National Suicide Research Foundation - Journal Articles

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    The development and validation of a dashboard prototype for real-time suicide mortality data
    (Frontiers Media S.A., 2022-08) Benson, Ruth; Brunsdon, C.; Rigby, J.; Corcoran, P.; Ryan, M.; Cassidy, E.; Dodd, P.; Hennebry, D.; Arensman, Ella; Health Research Board
    Data visualisation is key to informing data-driven decision-making, yet this is an underexplored area of suicide surveillance. By way of enhancing a real-time suicide surveillance system model, an interactive dashboard prototype has been developed to facilitate emerging cluster detection, risk profiling and trend observation, as well as to establish a formal data sharing connection with key stakeholders via an intuitive interface. Individual-level demographic and circumstantial data on cases of confirmed suicide and open verdicts meeting the criteria for suicide in County Cork 2008-2017 were analysed to validate the model. The retrospective and prospective space-time scan statistics based on a discrete Poisson model were employed via the R software environment using the "rsatscan" and "shiny" packages to conduct the space-time cluster analysis and deliver the mapping and graphic components encompassing the dashboard interface. Using the best-fit parameters, the retrospective scan statistic returned several emerging non-significant clusters detected during the 10-year period, while the prospective approach demonstrated the predictive ability of the model. The outputs of the investigations are visually displayed using a geographical map of the identified clusters and a timeline of cluster occurrence. The challenges of designing and implementing visualizations for suspected suicide data are presented through a discussion of the development of the dashboard prototype and the potential it holds for supporting real-time decision-making. The results demonstrate that integration of a cluster detection approach involving geo-visualisation techniques, space-time scan statistics and predictive modelling would facilitate prospective early detection of emerging clusters, at-risk populations, and locations of concern. The prototype demonstrates real-world applicability as a proactive monitoring tool for timely action in suicide prevention by facilitating informed planning and preparedness to respond to emerging suicide clusters and other concerning trends.
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    Study protocol for the implementation and evaluation of the Self-harm Assessment and Management for General Hospitals programme in Ireland (SAMAGH)
    (BioMed Central Ltd, 2020) Arensman, Ella; Troya, M. Isabela; Nicholson, Sarah; Sadath, Anvar; Cully, Grace; Ramos Costa, Ana Paula; Benson, Ruth; Corcoran, Paul; Griffin, Eve; Williamson, Eileen; Eustace, Joe; Shiely, Frances; Browne, John; Rigby, Jan; Jeffers, Anne; Cassidy, Eugene; Health Research Board
    Background: Previous self-harm is one of the strongest predictors of future self-harm and suicide. Increased risk of repeated self-harm and suicide exists amongst patients presenting to hospital with high-risk self-harm and major self-harm repeaters. However, so far evidence-based training in the management of self-harm for mental health professionals is limited. Within this context, we aim to develop, implement and evaluate a training programme, SAMAGH, Self-harm Assessment and Management Programme for General Hospitals in Ireland. SAMAGH aims to (a) reduce hospital-based self-harm repetition rates and (b) increase rates of mental health assessments being conducted with self-harm patients. We also aim to evaluate the training on self-harm knowledge, attitudes, and skills related outcomes of healthcare professionals involved in the training. Methods/design: The study will be conducted in three phases. First, the SAMAGH Training Programme has been developed, which comprises two parts: 1) E-learning Programme and 2) Simulation Training. Second, SAMAGH will be delivered to healthcare professionals from general hospitals in Ireland. Third, an outcome and process evaluation will be conducted using a pre-post design. The outcome evaluation will be conducted using aggregated data from the National Self-Harm Registry Ireland (NSHRI) on self-harm repetition rates from all 27 public hospitals in Ireland. Aggregated data based on the 3-year average (2016, 2017, 2018) self-harm repetition rates prior to the implementation of the SAMAGH will be used as baseline data, and NSHRI data from 6 and 12 months after the implementation of SAMAGH will be used as follow-up. For the process evaluation, questionnaires and focus groups will be administered and conducted with healthcare professionals who completed the training. Discussion: This study will contribute to the evidence base regarding the effectiveness of an evidence informed training programme that aims to reduce repeated hospital self-harm presentations and to improve compliance with self-harm assessment and management. This study is also expected to contribute to self-harm and suicide training with the possibility of being translated to other settings. Its feasibility will be evaluated through a process evaluation.
