Prevention of suicidal behaviour: Results of a controlled community-based intervention study in four European countries

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dc.contributor.author Hegerl, Ulrich
dc.contributor.author Maxwell, Margaret
dc.contributor.author Harris, Fiona
dc.contributor.author Koburger, Nicole
dc.contributor.author Mergl, Roland
dc.contributor.author Székely, András
dc.contributor.author Arensman, Ella
dc.contributor.author Van Audenhove, Chantal
dc.contributor.author Larkin, Celine
dc.contributor.author Toth, Mónika Ditta
dc.contributor.author Quintão, Sónia
dc.contributor.author Värnik, Airi
dc.contributor.author Genz, Axel
dc.contributor.author Sarchiapone, Marco
dc.contributor.author McDaid, David
dc.contributor.author Schmidtke, Armin
dc.contributor.author Purebl, György
dc.contributor.author Coyne, James C.
dc.contributor.author Gusmão, Ricardo
dc.date.accessioned 2019-12-09T09:52:58Z
dc.date.available 2019-12-09T09:52:58Z
dc.date.issued 2019-11-11
dc.identifier.citation Hegerl, U., Maxwell, M., Harris, F., Koburger, N., Mergl, R., Székely, A., Arensman, E., Van Audenhove, C., Larkin, C., Toth, M. D., Quintão, S., Värnik, A., Genz, A., Sarchiapone, M., McDaid, D., Schmidtke, A., Purebl, G., Coyne, J. C., Gusmão, R. and on behalf of The, O.-E. C. (2019) 'Prevention of suicidal behaviour: Results of a controlled community-based intervention study in four European countries', PLOS ONE, 14(11), e0224602. (26pp.) doi: 10.1371/journal.pone.0224602 en
dc.identifier.volume 14 en
dc.identifier.issued 11 en
dc.identifier.startpage 1 en
dc.identifier.endpage 26 en
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/9353
dc.identifier.doi 10.1371/journal.pone.0224602 en
dc.description.abstract The ‘European Alliance Against Depression’ community-based intervention approach simultaneously targets depression and suicidal behaviour by a multifaceted community based intervention and has been implemented in more than 115 regions worldwide. The two main aims of the European Union funded project “Optimizing Suicide Prevention Programmes and Their Implementation in Europe” were to optimise this approach and to evaluate its implementation and impact. This paper reports on the primary outcome of the intervention (the number of completed and attempted suicides combined as ‘suicidal acts’) and on results concerning process evaluation analysis. Interventions were implemented in four European cities in Germany, Hungary, Portugal and Ireland, with matched control sites. The intervention comprised activities with predefined minimal intensity at four levels: training of primary care providers, a public awareness campaign, training of community facilitators, support for patients and their relatives. Changes in frequency of suicidal acts with respect to a one-year baseline in the four intervention regions were compared to those in the four control regions (chi-square tests). The decrease in suicidal acts compared to baseline in the intervention regions (-58 cases, -3.26%) did not differ significantly (χ2 = 0.13; p = 0.72) from the decrease in the control regions (-18 cases, -1.40%). However, intervention effects differed between countries (χ2 = 8.59; p = 0.04), with significant effects on suicidal acts in Portugal (χ2 = 4.82; p = 0.03). The interviews and observations explored local circumstances in each site throughout the study. Hypothesised mechanisms of action for successful implementation were observed and drivers for ‘added-value’ were identified: local partnership working and ‘in-kind’ contributions; an approach which valued existing partnership strengths; and synergies operating across intervention levels. It can be assumed that significant events during the implementation phase had a certain impact on the observed outcomes. However, this impact was, of course, not proven. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights ©2019 Hegerl et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Prevention en
dc.subject Suicidal behaviour en
dc.subject Community-based en
dc.subject Intervention en
dc.subject Europe en
dc.title Prevention of suicidal behaviour: Results of a controlled community-based intervention study in four European countries en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Ella Arensman, National Suicide Foundation and School of Public, University College Cork, Cork, Ireland. +353-21-490-3000 Email:earensman@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Seventh Framework Programme en
dc.description.status Peer reviewed en
dc.identifier.journaltitle PLoS ONE en
dc.internal.IRISemailaddress earensman@ucc.ie en
dc.identifier.articleid e0224602 en
dc.relation.project info:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/223138/EU/Optimizing suicide prevention programs and their implementation in Europe/OSPI-EUROPE en


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©2019 Hegerl et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as ©2019 Hegerl et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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