Crisis-The Journal of Crisis Intervention and Suicide Prevention最新文献

Background: Suicide risk is elevated among first responders. The three-step theory of suicide (3ST), not yet tested in first responders, proposes that the combination of pain and hopelessness leads to suicidal desire, but most relevant studies examine psychological pain and a few studies exist regarding the impact of physical pain. Aims: This study aimed to replicate and expand the understanding of the 3ST by examining physical and psychological pain in Step 1 within first responders. Method: First responders (n = 204) completed an anonymous online survey assessing physical pain, psychological pain, hopelessness, and suicidal desire. Moderation analyses were used to test whether psychological pain and physical pain, respectively, potentiate the relationship between hopelessness and suicidal desire. Results: Physical pain moderated the relationship between hopelessness and suicidal desire, such that high levels of physical pain potentiated the relationship and low levels diminished the relationship, while psychological pain did not. Findings support the 3ST and provide evidence for the important role of physical pain in examining suicidal desire among first responders. Limitations and Conclusion: Although data were cross-sectional, results may inform development of measures tailored to first responders, which could ultimately lead to improved methods for assessing critical components of first responder and suicide risk.

Background: Crisis supporters can experience numerous stressors in their role that can impact their own mental well-being. The area remains underexplored in research, particularly relating to substance use, and new trends in the role such as working remotely or the impact of providing chat-based support. Aims: This study identifies crisis support-related stressors, as well as levels of mental well-being and substance use, and factors associated with mental well-being. Method: Participants (n = 422) were recruited from four leading crisis support services and via social media advertising. They responded to an online survey, assessing demographics, stressors, mental well-being (compassion fatigue, compassion satisfaction, and psychological distress), substance use, and coping styles. Results: Findings identified several important stressors (e.g., argumentative callers) and moderate to high rates of compassion fatigue and psychological distress. High levels of compassion satisfaction were reported, and levels of risky substance use were low. Problem-focused coping emerged as a key factor related to positive mental well-being, while emotion-focused, avoidant coping, remote work, and providing chat-based support were linked to negative well-being. Limitations: The study's cross-sectional design and convenience sample limit causal inferences and generalizability. Conclusion: The findings reveal significant stressors and challenges in crisis supporters that require consideration and intervention.

Background: Exposure to suicide is associated with a range of psychosocial harms which Australian employers have a legislated responsibility to mitigate. Aims: Examine the impact of suicide on staff, current workplace responses and the efficacy of a new, systemic model of workplace postvention. Method: Interviews and focus groups with 54 staff in 22 workplaces from the commercial, government, and not-for-profit sectors. Results: Every participant had experienced the suicide of a client or colleague and reported a range of short- and long-term negative impacts, including suicidal ideation. This contrasted with the overall lack of workplace postvention, which increased the risks of psychosocial harms to staff. The new model was effective in tailoring a systemic approach to workplace postvention. Limitations: The small size of the sample limits generalizability; however, the prevalence of exposure to suicide and lack of workplace preparedness were strikingly consistent. Conclusion: The impact of suicide on staff is significant and current workplace responses are ineffective and potentially harmful. The new model improves staff and workplace preparedness through tailored and co-designed training, governance and supports.

Background: The literature is scant on the associations between employment-related variables and suicidal ideation. Aims: The objectives were to explore these associations in the national French working population. Methods: The study relied on two independent national French surveys and their samples of 22,420 workers (employees and self-employed workers) and 25,628 employees, respectively. Employment variables included occupation, economic activity of the company, public/private sector, company size, permanent/temporary work, full/part time, seniority, and employee/self-employed worker. Suicidal ideation was assessed using one item. The associations between employment variables and suicidal ideation were studied using bi- and multivariable weighted analyses (Rao-Scott Chi-2 test and logistic regression). Gender differences were explored and covariates were taken into account. Results: The associations between employment variables and suicidal ideation were mostly not statistically significant. Some differences in suicidal ideation between occupations and economic activities were difficult to interpret due to overlaps in the confidence intervals. The prevalence of suicidal ideation increased with seniority among employees. Limitations: The study design was cross-sectional. Conclusion: The studied employment variables may have little effect on suicidal ideation. As suicidal ideation is a risk factor for suicide, more research is needed to explore the work-related risk factors for suicide and suicidal ideation.

