scholarly journals Reducing Suicidal Ideation among Turkish Migrants in the Netherlands and in the UK A Pilot RCT of a guided Online Intervention

2020 ◽  
Author(s):  
Ozlem Eylem ◽  
Annemieke van Straten ◽  
Leonore de Wit ◽  
Shanaya Rathod ◽  
Kamaldeep Bhui ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempts ◽  
Intervention Group ◽  
Online Intervention ◽  
Direct Access ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Turkish Migrants ◽  
Therapeutic Benefits ◽  
Culturally Adapted

Abstract Background: The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines indications for its effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods: Turkish migrants (first and second generation) with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6 weeks guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results: A total of 85 people signed up via the study website and 18 (10 intervention, 8 waitlist control) were included. While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were: not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression and hopelessness scores were improved in both groups. Conclusion: The online intervention, as might be expected in a small feasibility study, was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration: NTR5028. Registered 1 March 2015, https://www.trialregister.nl/trial/4926

scholarly journals Reducing Suicidal Ideation among Turkish Migrants in the Netherlands and in the UK: The Feasibility of a Randomised Controlled Trial of a Guided Online Intervention

2021 ◽  
Author(s):  
Ozlem Eylem ◽  
Annemieke van Straten ◽  
Leonore de Wit ◽  
Shanaya Rathod ◽  
Kamaldeep Bhui ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Intervention Group ◽  
Online Intervention ◽  
Direct Access ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Therapeutic Benefits ◽  
Culturally Adapted

Abstract Background: The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods: Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6 weeks guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results: 85 people signed up via the study website and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were: not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression and hopelessness scores were improved in both groups. Conclusion: Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration: NTR5028. Registered 1 March 2015, https://www.trialregister.nl/trial/4926

scholarly journals Reducing Suicidal Ideation among Turkish Migrants in the Netherlands and in the UK: The Feasibility of a Randomised Controlled Trial of a Guided Online Intervention

2020 ◽  
Author(s):  
Ozlem Eylem ◽  
Annemieke van Straten ◽  
Leonore de Wit ◽  
Shanaya Rathod ◽  
Kamaldeep Bhui ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Intervention Group ◽  
Online Intervention ◽  
Direct Access ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Therapeutic Benefits ◽  
Culturally Adapted

Abstract Background: The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual.Methods: Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6 weeks guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis.Results: 85 people signed up via the study website and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were: not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression and hopelessness scores were improved in both groups.Conclusion: Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not.Trial registration: NTR5028. Registered 1 March 2015, https://www.trialregister.nl/trial/4926

scholarly journals Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ozlem Eylem ◽  
Annemieke van Straten ◽  
Leonore de Wit ◽  
Shanaya Rathod ◽  
Kamaldeep Bhui ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Intervention Group ◽  
Online Intervention ◽  
Direct Access ◽  
Suicidal Thoughts ◽  
Turkish Migrants ◽  
Therapeutic Benefits ◽  
Culturally Adapted

Abstract Background The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6-week guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow-up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results Eighty-five people signed up via the study website, and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression, and hopelessness scores were improved in both groups. Conclusion Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, and careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration Netherlands Trial Register, NTR5028. Registered on 1 March 2015

scholarly journals Examining the effect of smoking on suicidal ideation and attempts: triangulation of epidemiological approaches

2020 ◽  
Vol 217 (6) ◽  
pp. 701-707 ◽  
Author(s):  
Ruth Harrison ◽  
Marcus R. Munafò ◽  
George Davey Smith ◽  
Robyn E. Wootton
Keyword(s):  
Suicidal Ideation ◽  
Odds Ratio ◽  
Suicide Attempts ◽  
Causal Effect ◽  
Smoking Status ◽  
Strong Association ◽  
Mendelian Randomisation ◽  
Polymorphism Analysis ◽  
Suicidal Thoughts ◽  
Smoking Behaviours

BackgroundPrevious literature has demonstrated a strong association between cigarette smoking, suicidal ideation and suicide attempts. This association has not previously been examined in a causal inference framework and could have important implications for suicide prevention strategies.AimsWe aimed to examine the evidence for an association between smoking behaviours (initiation, smoking status, heaviness, lifetime smoking) and suicidal thoughts or attempts by triangulating across observational and Mendelian randomisation analyses.MethodFirst, in the UK Biobank, we calculated observed associations between smoking behaviours and suicidal thoughts or attempts. Second, we used Mendelian randomisation to explore the relationship between smoking and suicide attempts and ideation, using genetic variants as instruments to reduce bias from residual confounding and reverse causation.ResultsOur observational analysis showed a relationship between smoking behaviour, suicidal ideation and attempts, particularly between smoking initiation and suicide attempts (odds ratio, 2.07; 95% CI 1.91–2.26; P < 0.001). The Mendelian randomisation analysis and single-nucleotide polymorphism analysis, however, did not support this (odds ratio for lifetime smoking on suicidal ideation, 0.050; 95% CI −0.027 to 0.127; odds ratio on suicide attempts, 0.053; 95% CI, −0.003 to 0.110). Despite past literature showing a positive dose-response relationship, our results showed no clear evidence for a causal effect of smoking on suicidal ideation or attempts.ConclusionsThis was the first Mendelian randomisation study to explore the effect of smoking on suicidal ideation and attempts. Our results suggest that, despite observed associations, there is no clear evidence for a causal effect.

