scholarly journals Exploring Suicidal Ideation Using an Innovative Mobile App-Strength Within Me: The Usability and Acceptability of Setting up a Trial Involving Mobile Technology and Mental Health Service Users

10.2196/18407 ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. e18407
Author(s):  
Ashley Jane Bruen ◽  
Abbie Wall ◽  
Alina Haines-Delmont ◽  
Elizabeth Perkins
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Real Time ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Public Health Problem ◽  
Mobile App ◽  
Inpatient Setting ◽  
Service Users ◽  
Risk Of Death

Background Suicide is a growing global public health problem that has resulted in an increase in the demand for psychological services to address mental health issues. It is expected that 1 in 6 people on a waiting list for mental health services will attempt suicide. Although suicidal ideation has been shown to be linked to a higher risk of death by suicide, not everybody openly discloses their suicidal thoughts or plans to friends and family or seeks professional help before suicide. Therefore, new methods are needed to track suicide risk in real time together with a better understanding of the ways in which people communicate or express their suicidality. Considering the dynamic nature and challenges in understanding suicide ideation and suicide risk, mobile apps could be better suited to prevent suicide as they have the ability to collect real-time data. Objective This study aims to report the practicalities and acceptability of setting up and trialing digital technologies within an inpatient mental health setting in the United Kingdom and highlight their implications for future studies. Methods Service users were recruited from 6 inpatient wards in the north west of England. Service users who were eligible to participate and provided consent were given an iPhone and Fitbit for 7 days and were asked to interact with a novel phone app, Strength Within Me (SWiM). Interaction with the app involved journaling (recording daily activities, how this made them feel, and rating their mood) and the option to create safety plans for emotions causing difficulties (identifying strategies that helped with these emotions). Participants also had the option to allow the study to access their personal Facebook account to monitor their social media use and activity. In addition, clinical data (ie, assessments conducted by trained researchers targeting suicidality, depression, and sleep) were also collected. Results Overall, 43.0% (80/186 response rate) of eligible participants were recruited for the study. Of the total sample, 67 participants engaged in journaling, with the average number of entries per user being 8.2 (SD 8.7). Overall, only 24 participants created safety plans and the most common difficult emotion to be selected was feeling sad (n=21). This study reports on the engagement with the SWiM app, the technical difficulties the research team faced, the importance of building key relationships, and the implications of using Facebook as a source to detect suicidality. Conclusions To develop interventions that can be delivered in a timely manner, prediction of suicidality must be given priority. This paper has raised important issues and highlighted lessons learned from implementing a novel mobile app to detect the risk of suicidality for service users in an inpatient setting.

scholarly journals Exploring Suicidal Ideation Using an Innovative Mobile App-Strength Within Me: The Usability and Acceptability of Setting up a Trial Involving Mobile Technology and Mental Health Service Users (Preprint)

2020 ◽  
Author(s):  
Ashley Jane Bruen ◽  
Abbie Wall ◽  
Alina Haines-Delmont ◽  
Elizabeth Perkins
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Real Time ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Public Health Problem ◽  
Mobile App ◽  
Inpatient Setting ◽  
Service Users ◽  
Risk Of Death

BACKGROUND Suicide is a growing global public health problem that has resulted in an increase in the demand for psychological services to address mental health issues. It is expected that 1 in 6 people on a waiting list for mental health services will attempt suicide. Although suicidal ideation has been shown to be linked to a higher risk of death by suicide, not everybody openly discloses their suicidal thoughts or plans to friends and family or seeks professional help before suicide. Therefore, new methods are needed to track suicide risk in real time together with a better understanding of the ways in which people communicate or express their suicidality. Considering the dynamic nature and challenges in understanding suicide ideation and suicide risk, mobile apps could be better suited to prevent suicide as they have the ability to collect real-time data. OBJECTIVE This study aims to report the practicalities and acceptability of setting up and trialing digital technologies within an inpatient mental health setting in the United Kingdom and highlight their implications for future studies. METHODS Service users were recruited from 6 inpatient wards in the north west of England. Service users who were eligible to participate and provided consent were given an iPhone and Fitbit for 7 days and were asked to interact with a novel phone app, Strength Within Me (SWiM). Interaction with the app involved journaling (recording daily activities, how this made them feel, and rating their mood) and the option to create safety plans for emotions causing difficulties (identifying strategies that helped with these emotions). Participants also had the option to allow the study to access their personal Facebook account to monitor their social media use and activity. In addition, clinical data (ie, assessments conducted by trained researchers targeting suicidality, depression, and sleep) were also collected. RESULTS Overall, 43.0% (80/186 response rate) of eligible participants were recruited for the study. Of the total sample, 67 participants engaged in journaling, with the average number of entries per user being 8.2 (SD 8.7). Overall, only 24 participants created safety plans and the most common <i>difficult emotion</i> to be selected was feeling sad (n=21). This study reports on the engagement with the SWiM app, the technical difficulties the research team faced, the importance of building key relationships, and the implications of using Facebook as a source to detect suicidality. CONCLUSIONS To develop interventions that can be delivered in a timely manner, prediction of suicidality must be given priority. This paper has raised important issues and highlighted lessons learned from implementing a novel mobile app to detect the risk of suicidality for service users in an inpatient setting.

