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

Call centers offering social services receive calls from a diverse range of people with varied presenting concerns. Although these centers are not typically designed to assist callers in crisis, unlike suicide prevention or crisis lines, they still encounter a small but significant number of calls from people in active crisis. This article serves as a case study to highlight the importance of crisis intervention readiness and to provide guidelines for non-crisis-oriented call centers on managing crisis calls. It features procedures used by Kick It California (KIC), a tobacco cessation quitline, as a sample blueprint. KIC's crisis management protocol is offered, including guidelines for assessing risk levels and implementing emergency procedures. Additionally, the article outlines strategies for quality assurance as well as ethical and legal considerations, as foundational elements for crisis management procedures in social service call centers.

Suicide is a major public health concern globally, and despite decades of research, there has been a disappointing lack of progress in identifying effective prevention strategies and interventions. We argue over-reliance on traditional statistical significance cutoffs and underreporting of marginal findings may be limiting the clinical benefits of research in the field of suicide prevention and in turn impeding practical progress. The consistent reliance on statistically significant results at p < .05 may limit the visibility of potentially promising results to clinicians making treatment decisions. Expanding awareness of promising interventions - which can then be further scrutinized and subjected to further research - could have an important and needed impact on the field. The American Statistical Association has called upon researchers to view the p-value as continuous, with the call being adopted by leading journals. However, most suicide journals do not have explicit policies around how to use p-values for evaluating the strength of the evidence, and the use of continuous p-values has clearly not been routinely adopted by suicide researchers. We want to call upon suicide researchers to be more open to considering and publishing marginally significant findings that suggest promising trends for suicide prevention strategies and interventions.

Background: Suicide remains a taboo subject for many people in Ghana, buried in cultural beliefs. Suicide deaths are frequently addressed without regard for the effect such events have on the bereaved relatives. Aim: To explore what is known about suicide in Ghana and how suicide bereavement might impact families. Method: Narrative review based on a thorough literature search in PsycINFO, Scopus, and PubMed. Gray literature as well as organizational reports and newspaper articles were also included. Demographics, trends, patterns, and factors for suicidal behavior are explored. Results: The findings are contextualized within the Ghanaian social context of suicide and the ramifications for the bereaved individuals. Suicidal behavior is influenced by elements in an individual's micro- and macro-systems, such as conflicting relationships, poor academic achievement, cultural practices, the death of a spouse, and socioeconomic reasons. These variables render a death by suicide more challenging for the bereaved. Limitation: The findings cannot be generalized to other countries. Conclusion: The devastating impact of suicide bereavement in Ghana must be understood within a sociocultural context. Nonetheless, few studies have investigated the experiences of suicide loss survivors, leaving a substantial gap in the understanding and development of postvention and suicide bereavement support in this country.

Background: This study examined if firefighters (an occupational group at elevated suicide risk) who have made a suicide plan involving a firearm reported higher suicidal intent than those whose plans did not involve a firearm. Methods: Participants included 173 firefighters (M [SD] age = 32.0 [9.9], 95.8% male) who reported having made a suicide plan during their tenure as firefighters. We used a self-report version of the Self-Injurious Thoughts and Behaviors Interview-Short Form (SITBI-SF) to determine the presence and nature of suicide plans during firefighter tenure. We used Item 4 of the Suicidal Behaviors Questionnaire-Revised (SBQ-R) to assess suicidal intent. Results: Overall, 44.5% of suicide plans involved firearms. Firefighters who reported a suicide plan involving a firearm reported significantly higher mean levels of suicidal intent than firefighters who did not report a suicide plan involving a firearm. Limitations: This investigation relied on a cross-sectional convenience sample which limits our ability to establish causal claims. Conclusions: Firefighters who report a suicide plan specifically using a firearm may represent an especially at-risk group. Clinicians should assess for both suicidal intent and means during risk assessments and deliver rigorous lethal means safety counseling to mitigate suicide risk among firefighters.

Background: Suicide bereavement is associated with complex emotional challenges, stigma, and elevated risk of subsequent suicide. Early responders are often the first to interact with or inform survivors of the death. Thus, these interactions hold the potential to shape their loss experience, pursuit of support services, and healing process. Yet, a few studies explore these interactions in depth. Aim: This study investigates the interactions between suicide loss survivors and early responders within 72 h of loss and their impact on the pursuit of mental health and support services. Method: The study employs a cross-sectional survey of 120 suicide loss survivors. Results: Survivors who sought mental health support reported higher levels of compassionate communication, personal disclosures, follow-up interactions, information sharing, and referrals. Limitations: A demographically homogenous sample primarily consisting of white females limits generalizability. The small sample size and reliance on survey data constrained statistical analyses. Conclusions: These findings underscore the importance of early responder interactions in suicide postvention and support the potential effectiveness of active postvention models.

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.

Evaluations of interventions targeting the population level are an essential component of the policy development cycle. Pre-post designs are widespread in suicide prevention research but have several significant limitations. To inform future evaluations, our aim is to explore the three most frequently used approaches for assessing the association between population-level interventions or exposures and suicide - the pre-post design, the difference-in-difference design, and Poisson regression approaches. The pre-post design and the difference-in-difference design will only produce unbiased estimates of an association if there are no underlying time trends in the data and there is no additional confounding from other sources. Poisson regression approaches with covariates for time can control for underlying time trends as well as the effects of other confounding factors. Our recommendation is that the default position should be to model the effects of population-level interventions or exposures using regression methods that account for time effects. The other designs should be seen as fall-back positions when insufficient data are available to use methods that control for time effects.

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: 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.