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

Background: Parents of adolescents with suicide attempts experience psychological distress and often request support. This may be provided through web-based psychoeducation. Aim: To examine the feasibility, acceptability, and use of a psychoeducation website for parents. Method: In a Danish feasibility trial, parents accessed a website during 2023-2024 and completed self-report measures on usage and satisfaction. Results: Among 29 enrolled parents, most visited the website once or twice, usually for less than one hour. Text-based information and video clips were rated as most useful. While around half of the participants indicated that the website did not fully meet their needs, most would recommend it to others. Limitations: Small sample size. Conclusion: The website was accessed and used, although many parents may need additional professional support.

Background and Aims: Exposure to media reporting on suicide leads to imitative suicide. This effect remains unexplored for frequently used sites, which this study will examine. Method: Data on 497 Australian newspaper articles on suicide that mentioned any of the top six most frequently used sites were retrieved between 2008 and 2017. The data were combined with national suicide data occurring during the same period, by determining the number of suicides occurring at the same sites that were reported in selected weeks pre- and post-article. Results: Articles on suicide that mentioned frequently used sites were associated with a greater risk of suicide imitation at those same sites. A greater risk of imitation was associated with articles that reported the suicide method, suicide statistics and prevention initiatives, and published in the inside pages of a newspaper. A reduction in suicide was associated with articles that focused on a suicide death, reported the deceased being well-known, and reported on interviews with the bereaved. Limitations: Data were collected from text-based transcripts without imagery and excluded other traditional media (e.g., television). Conclusion: This study identified elements of media reporting on suicide at frequently used sites that were associated with increases and decreases in subsequent suicides at such sites.

Background: Accurate classification of intentional death as suicide is essential to target prevention measures appropriately. Unfortunately, manner of death (MOD) for many opioid-related fatalities are unclassified in the United States, and in Maryland, as many as 82% of overdose deaths are classified as undetermined manner. Aims: For opioid-related fatalities in Maryland, leverage death certificate data to develop a model for identifying suicide as MOD among those classified as undetermined by the medical examiner. Method: Demographic and toxicology data were used to develop a classification model for opioid-related deaths where MOD was known, and then applied to a cohort where MOD was undetermined to estimate the likelihood that the intent was suicide. Results: Antidepressants, neuroleptics, oxycodone, benzodiazepines, and acetaminophen were more common in deaths classified as suicide while fentanyl, cocaine, and morphine were more common among accidental deaths. Our classification model correctly identified suicide cases 82% of the time (PPV = 0.82; AUC = 0.90) and expanded the number of suicide cases by 43% when applied to undetermined deaths. Limitations: The accuracy and completeness of death records. Conclusions: Data from standard autopsies can be used to detect additional suicide deaths with good statistical precision. Incorporating clinical information could enhance predictive accuracy and improve classification.

Background: Individuals who have attempted suicide are at high risk of recurrence, necessitating targeted interventions. The Hospital Outreach Postsuicide attempt Engagement (HOPE) program provides psychosocial support postsuicide attempt, aiming to reduce re-presentations including those to the emergency department (ED). This study evaluated the longitudinal outcomes of HOPE participants compared to a matched treatment as usual (TAU) control group within a major health service in Victoria, Australia. Methods: This case-controlled study included 100 HOPE participants and 100 matched TAU participants. ED presentations were analyzed over 4 years (2 years pre- and post-HOPE) to assess frequency, type, and time to re-presentation. Results: There were no significant differences in the overall number of ED presentations between the HOPE and TAU groups. However, HOPE participants exhibited significantly fewer mental health-related ED presentations postintervention. Time to first mental health-related re-presentation did not differ significantly between groups. Limitations: Only participants who completed a minimum level of HOPE program engagement were included, precluding an intention-to-treat analysis. Conclusions: While the HOPE program reduced mental health-related ED presentations, it did not significantly extend the time to re-presentation for suicide attempts. These findings suggest that while beneficial for immediate care needs, HOPE may require integration with long-term community-based support to improve outcomes. Future research should explore broader measures of effectiveness, including patient-reported outcomes and quality of life metrics.

Background: US federal and state governments are investing in comprehensive behavioral health crisis system reforms. These reforms aim to prevent suicide, limit police involvement in crises, and reduce reliance on hospitals and emergency departments. Arizona's reform is considered a model for other states. Aims: We evaluated whether Arizona's crisis system reform was associated with reductions in behavioral health-related hospitalizations. Method: We used a comparative interrupted time series design to assess Arizona's implementation of their crisis response system in 2015. We used 2011-2018 Healthcare Cost and Utilization Project (HCUP) State Inpatient Dataset (SID) data and selected Colorado, Kentucky, Michigan, New Jersey, New Mexico, and Washington as comparison states. Results: Arizona's annual behavioral health-related hospital discharge rate per 100,000 population decreased from 686.3 in 2011 to 673.7 in 2014 and increased from 759.3 in 2016 to 955.7 in 2019. The comparative interrupted time series analyses revealed that implementation of Arizona's crisis system was not associated with a change in the rate of behavioral health hospitalizations. Limitations: There may be some unmeasured, time-varying factors related to the rate of behavioral health-related hospitalizations between Arizona and our comparison states that we are not accounting for. Also, hospitals switched from using ICD-9 to ICD-10 codes in 2015, the same year as Arizona implemented their crisis system. Conclusions: More research is needed to confirm whether and how comprehensive crisis response systems impact behavioral health-related hospitalizations.