scholarly journals Suicidality amongst young adults in South-south Nigeria

2021 ◽  
Vol 8 (8) ◽  
pp. 3737
Author(s):  
Obielumanii I. Oguche ◽  
Ulunma I. Mariere ◽  
Adedotun D. Adesina ◽  
Hilda C. Afakwu-Adimoha ◽  
Rukevwe Akakabota ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Young Adults ◽  
Suicidal Ideation ◽  
Attempted Suicide ◽  
Suicide Ideation ◽  
Positive Family History ◽  
Critical Time ◽  
Public Health Problem ◽  
Suicidal Plans

Background: Suicidality is a broad term that encompasses suicidal ideation, suicide plans and suicide attempts. Suicide cuts across all age groups however the young adulthood phase is a critical time for the onset of suicidal behaviours. Often suicide is underreported because of the shame, as such it is a neglected public health problem in our environment. This study seeks to describe the pattern of suicidality and reported health seeking behaviour amongst young people in Bayelsa State.Methods: A descriptive cross-sectional study conducted in the national youth service corps orientation camp, Bayelsa amongst 387 corps members. With the aid of an electronic, self-administered questionnaire adapted from the WHO STEPwise manual on non-communicable diseases; information on socio demographic features, suicide ideation, plan and attempt were obtained. Data was analysed using IBM SPSS version 25.0.Results: The mean age was 25.37 (SD±2.38) years. Most participants were males (58.9%) and single (95.3%). Prevalence of suicidal ideation, plans and attempts was 7.5%, 4.4% and 3.1% respectively. Above one third (35.4%) of those who made suicidal plans in the past 12 months, actually attempted suicide, 4.4% and 2.6% of the respondents had a positive family history of suicide attempt and suicide death respectively.Conclusions: Young adults are a critical population for suicidality. Public health awareness on mental health promotion and uptake of mental health service should be encouraged. Decriminalisation of attempted suicide in Nigeria and better surveillance will enable more effective suicide prevention strategies.

scholarly journals High Risk of Suicide in Behavioral Variant Frontotemporal Dementia

2018 ◽  
Vol 34 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Milena Zucca ◽  
Elisa Rubino ◽  
Alessandro Vacca ◽  
Flora Govone ◽  
Annalisa Gai ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
High Risk ◽  
Frontotemporal Dementia ◽  
Suicide Risk ◽  
Attempted Suicide ◽  
Disease Duration ◽  
Suicide Ideation ◽  
Behavioral Variant Frontotemporal Dementia ◽  
High Level ◽  
Anxiety Depression

Aim: The purpose of the study was to determine the prevalence of suicidal ideation and attempts in patients with behavioral variant frontotemporal dementia (bvFTD), evaluating possible risk factors for suicidality. Methods: Risk of suicide was assessed using the Scale for Suicide Ideation (SSI) in 35 patients with bvFTD and 25 controls. Results: According to SSI, 40% of patients with bvFTD had suicidal ideation in comparison to 8% of controls ( P = .009). Four patients with bvFTD have attempted suicide versus none control ( P = .006). Patients with bvFTD with suicide risk showed higher levels of anxiety, depression, stress, and hopelessness than patients without suicide risk ( P < .001). Patients who attempted suicide were younger and had a longer disease duration than those with only suicide ideation. Intriguingly, 40% of patients with parkinsonism presented high level of suicide ideation. Conclusions: Our findings show that patients with bvFTD have a high risk of suicide. Additional studies in larger populations are needed to confirm our results.

