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

Background: Digital-based mobile interventions hold significant promise in preventing suicide. Although mixed, some evidence suggests these interventions are effective and capable of overcoming barriers such as cost and stigma. Aim(s): This review aimed to determine the effectiveness of digital interventions designed to address suicidal ideation and behaviors and the impacts of age, gender, and control group type on these outcomes. Methods: Databases were searched for randomized controlled trials (RCTs) on digital suicide interventions (apps/online programs) published before January 1, 2022. Data were analyzed using a random-effects model in Stata 17. Results: The search identified 4,317 articles, and 16 were included. Risk of bias analysis found studies to be of low-to-moderate quality. The random-effects model indicated a small but significant effect of treatment on suicidal ideation, k = 16, g = 0.11 (95% CI: 0-0.23), p = .049. Subgroup analyses found the interventions to have a significant effect on adults (g = 0.15, 95% CI: 0.03, 0.28, p = .01) but not adolescents. The interventions showed better effects compared to waitlist controls (g = 0.28, 95% CI: 0.19, 0.38) but not compared to treatment as usual or active controls [χ²(2) = 29.41, p < .001]. Limitations: Sample sizes across studies were insufficient for examining the effectiveness of digital interventions by gender. Limited studies reported on suicidal behaviors, so the impact of digital interventions on these behaviors could not be analyzed. Conclusions: This review found a significant effect of digital interventions for reducing suicidal ideation and highlights the importance of examining the effectiveness across subgroups.

Background: Youth suicidality presents challenges for healthcare workers, particularly in Nova Scotia, Canada, where rates exceed national averages. Professional confidence, comfort, and anxiety in managing suicidal youth may be associated with training and education. Aims: This study examined associations between healthcare workers' educational backgrounds, their mental health training, and their perceptions, attitudes, and emotional responses when working with suicidal youth. Method: A cross-sectional survey of 123 healthcare workers in Nova Scotia assessed demographics, training, and clinical responses. Descriptive statistics, Pearson's correlations, t-tests, and regression analyses (adjusting for experience) examined associations between training, confidence, comfort, and anxiety. Results: Participants reported moderate confidence (M = 3.7, SD = 0.9) and comfort (M = 3.7, SD = 0.9), with higher anxiety (M = 3.0, SD = 1.0), particularly in family-related contexts (M = 3.5, SD = 1.1). General training was associated with greater confidence and comfort but not significantly with anxiety. Specialized training (e.g., mental health degrees) was associated with lower anxiety and reduced avoidance of suicidal youth and families. Limitations: The cross-sectional design, self-report measures, and purposive sampling limit causal inference and generalizability. Conclusion: Findings suggest training type relates to professional responses, highlighting the need for further research on tailored educational interventions.

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 prevention strategies internationally recommend promoting responsible media reporting of suicide to reduce negative impacts on population suicides. Existing tools to assess the quality of suicide reporting do not capture specific harmful features of the online setting. We aimed to adapt PRINTQUAL, a tool for assessing newspaper reporting of suicide, for online news reports. Methods: We identified all online news reports about the 2020 suicide of a British female television celebrity over a 14-month period and used content analysis to identify features of poor-quality and good-quality reporting based on media guidelines on suicide reporting. We gained expert consensus on items to include negative/poor-quality and positive/good-quality subscales for the new tool: PRINTQUAL-web. Weightings were calculated using an expert judgement ranking exercise. Results: Content analysis of 342 online articles published from 15/02/20 to 05/04/21 identified 18 items for a proposed negative/poor-quality subscale and four items for a positive/good-quality subscale, gaining consensus on inclusion/exclusion and weightings, and rescaling scores for easier interpretation. Limitations: PRINTQUAL-web does not account for article prominence or quantitative reach (e.g., views or circulation) and relies on a binary agree/disagree rating which may not capture nuance. Conclusions: The PRINTQUAL-web and PRINTQUAL tools assess the quality of online and print reporting of suicide, respectively, with rescaling permitting score comparisons across different corpora of reporting.

Background: Adolescent suicide is a growing social issue in South Korea, exacerbated by a decreasing adolescent population and rising suicide attempt rates. Aims: This study investigates the direct effects of school and parental factors on suicidality in South Korean adolescents and their indirect effects through psychological factors. Method: Using data from 4,650 adolescents who participated in the 2021 Survey on the Mental Health of Teenagers, this study set school factors as school attachment, teacher attachment, and peer attachment; parental factors as parental neglect, interference, and abuse; and psychological factors as depression, anxiety, and strain. Structural equation modeling was used for analysis. Results: School and parental factors had no direct impact on suicidality. However, weak school attachments and negative parental behaviors increased psychological distress, indirectly raising suicidality among adolescents. Limitations: This study could not use all the factors mentioned in the social bonding theory and general strain theory as factors affecting suicidality in the analysis, and the findings are limited to cross-sectional data. Conclusion: This study highlights the importance of addressing school, parental, and psychological factors in adolescent suicide. Government, schools, and families must collaborate to improve adolescent mental health through prevention policies, counseling, stress-relief programs, and enhanced communication.

Background: Gatekeeper training (GKT) programs improve knowledge and self-efficacy in suicide prevention, but the sustainability of these improvements is uncertain. While booster sessions are suggested to enhance retention, existing research is inconclusive. Aim: This study aimed to evaluate the effectiveness of booster sessions in the LifeKeepers GKT program for maintaining long-term knowledge and self-efficacy at 6 months post-training. Method: A total of 1,732 participants who had completed LifeKeepers GKT were randomly assigned to one of three trial groups, an intervention (booster), control (training as usual), or attention control group. Participants completed measures of knowledge and self-efficacy at 3, 6, and 12 months and reported their frequency of interventions and referrals at 3 and 6 months. Results: No significant differences were found between the groups in terms of knowledge retention, self-efficacy, or behavior change at any follow-up point. However, sustained improvements were observed across all groups. Limitations: Ceiling effects and attrition may have influenced the findings. Conclusion: Booster sessions did not significantly enhance knowledge, self-efficacy, or behavior outcomes. All groups demonstrated sustained improvements, but ceiling effects and attrition caution against overinterpreting the findings. Further research is needed to explore effective strategies for long-term retention.

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.