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

Background: Passive and active suicidal ideation (SI) have been shown to be co-occurring but are distinguishable constructs with presumably differential sets of predictors. Aims: The present analysis integrates nomothetic and idiographic analyses to unravel the relations between passive and active SI and momentary affective states in real-time data to tap several knowledge gaps. Methods: 54 psychiatric inpatients rated their current passive and active SI and positive as well as negative affect for six consecutive days (10 random prompts daily) using ecological momentary assessments on smartphones. Data were analyzed using group iterative multiple model estimation (GIMME). Results: On subgroup level, only significant contemporaneous paths emerged (with no direct paths from affect to active SI). In general, the personalized models revealed large heterogeneity. The number, direction, and strengths of individual paths differed enormously (with fewer direct paths from affect to active SI than to passive SI overall). Passive and active SI were interrelated in the majority of individual models. Limitations: Findings are limited by item wording, co-occurence of passive and active SI, and the short observation interval. Conclusion: The heterogeneous individual models potentially reflect structural and functional differences in the development and maintenance of SI.

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.

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.

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: 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: 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.

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.

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.