scholarly journals Dermatologists’ perceptions of suicidality in dermatological practice: a survey of prevalence estimates and attitudes in Austria

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ekaterina Pronizius ◽  
Martin Voracek
Keyword(s):  
Mental Health ◽  
Atopic Dermatitis ◽  
Suicidal Ideation ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Suicide Risk ◽  
Female Gender ◽  
Treatment Quality ◽  
Person Perspective ◽  
Low Rate

Abstract Background Chronic illnesses belong to suicide risk factors. The goal of the current study was to estimate the rate of suicide-related behaviors in patients with atopic dermatitis, psoriasis, or acne from a third-person perspective (namely, Austrian dermatologists). Methods A link to a questionnaire specially developed for this study was emailed to 450 self-employed dermatologists in Austria, from which a total of 45 participated. Results Three dermatologists reported more than five patients with atopic dermatitis, psoriasis, or acne who committed suicide in 2017. Seven doctors treated between 1 and 10 such patients suffering from suicidal ideation. These results are suggestive for a low rate of suicidal ideations in Austrian dermatology ordinations. The majority of dermatologists in the sample (82%) knew that these patients are at higher suicide risk. 60% of participants also believed that it rather would not be a problem for them to recognize suicidal ideation. When facing patients in a suicide crisis, reported intervention steps were: referring them to a specialist in psychiatry, or having a conversation about it. In the sample, most challenging about suicide was lack of time and lack of knowledge. Dermatologists were also interested in cooperating with mental health professionals and in the implementation of new prevention strategies (e.g., suicide-related training programs). Analysis revealed that private specialists, as compared with contract physicians, had fewer patients, but spent more time with them. Yet, these differences did not appear to influence the quality of treatment they provided. Treatment quality was defined as the extent to which doctors tell their patients that additional psychological treatments could be helpful and asking them about their emotional state. Female gender and a professional background in psychology impacted positively on treatment quality. Conclusions Possible explanations for the low rate of suicidal ideations reported include the advanced Austrian health care system and dermatologists’ underestimation of the problem. Implications of the study are to promote cooperation between dermatologists and mental health professionals and to address patient suicidality from a first-person perspective (i.e., the patients).

scholarly journals Work Expectations and Trajectories of Depressive Symptoms and Passive Suicidal Ideation Among Baby Boomers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 557-557
Author(s):  
Linh Dang ◽  
Briana Mezuk
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Baby Boomers ◽  
Quantitative Research ◽  
Suicide Ideation ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Future Research ◽  
Full Time

Abstract Expectations regarding work (e.g., probability of retiring at a certain age), whether realized or not, may influence mental health, however there is limited quantitative research on this question. This study examined the longitudinal relationship between expectations of full-time work after age 62 and depressive symptoms and passive suicidal ideation among Baby Boomers, a generation that experienced the Great Recession as they neared retirement. Data came from the Health and Retirement Study, 2008 - 2016 (N = 8,954, mean age = 55.3, 52.2% female, 77.8% non-Hispanic White). Clinically-relevant depressive symptoms were indexed by the Composite International Diagnostic Interview (CIDI). Expectation (probability) of working after age 62 was modeled continuously (range: 0 to 1). Multivariate mixed-effects logistic regression models of screening positive on the CIDI and passive suicide ideation were fit, separately, adjusting for demographics, household income and wealth, and health characteristics. Respondents working at baseline were less likely to screen positive on the CIDI longitudinally (OR: 0.36, 95% CI: 0.26 - 0.51), and while expectations were inversely associated with screening positive on the CIDI this was not significant after accounting for work status (OR: 0.68, 95% CI: 0.43 - 1.09, p=0.104). Longitudinally, higher expectations of working were inversely associated with passive suicidal ideation (OR: 0.54, 95% CI: 0.32 - 0.92) even after accounting for working status. Future research will examine variation in these relationships by contextual factors like wealth, sex, and race/ethnicity to clarify how these features shape the association between work and mental health for this generation of older adults.

scholarly journals A Rapid Learning Health System to Support Implementation of Early Intervention Services for Psychosis in Quebec, Canada: Study Protocol

