments: Systematic review and meta-analysis of positive predictive values for risk scales

2017 ◽  
Vol 210 (6) ◽  
pp. 387-395 ◽  
Author(s):  
Gregory Carter ◽  
Allison Milner ◽  
Katie McGill ◽  
Jane Pirkis ◽  
Nav Kapur ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Meta Analysis ◽  
Modifiable Risk Factors ◽  
High Quality ◽  
Policy Makers ◽  
Predictive Values ◽  
Effective Interventions ◽  
Self Harm ◽  
Meta Analyses

BackgroundPrediction of suicidal behaviour is an aspirational goal for clinicians and policy makers; with patients classified as ‘high risk’ to be preferentially allocated treatment. Clinical usefulness requires an adequate positive predictive value (PPV).AimsTo identify studies of predictive instruments and to calculate PPV estimates for suicidal behaviours.MethodA systematic review identified studies of predictive instruments. A series of meta-analyses produced pooled estimates of PPV for suicidal behaviours.ResultsFor all scales combined, the pooled PPVs were: suicide 5.5% (95% CI 3.9–7.9%), self-harm 26.3% (95% CI 21.8–31.3%) and self-harm plus suicide 35.9% (95% CI 25.8–47.4%). Subanalyses on self-harm found pooled PPVs of 16.1% (95% CI 11.3–22.3%) for high-quality studies, 32.5% (95% CI 26.1–39.6%) for hospital-treated self-harm and 26.8% (95% CI 19.5–35.6%) for psychiatric in-patients.ConclusionsNo ‘high-risk’ classification was clinically useful. Prevalence imposes a ceiling on PPV. Treatment should reduce exposure to modifiable risk factors and offer effective interventions for selected subpopulations and unselected clinical populations.

Decision making and problem solving in adolescents who deliberately self-harm

2008 ◽  
Vol 39 (1) ◽  
pp. 95-104 ◽  
Author(s):  
A. Oldershaw ◽  
E. Grima ◽  
F. Jollant ◽  
C. Richards ◽  
M. Simic ◽  
...  
Keyword(s):  
Decision Making ◽  
Problem Solving ◽  
High Risk ◽  
Iowa Gambling Task ◽  
Previous History ◽  
Risk Behaviour ◽  
High Risk Behaviour ◽  
Adolescents And Adults ◽  
Sh Group ◽  
Self Harm

BackgroundHealthy adolescents, and adults who engage in reward-driven, risky behaviours, demonstrate poor decision-making ability. Decision making in deliberate self-harm (DSH), a reward-driven, high-risk behaviour, has received little attention. This study assessed decision making and problem solving in adolescents with current or past SH.MethodDecision making and problem solving were assessed using the Iowa Gambling Task (IGT) and the Means–Ends Problem-Solving Procedure (MEPS) respectively in 133 adolescents (57 healthy and 22 depressed controls with no SH history and 54 with SH history). A second analysis separated the SH group into current (n=30) and past (n=24) SH.ResultsThe collective performance of adolescents with SH history did not differ from depressed or healthy adolescents on the IGT. However, current self-harming adolescents had a trend towards more high-risk choices (p=0.06) than those with previous SH history and were the only group not to significantly improve over time, persisting with high-risk strategy throughout. Those who no longer self-harmed learnt to use a low-risk strategy similar to healthy and depressed controls. Recency of last SH episode correlated with IGT performance. Depressed participants performed well on the IGT but poorly on the MEPS. By contrast, both collective and divided SH groups had comparable MEPS scores to healthy controls, all performing better than depressed participants.ConclusionPoor decision making is present in adolescents who currently self-harm but not in those with previous history; improvement in decision-making skills may therefore be linked to cessation of self-harm. Depressed adolescents who do and do not self-harm may have distinct characteristics.