scholarly journals Effect of Housing First on Suicidal Behaviour

2017 ◽  
Vol 62 (7) ◽  
pp. 473-481 ◽  
Author(s):  
Joshua P. Aquin ◽  
Leslie E. Roos ◽  
Jino Distasio ◽  
Laurence Y. Katz ◽  
Jimmy Bourque ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
Homeless Persons ◽  
Housing First ◽  
Randomised Control Trial ◽  
Management Support ◽  
Treatment As Usual ◽  
Effect Of Treatment

Objective: This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour. Method: The At Home/Chez Soi project is an unblinded, randomised control trial conducted across 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, Moncton) from 2009 to 2013. Homeless adults with a diagnosed major mental health disorder were recruited through community agencies and randomised to HF ( n = 1265) and TAU ( n = 990). HF participants were provided with private housing units and received case management support services. TAU participants retained access to existing community supports. Past-month suicidal ideation was measured at baseline and 6, 12, 18, and 21/24 months. A history of suicide attempts was measured at baseline and the 21/24-month follow-up. Results: Compared to baseline, there was an overall trend of decreased past-month suicidal ideation (estimate = –.57, SE = .05, P < 0.001), with no effect of treatment group (i.e., HF vs. TAU; estimate = –.04, SE = .06, P = 0.51). Furthermore, there was no effect of treatment status (estimate = –.10, SE = .16, P = 0.52) on prevalence of suicide attempts (HF = 11.9%, TAU = 10.5%) during the 2-year follow-up period. Conclusion: This study failed to find evidence that HF is superior to TAU in reducing suicidal ideation and attempts. We suggest that HF interventions consider supplemental psychological treatments that have proven efficacy in reducing suicidal behaviour. It remains to be determined what kind of suicide prevention interventions (if any) are specifically effective in further reducing suicidal risk in a housing-first intervention.

The relationship between an electronic mental health stigma campaign and suicidal thoughts and behaviours: a two-arm randomized controlled trial in the Australian construction industry

2019 ◽  
Vol 35 (3) ◽  
pp. 478-485
Author(s):  
A Milner ◽  
Z Aitken ◽  
P C F Law ◽  
A D LaMontagne ◽  
C Mann ◽  
...  
Keyword(s):  
Mental Health ◽  
Construction Industry ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Intervention Group ◽  
Mental Health Stigma ◽  
Post Intervention ◽  
Suicidal Thoughts

Abstract Males employed in the construction industry are at greater risk of suicide than other employed males. It is plausible that a high level of stigma against mental health problems explains the elevated rates of suicide among this group. This study sought to test the effectiveness of an electronic mental health stigma intervention on suicide ideation, communication about suicide and attempts. Participants were randomly assigned to receive either a series of brief contact interventions over a 6-week period or a wait list control. Suicidal ideation, communication about suicide and suicide attempts were assessed using the Suicidal Behaviors Questionnaire-Revised at post-intervention. We used linear regression to assess effectiveness at post-intervention, adjusting for relevant covariates using both conventional methods and a propensity score approach. Results indicate that the intervention had no significant impact on suicidal thoughts, communication or suicide attempts. There was some indication that individuals in the intervention group reported a slight increase in attempts and communication about suicide. These observations underscore an urgent need for more research to understand the complex and nuanced relationship between stigma and suicide in non-clinical populations.

Psychosocial factors that distinguish between men and women who have suicidal thoughts and attempt suicide: findings from a national probability sample of adults

2022 ◽  
pp. 1-9
Author(s):  
Cara Richardson ◽  
Kathryn A. Robb ◽  
Sally McManus ◽  
Rory C. O'Connor
Keyword(s):  
Social Support ◽  
Mental Illness ◽  
Sex Differences ◽  
Suicidal Ideation ◽  
Psychosocial Factors ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Childhood Adversity ◽  
Suicidal Thoughts ◽  
Men And Women