2021 ◽  
Author(s):  
Manuela Ferrari ◽  
Srividya Iyer ◽  
Annie Leblanc ◽  
Marc-André Roy ◽  
Amal Abdel-Baki
Keyword(s):  
Early Intervention ◽  
Real Time ◽  
Preliminary Evidence ◽  
Mobile App ◽  
Service Users ◽  
Scan Design ◽  
Rapid Learning ◽  
Early Intervention Services ◽  
Essential Components ◽  
Intervention Services

Abstract Background: Given the strong evidence for their effectiveness, early intervention services for psychosis (EIS) are being widely implemented. However, heterogeneity in the implementation of essential components, remains an ongoing challenge. Rapid learning health systems (RLHS), that embed data collection in clinical settings for real-time learning and continual quality improvement, can address this challenge. We therefore implemented a RLHS in 11 EIS in Quebec, Canada. This project aims to determine the feasibility and acceptability of implementing a RLHS in EIS, and to assess its impact on compliance with standards for essential EIS components. Methods: Following literature recommendations, the implementation of this RLHS involves six iterative phases: external and internal scan, design, implementation, evaluation, adjustment, and dissemination. Multiple stakeholder groups (service users, families, clinicians, researchers, decision makers, provincial EIS association) are involved in all phases. Meaningful indicators of EIS quality (e.g., satisfaction, timeliness of response to referrals) were selected based on literature review, provincial guidelines, and stakeholder consensus on indicators prioritisation. A digital infrastructure was designed and deployed that comprises (a) a user-friendly interface for routinely collecting data from programs (b) a digital terminal and mobile app to collect feedback from service users and families regarding care received, health, and quality of life (c) data analytic, visualization and reporting functionalities to provide participating programs with real-time feedback on their performance over time, and in relation to standards and to other programs, along with tailored recommendations. Community of practice activities are being conducted that leverage insights from data to build capacity among programs to continually progress towards aligning their practice with standards/best practices. Guided by the RE-AIM framework, we are collecting quantitative and qualitative data on the Reach, Effectiveness Adoption, Implementation and Maintenance of our RLHS. These RE-AIM data will be analyzed to evaluate our RLHS’s impacts. Discussion: This project will yield valuable insights about how a RLHS can be implemented by EIS, along with preliminary evidence for its acceptability, feasibility and impacts on program-level outcomes. Its findings will refine our RLHS further and advance approaches that bring data, stakeholder voices and collaborative learning to improve outcomes and service quality in psychosis. Trial registration: NA

611 Screening Adults for Depression and Suicidality in an Outpatient Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S149-S150
Author(s):  
Amanda Rose ◽  
Alan D Gilbertson ◽  
Heather Belacic ◽  
John Crow
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Suicide Risk ◽  
Compliance Rate ◽  
Quality Improvement Initiative ◽  
Burn Patients ◽  
Initial Visit ◽  
Burn Center

Abstract Introduction In response to NIH recommendations and ABA verification standards, a protocol was initiated to screen adult burn patients in an outpatient verified burn center for depression and suicidality. It utilized the Patient Health Questionnaire (PHQ-9), a widely recognized depression screening tool. The protocol dictated patients scoring 10 or greater, or endorsing the suicide risk question would require further assessment. This project was part of a quality improvement initiative to assess initiating the protocol, identifying at-risk patients, and making appropriate referrals. Methods The initial visit of adults (ages 19 and over) seen over a one year period were retrospectively reviewed. For adults screening positive in the EMR, a Data Collection Form was completed gathering information on PHQ-9 scores, mental health treatment and diagnosis, and burn injuries. Results There were 748 adults seen for an initial visit at the burn center, ages 19–85, 61% men and 39% women. Of those patients, 572 had a PHQ-9 score documented in the EMR, demonstrating a 76% compliance rate with administration. Of those screened, 52 met criteria for inclusion by scoring 10 or greater or endorsing the suicide risk question on the PHQ-9. Scoring ranges on the PHQ-9 were as follows (N=52): 15.4% mild; 50% moderate; 19.2% moderate-severe; and 15.4% severe. Sixty percent of patients endorsed some suicidal ideation. Fifty two percent of patients were documented clearly as being on psychotropic medication or in specialized mental health services. Results were reviewed or discussed with patients in 81% of the initial visit notes. Nineteen of the 52 patients were offered a referral for mental health services. Conclusions Initiating this protocol creates an opportunity to begin conversations about mental health and offer additional support to patients. Approximately 9% of the outpatients screened at the burn center endorsed significant symptoms of depression and or suicidal ideation. Nearly half of these patients were not actively receiving treatment for these symptoms and could potentially benefit from mental health services. This project highlighted that compliance with administering and documenting the PHQ-9 and referral for follow-up services could be improved at this institution. Applicability of Research to Practice This protocol supports the need for continued evaluation and screening for depression and suicide risk in adult burn patients. Consideration should be given for monitoring other mental health conditions that could create barriers to care or compliance with treatment, such as anxiety, PTSD, psychosis, etc.