Background: Suicide bereavement increases the probability of adverse outcomes related to grief, social functioning, mental health, and suicidal behavior. While more support for individuals bereaved by suicide has become available, the evidence regarding its effectiveness is not straightforward. The literature suggests that identifying best-practice components is key in designing effective postvention interventions. Aims: This metareview aims to identify components of suicide bereavement interventions perceived to be effective by suicide-bereaved people. Method: The review adhered to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Systematic searches in Medline, PsycINFO, Embase, Emcare, EBM Reviews, Scopus, and Web of Science identified 11 eligible systematic reviews published between 2008 and 2023. The methodological quality was assessed using the Measurement Tool to Assess Systematic Reviews (AMSTAR-2) (PROSPERO registration CRD42023458300). Results: Our narrative synthesis reported the components perceived to be effective in relation to structure and content of interventions, facilitators, and modality (peer, group, community, online). Limitations: The quality of the included reviews varied considerably, and not all reviews reported on perceived effectiveness of interventions' components. Meta-analysis of findings was not possible due to study heterogeneity. Conclusion: The findings provide crucial information for researchers, service providers, and policymakers to enhance the provision of evidence-based support for people bereaved by suicide.

Background: Men account for 75% of all suicide deaths in Australia. Societally dominant masculine norms have been theorized to be linked with suicidality and reduced help-seeking. However, evidence is needed to establish this relationship further. Aims: To further understand the relationships between 11 masculine norms, suicidal ideation, and mental health help-seeking behavior longitudinally in Australian males. Method: We analyzed data from a cohort of 8,214 males (aged 18-55 years), using logistic regression to examine if conformity to any of the 11 masculine norms measured by the Conformity to Masculine Norms Inventory (CMNI-22) at Wave 1 was associated with suicidal ideation and help-seeking at Wave 2. Results: Analyses revealed that being in the high conformity group for the norm of emotional control at Wave 1 was associated with higher odds of suicidal ideation longitudinally. Being in the low conformity group for the global construct of masculine norms and the specific norms of emotional control and power over women was associated with higher rates of mental health help-seeking behavior longitudinally. Limitations: The CMNI-22 scale's limited construct validity and the use of a single-item measure for suicidal ideation may have restricted the accurate capture of masculine norms and suicidal behaviors in Australian men. Conclusion: These results provide support for the contention that suicidality is a profoundly gendered phenomenon by showing an association between masculine norms and suicidal ideation in men. These norms should be a point of focus of male suicide prevention initiatives.

Background: Prevention strategies for suicide emphasize restrictions on firearm access. These restrictions may lose efficacy if individuals substitute other lethal suicide methods. Aims: The objective of this study is to determine the extent to which individuals who die by suicide in the United States substitute hanging for firearm injury. Methods: This study is a repeated cross-sectional analysis of suicide deaths in the United States from 2003 to 2021. Multiple regression was used to estimate the effect of firearm access proxies on individual suicide methods (hanging vs. firearm injury). Results: The probability of death by hanging was significantly and negatively associated with proxies of firearm access. Limitations: This study does not compare crude rates of suicide by state, which rise on average with rates of firearm ownership. The National Violent Death Reporting System expanded over the sample period, so early years have incomplete ascertainment. Rates of gun ownership and gun safety law scales are measured as proxies. Conclusions: Although means restriction around firearm access is a critical tool for suicide prevention, complementary strategies for prevention around hanging merit further study.

Background: Real-time suicide registers are being established in many countries and enable regular monitoring of suspected suicides over time. The use of these data to monitor for suicide clusters is in its infancy. Aims: We sought to test the feasibility of using real-time suicide register data to detect spatiotemporal suicide clusters. Method: Using the Victorian Suicide Register and SaTScan's spatiotemporal scan statistic, we simulated a monthly search for clusters from January 2015 to June 2022 using rolling 2-year windows of data in each search. Monthly scans were performed at three different levels of geographic granularity and for all-ages and under-25 populations. Results: Our results indicated the rapid identification of possible suicide clusters and demonstrated a practical approach to combining real-time suicide data and scanning algorithms. We developed new model outputs that showed cluster timelines. Limitations: The main limitations are that the computational burden of fitting multiple models meant we were unable to scan for ellipses and other irregular shapes and we were unable to consider space-time permutation models. Conclusions: Using data from a real-time suicide register, we were able to scan for space-time suicide clusters simulating the situation where the data are updated monthly with new updates.

Background: In 2018, news outlets began reporting on a suicide epidemic among New York City's yellow taxi drivers. Within months, print, television, radio, and internet outlets had produced pieces describing the deaths of drivers struggling to endure transformations in their industry. Aims: We explored taxi drivers' perspectives regarding suicide news coverage and the degree to which the coverage affected their lives. Methods: Current and recent taxi drivers participated in open-ended, life-history-informed interviews, which were transcribed and analyzed thematically. Results: We interviewed 21 participants. Four themes related to interviewees' experience of suicide-related media coverage emerged: drivers' awareness of the news coverage and opinions regarding it, the degree to which the coverage motivated drivers to engage in conversation with others about stress, the extent to which coverage inspired drivers to think differently about mental health, and perceptions regarding the media's broader characterization of taxi drivers. Limitations: Interviews were conducted in English, a second language for many taxi drivers. Conclusion: Taxi drivers expressed diverse views regarding media reporting on driver suicides, with some viewing it as helpful, while others critiqued it as simplistic, stigmatizing, and sensationalist.