Abstract Background Previous research has highlighted the importance of understanding which psychosocial factors distinguish between those with suicide thoughts compared to those who attempt suicide. This study aims to investigate these distinguishing factors further within an ideation-to-action framework and to explore sex differences in suicide risk. Methods Participants (n = 7546, aged 16+) were from the cross-sectional Adult Psychiatric Morbidity Survey (APMS; 2014) of England. Face-to-face and self-completion questionnaires assessed lifetime suicidal ideation, lifetime suicide attempts, demographic characteristics, life experiences, social support, health and mental illness. Multinomial logistic regression examined factors differentiating between those with suicidal ideation only and suicide attempt histories (with or without suicidal ideation) in men and women. Results Overall men were less likely to report suicidal thoughts and attempts, compared to females. More factors differentiated between suicidal thoughts and attempts in women compared to in men; these included hospital admission for mental illness, below degree level qualifications, being single and childhood adversity. In men, factors which significantly differentiated between suicidal thoughts and attempts included self-report of professional diagnosis of mental illness and childhood adversity. Higher levels of social support were associated with being in the suicidal thoughts group v. in the attempts group in men. Conclusion This study identified some key differences between men and women in factors associated with suicide attempts compared to suicidal thoughts. The findings support the use of the ideation-to-action framework to investigate sex differences in suicidal behaviour. Future research should examine the extent to which these factors are associated with suicide risk over time.

Experience of suicidal thoughts: A discourse analytic study.

2014 ◽  
Vol 10 (2) ◽  
pp. 117-127 ◽  
Author(s):  
Dariusz Galasiński ◽  
Justyna Ziółkowska
Keyword(s):  
Suicidal Ideation ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Hospitals ◽  
Homogeneous Group ◽  
Analytic Study ◽  
Service Users ◽  
Suicidal Thoughts ◽  
The Relationship ◽  
Insight Into

In the paper we explore the relationship between current psychiatric thinking on suicide and service users’ accounts of suicidal ideation and suicide attempts. The data comes from recordings of psychiatric interviews collected in three psychiatric hospitals in Poland. Assuming a constructionist view of discourse we argue that the literature on suicide ignores and simplifies the experience of those who think about suicide and attempt to commit it and constructs their experiences as a homogeneous group of ‘thoughts’ only with content (without form). We also offer a preliminary insight into the complexity of ‘suicide thoughts, as narrated by those reporting them. We demonstrate that they are marginalised and made relatively irrelevant in the accounts of attempted suicide. Additionally, we demonstrate that while women construct suicide attempts (whether actually attempted in the end or not) as at least potentially beyond their control, men’s narratives very show them in control of the attempt, as if choosing an available option. We conclude by exploring possibilities of further qualitative discourse analytic research which builds on the findings we present here.

A Bayesian multilevel analysis of the longitudinal associations between relationship quality and suicidal ideation and attempts among youth with bipolar disorder

2020 ◽  
Author(s):  
Craig Sewall ◽  
Jeffrey M. Girard
Keyword(s):  
Bipolar Disorder ◽  
Risk Factor ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Relationship Quality ◽  
Suicide Attempts ◽  
Suicidal Thoughts ◽  
Increased Risk ◽  
Longitudinal Associations ◽  
Suicidal Thoughts And Behaviors

ABSTRACTBackground: Youth with bipolar disorder (BD) are at high risk for suicidal thoughts and behaviors and frequently experience interpersonal impairment, which is a risk factor for suicide. Yet, no study to date has examined the longitudinal associations between relationship quality in family/peer domains and suicidal thoughts and behaviors among youth with BD. Thus, we investigated how between-person differences--reflecting the average relationship quality across time--and within-person changes, reflecting recent fluctuations in relationship quality, act as distal and/or proximal risk factors for suicidal ideation (SI) and suicide attempts. Methods: We used longitudinal data from the Course and Outcome of Bipolar Youth Study (N=413). Relationship quality variables were decomposed into stable (i.e. average) and varying (i.e. recent) components and entered, along with major clinical covariates, into separate Bayesian multilevel models predicting SI and suicide attempt. We also examined how the relationship quality effects interacted with age and sex. Results: Poorer average relationship quality with parents (β= -0.33, 95% Bayesian Highest Density Interval (HDI) [-0.54, -0.11]) or friends (β= -0.33, 95% HDI [-0.55, -0.11]) were longitudinally associated with increased risk of SI but not suicide attempt. Worsening recent relationship quality with parents (β= -0.10, 95% HDI [-0.19, -0.03]) and, to a lesser extent, friends (β= -0.06, 95% HDI [-0.15, 0.03]), were also longitudinally associated with increased risk of SI. Worsening recent relationship quality with parents may also be associated with increased risk of suicide attempt (β= -0.13, 95% HDI [-0.29, 0.03]). The effects of certain relationship quality variables were moderated by gender but not age. Conclusions: Among youth with BD, having poorer average relationship quality with peers and/or parents represents a distal risk factor for SI but not suicide attempts. Additionally, worsening recent relationship quality with parents that is may be a time-sensitive indicator of increased risk for SI or suicide attempt.

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