Background: Certain forms of media reporting on suicide, particularly those involving celebrity suicides, have been associated with an increase in imitative suicidal behavior. Aims: This research employs data science methodologies, including association rule mining, to identify patterns of nonadherence to reporting guidelines in Irish national media articles about suicide. Methods: This study analyses a dataset of 2,939 articles identified as noncompliant with Samaritans' reporting guidelines, using association rule mining to explore relationships among key categories of nonadherence. Initial analysis was conducted on the full dataset, followed by comparative analysis of celebrity-related and noncelebrity-related subsets to examine potential differences in reporting practices. Results: The most frequent recommendation not adhered to was the provision of helpline information, with higher nonadherence rates observed in celebrity-related articles and an increasing trend from 2019 to 2021. The second most common nonadherence involved the use of the term commit. Among those articles not adhering to two or more recommendations, association rule mining revealed co-occurrence patterns, which differed between celebrity-related media reports and noncelebrity-related reports. The top rules were linkage between nonadherences of the recommendations surrounding Graphic images and Methodology - Suicide Or Self-Harm within celebrity-related media, and linkage between nonadherences of the Methodology - Suicide Or Self-Harm and Location Details recommendations within noncelebrity-related media. Limitations: The dataset represents only 20% of guideline-breaking suicide articles, manually tagged with high inter-rater reliability, but excludes positive practices, full guideline coverage, and distinctions between ideation, attempt, or death. Conclusions: Results are discussed in terms of their implications for supporting journalists in adhering to principles of the responsible reporting of suicide within the media, and the need to address celebrity-related and noncelebrity-related reporting separately. Relevant challenges are also discussed.

Introduction: Managing individuals at suicide risk poses significant challenges for mental health professionals (MHPs), particularly when these clients are also coping with the sudden loss of a loved one. Existing research suggests that stigma and perceived lack of competence often affect MHPs' willingness to treat such cases. However, the extent to which symptom severity and the cause of loss (suicide vs. accident) influence MPHs' decisions remains unclear. In this study, we examined these factors and whether suicide prevention training moderates MHPs' willingness to treat and their perceived competence. Method: Using a vignette-based design, we presented 413 MHPs (e.g., clinical psychologists, clinical social workers, and psychiatrics) from Israel with hypothetical cases manipulated by suicidal risk (no risk, depression, or high risk) and cause of loss (suicide or accident). Participants rated their willingness to treat, likelihood of referral, and perceived competence. Results: As suicide risk increased, MHPs showed a decreased willingness to treat and increased referral inclinations, regardless of the cause of loss. Suicide prevention training significantly increased willingness to treat and enhanced perceived competence. The cause of loss (suicide vs. accident) had no significant effect on willingness to treat or perceived competence. Limitations: The study relied on hypothetical vignettes and self-report measures, which may not fully capture the complexities of real-world clinical decision-making. Conclusions: These findings highlight the significance of targeted training programs during MHPs' academic studies and among experienced professionals to boost their competence and reduce stigma when treating individuals at suicide risk.

Background: The Veteran Crisis Line (VCL) Lethal Means Safety (LMS) Pilot offered cable gun locks or medication take-back envelopes to veteran callers at risk of suicide. Aims: We aimed to assess the acceptability of offering LMS interventions to these veterans and examined call outcomes, health care use, and mortality of veterans associated with acceptance of the intervention. Method: We assessed the acceptability of offering LMS interventions to eligible veterans who contacted the VCL between June 13, 2022, and March 31, 2023. To examine outcomes associated with acceptance of the intervention, we used inverse probability of treatment weights to balance veteran characteristics. Results: We found that 41.6% of veterans who were identified VHA enrollees accepted the intervention after being offered one, three times the rate of nonidentifiable veterans. Additionally, veterans who were offered any intervention, whether they accepted it or not, had a lower risk of having an emergency dispatch than those not offered one. Limitations: Veterans were not randomized to the intervention, so no causal inferences can be made. Conclusions: Our evaluation suggests that LMS interventions are acceptable to at-risk veterans. Further evaluation is needed to determine whether acceptance of an intervention has any long-term impacts on veteran outcomes.

Background: Exposure to domestic violence is associated with self-injurious thoughts and behaviors, including suicidal and nonsuicidal self-injury. However, an updated comprehensive review of the literature is unavailable. Aims: This systematic review aimed to describe the strength of the association between domestic violence exposure and self-injurious thoughts and behaviors among the adult population based on global literature. It also aimed to identify mediating and moderating factors and discuss whether the association varies according to the form of violence, sex, and between high-income countries (HICs) and low- and middle-income countries (LMICs). Method: Systematic searches in EBSCO, PubMed, ProQuest, SCOPUS, and Google Scholar identified 36 eligible articles published between 2012 and 2024. We assessed the methodological quality and extracted relevant data for narrative synthesis. Results: Studies showed a significant and moderate association between domestic violence exposure and self-injurious thoughts and behaviors in HICs and LMICs, as well as among males and females. Some studies reported a stronger association of self-injurious thoughts and behaviors with psychological and sexual violence. Mediators and moderators included posttraumatic stress disorder symptoms and loneliness. Limitations: Meta-analysis was not possible due to heterogeneity in definitions and measures of domestic violence and self-injurious thoughts and behaviors employed by the studies. Conclusion: There is strong evidence for the association between domestic violence and self-injurious thoughts and behaviors, indicating a critical need to integrate prevention and intervention efforts.