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    Prevalence and determinants of substance use among indigenous tribes in South India: Findings from a tribal household survey
    (Springer Nature Switzerland AG, 2021-01-25) Sadath, Anvar; Jose, Kurian; Jiji, K. M.; Mercy, V. T.; Ragesh, G.; Arensman, Ella; Government of Kerala
    Background: Indigenous populations have higher substance use than non-indigenous populations. Current evidence on indigenous substance use is largely derived from national household surveys, while there are no specifically designed, culturally specific methodological studies available to determine the prevalence of substance abuse among the indigenous tribes. The present study examined the prevalence and predictors of alcohol use, smoking, and betel quid chewing among indigenous tribes in South India. Method: We conducted a cross-sectional population-based random survey of 2186 tribal households in the Wayanad District, Kerala. A self-prepared, pilot-tested structured interview schedule was used to collect information on sociodemographic variables and substance use. Multivariate logistic regression models were used to examine the sociodemographic predictors of substance use. Results: The overall prevalence of current alcohol use, current smoking and daily betel quid use was 17.2%, 18.8% and 47.6% respectively. Consistently, male gender (alcohol use OR = 13.55; smoking OR = 3.42; betel quid use OR = 1.65), increasing age (OR = 1.32; OR = 1.01; OR = 1.03), Paniya tribe status (OR = 2.24; OR = 1.39; OR = 5.38) and employment status being working (OR = 2.07; OR = 1.77; OR = 1.26) increased the risk of alcohol use, smoking and betel quid chewing. Furthermore, having ‘no formal education’ was associated with smoking (OR = 1.35), and betel quid chewing (OR = 3.27). Conclusion: Substance use was high among the indigenous tribes. The male gender, increasing age, Paniya tribe and working status significantly influenced alcohol use, smoking and betel quid chewing. The results underscore the need for indigenous specific de-addiction policies and programmes, alongside a consideration of the critical sociodemographic predictors.
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    Predictive factors of nonfatal self-harm among community-dwelling older adults assessed for support services
    (Cambridge University Press, 2020-12-18) Cheung, Gary; Chai, Yi; Troya, M. Isabela; Luo, Hao; University of Auckland
    Background: Older adults receiving support services are a population at risk for self-harm due to physical illness and functional impairment, which are known risk factors. This study aims to investigate the relative importance of predictive factors of nonfatal self-harm among older adults assessed for support services in New Zealand. Methods: interRAI-Home Care (HC) national data of older adults (aged ≥ 60) were linked to mortality and hospital discharge data between January 1, 2012 and December 31, 2016. We calculated the crude incidence of self-harm per 100,000 person-years, and gender and age-adjusted standardized incidence ratios (SIRs). The Fine and Gray competing risk regression model was fitted to estimate the hazard ratio (HR; 95% CIs) of self-harm associated with various demographic, psychosocial, clinical factors, and summary scales. Results: A total of 93,501 older adults were included. At the end of the follow-up period, 251 (0.27%) people had at least one episode of nonfatal self-harm and 36,333 (38.86%) people died. The overall incidence of nonfatal self-harm was 160.39 (95% CI, 141.36–181.06) per 100,000 person-years and SIR was 5.12 (95% CI, 4.51–5.78), with the highest incidence in the first year of follow-up. Depression diagnosis (HR, 3.02, 2.26–4.03), at-risk alcohol use (2.38, 1.30–4.35), and bipolar disorder (2.18, 1.25–3.80) were the most significant risk factors. Protective effects were found with cancer (0.57, 0.36–0.89) and severe level of functional impairment measured by Activities of Daily Living (ADL) Hierarchy Scale (0.56, 0.35–0.89). Conclusion: Psychiatric factors are the most significant predictors for nonfatal self-harm among older adults receiving support services. Our results can be used to inform healthcare professionals for timely identification of people at high risk of self-harm and the development of more efficient and targeted prevention strategies, with specific attention to individuals with depression or depressive symptoms, particularly in the first year of follow-up.
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    Using a television programme as a tool to increase perceived awareness of mental health and well-being - Findings from ' Our Mental Health ' survey
    (Cambridge University Press, 2020-03-04) McTernan, Niall; Ryan, Fenella; Williamson, Eileen; Chambers, D.; Arensman, Ella
    Background: International research shows that media can increase knowledge, raise public awareness and reduce stigma relating to mental health.Methods: Following the broadcast of a documentary on national television featuring interviews with young people who had experienced mental health difficulties and suicidal behaviour, an anonymous online survey, aimed at examining public perceptions of the impact of a television documentary, was conducted, using a mixed methods approach.Results: 2311 people completed the survey. Of those who watched the documentary and answered the closed questions (n = 854), 94% stated that the documentary will positively impact young people's mental health and well-being. The majority (91%) stated that the documentary will encourage young people to talk to someone if experiencing difficulties and 87% indicated it will help to reduce stigma associated with mental health. Viewers had a 5% higher level of intention to seek help than non-viewers. Participants indicated that the identifiable personal stories and discourse around stigma and shame, and the increased understanding and awareness gained, had the most profound impact on them.Conclusions: These findings indicate that a documentary addressing mental health and suicidal behaviour, which incorporates real life identifiable stories of resilience and recovery, has the potential to impact positively on emotional well-being and general mood, to reduce stigma related to mental health and to encourage help-seeking behaviour. Documentaries including these concepts, with a public mental health focus and a consistent message, incorporating pre- and post-evaluations, and customisation for target audiences in compliance with current media recommendations, should be considered.