Strategies for preventing suicide

1997 ◽  
Vol 171 (4) ◽  
pp. 351-354 ◽  
Author(s):  
Glyn Lewis ◽  
Keith Hawton ◽  
Peter Jones
Keyword(s):  
High Risk ◽  
Population Attributable Fraction ◽  
Population Based ◽  
Number Needed To Treat ◽  
Deliberate Self Harm ◽  
Suicide Rates ◽  
Population Attributable Fractions ◽  
Effective Interventions ◽  
Self Harm ◽  
The Uk

BackgroundThe Health of the Nation includes a target for reducing population suicide rates. We have examined and quantified various high-risk and population-based strategies for prevention based upon a number of stated assumptions and hypothetical interventions.MethodThe published literature was used to estimate the population attributable fractions for both high-risk and population-based strategies. The number needed to treat for the high-risk strategies was calculated, assuming an intervention that reduced suicide rates by 25%ResultsInterventions that would reduce rates of suicide by 25% would reduce population rates by about 2.6% for those recently discharged from hospital and by up to 5.8% for those presenting to general hospital with deliberate self-harm. The population attributable fraction for unemployment was 10.9%ConclusionsHigh-risk strategies will have only a modest effect on population suicide rates, even if effective interventions are developed. Evaluating interventions for deliberate self-harm patients seems worthwhile. The UK Government's target for suicide reduction is more likely to be achieved using population-based strategies. Reducing the availability of methods commonly used for committing suicide is the most practicable current policy, although more radical approaches, for example reducing unemployment, may also substantially reduce suicide rates.

scholarly journals Self-harm prevalence and associated factors among street children in Mashhad, North East of Iran

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Lida Jarahi ◽  
Maliheh Dadgarmoghaddam ◽  
Atiyeh Naderi ◽  
AmirAli Moodi Ghalibaf
Keyword(s):  
High Risk ◽  
Street Children ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
High Risk Behaviors ◽  
North East ◽  
Health Decision ◽  
Self Harm ◽  
Low Educated

Abstract Background Self-harm is intentional harmful behavior in the context of emotional distress. Street children are boys and girls under eighteen who are forced to work or live on the streets. These children are exposed to violent situations and high-risk behaviors like self-harm. This study investigated the prevalence of self-harm in street children in Mashhad, the second Metropolis of Iran. Methods In this cross-sectional study, 98 children were assessed with a 22-item of self-harm Inventory (SHI) questionnaire. A trained social worker interviewed the participants who were referred to Mashhad Welfare Office, February-July 2020. Results The mean age of participants was 13.8 (2.3) years old, and 71.4 % of them were male. Of street children 59.2 % have had self-harming behavior, among them 8.6 % had one self-harming behavior, and others have more than one. The self-harmed people who had physical injuries, more frequent injuries were hitting (26.5 %), self-starvation (23.5 %), cutting (21.4 %), respectively. In comparison, common psychological injuries were God-distancing (29.6 %) and self-defeating thoughts (19.4 %). The most important risk factors were having a mental disorder (OR = 6.3, P = 0.002), losing parents (OR = 4.4, P = 0.01), self-harming or suicide history in relatives (OR = 3.2, P = 0.001, OR = 4.3, P = 0.03 respectively), low-educated parents (OR = 4.2, P = 002, OR = 2.8, P = 0.02 for father and mother respectively), and age-increasing (OR = 1.5, P = 0.001). Conclusions The prevalence of self-harming in street children is significantly high. Some of these children are in more high-risk conditions that face them to suffer from self-harming at a younger age. Family factors are more important in predicting self-harming and community health decision-makers should provide educational interventions and psychological support for these children and their families.

scholarly journals Short-term management of repeated self-harm in secure institutions

2011 ◽  
Vol 17 (6) ◽  
pp. 435-446 ◽  
Author(s):  
Jaydip Sarkar
Keyword(s):  
High Risk ◽  
Morbidity And Mortality ◽  
Pragmatic Approach ◽  
Short Term ◽  
Algorithmic Approach ◽  
Forensic Patients ◽  
Security Breaches ◽  
Self Harm ◽  
Harm To Others ◽  
Term Management

SummaryThe challenge of managing repeated self-harm and the high risk of morbidity and mortality are compounded in forensic patients, where there are additional risks of harm to others, absconding and security breaches. There is an urgent need for clinically sound, practice-based and theoretically grounded strategies for managing these associated risks. This is essential as available UK guidelines appear inadequate for this group of patients. This article promotes a pragmatic approach to assessing the risk of self-harm clinically to arrive at hierarchical risk judgements. It further suggests an algorithmic approach to managing these risks and provides testable strategies that can be adapted for use in various secure institutions.

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