The Effects of Suicide Ideation Assessments on Urges to Self-Harm and Suicide

Crisis ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Rahel Eynan ◽  
Yvonne Bergmans ◽  
Jesmin Antony ◽  
John R. Cutcliffe ◽  
Henry G. Harder ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Psychiatric Service ◽  
Exclusion Criterion ◽  
Primary Concern ◽  
Assessment Protocol ◽  
Self Harm ◽  
Study Participants

Background: Participants’ safety is the primary concern when conducting research with suicidal or potentially suicidal participants. The presence of suicide risk is often an exclusion criterion for research participants. Subsequently, few studies have examined the effects of research assessments on study participants’ suicidality. Aims: The purpose of this research was to examine the patterns of postassessment changes in self-harm and suicide urges of study participants who were recently discharged from an inpatient psychiatric service. Method: Study participants (N = 120) were recruited from patients with a lifetime history of suicidal behavior admitted with current suicidal ideation or suicide attempt to an inpatient psychiatric service and/or a crisis stabilization unit. Participants were assessed for suicidal ideation with the Suicide Ideation Scale at 1, 3, and 6 months following their discharge from hospital. The risk assessment protocol was administered at the start and at the end of each of the study follow-up assessments. Results: Changes in self-harm and suicide urges following study assessments were small, infrequent, and were most likely to reflect a decrease in suicidality. Similarly, participants rarely reported worsening self-control over suicidal urges, and when they did, the effect was minimal. By the end of the 6-month follow-up period, increases in self-harm and suicidal urges postassessment were not seen. Conclusion: The inclusion of suicidal participants in research interviews rarely increased suicide risk. Research involving suicidal individuals is possible when study protocols are well planned and executed by trained assessors and clinicians who are able to identify participants at risk and provide intervention if necessary. The few participants that required intervention had high levels of suicide ideation and behavior at baseline and almost all reported symptoms of posttraumatic stress disorder. Further study is needed to better characterize this subgroup of participants.

Differences in Suicide Risk Severity Among Suicidal Youth With Anxiety Disorders

Crisis ◽  
2019 ◽  
Vol 40 (5) ◽  
pp. 333-339 ◽  
Author(s):  
Joanna Herres ◽  
Annie Shearer ◽  
Tamar Kodish ◽  
Barunie Kim ◽  
Shirley B. Wang ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Suicidal Ideation ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Self Report ◽  
Health Concern ◽  
Future Research ◽  
Major Depressive

Abstract. Background: Adolescent suicidality is a growing public health concern. Although evidence supports a link between anxiety and suicidality, little is known about risk associated with specific anxiety disorders. Aims: This study examined the prevalence of anxiety disorders in a sample of adolescents with depression and suicidal ideation and the associations between specific anxiety disorders and suicide ideation severity and attempt history. Method: The sample consisted of 115 adolescents ( Mage= 14.96 years; 55.8% African American) entering a clinical trial for suicidal ideation and depressive symptoms. Prior to treatment, adolescents completed self-report and interview measures. Results: In all, 48% of the sample met criteria for an anxiety disorder, 22% met criteria for social anxiety disorder (SAD), and 40% met criteria for major depressive disorder (MDD). SAD was uniquely associated with more severe suicidal ideation. Limitations: Findings may not generalize to all suicidal adolescents, and non-measured variables may account for the observed relationships. Conclusion: Future research should examine whether targeting social anxiety would improve treatment response for suicidal adolescents.

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