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

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dc.contributor.authorHegerl, Ulrich
dc.contributor.authorMaxwell, Margaret
dc.contributor.authorHarris, Fiona
dc.contributor.authorKoburger, Nicole
dc.contributor.authorMergl, Roland
dc.contributor.authorSzékely, András
dc.contributor.authorArensman, Ella
dc.contributor.authorVan Audenhove, Chantal
dc.contributor.authorLarkin, Celine
dc.contributor.authorToth, Mónika Ditta
dc.contributor.authorQuintão, Sónia
dc.contributor.authorVärnik, Airi
dc.contributor.authorGenz, Axel
dc.contributor.authorSarchiapone, Marco
dc.contributor.authorMcDaid, David
dc.contributor.authorSchmidtke, Armin
dc.contributor.authorPurebl, György
dc.contributor.authorCoyne, James C.
dc.contributor.authorGusmão, Ricardo
dc.contributor.funderSeventh Framework Programmeen
dc.date.accessioned2019-12-09T09:52:58Z
dc.date.available2019-12-09T09:52:58Z
dc.date.issued2019-11-11
dc.description.abstractThe ‘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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide0224602en
dc.identifier.citationHegerl, 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.0224602en
dc.identifier.doi10.1371/journal.pone.0224602en
dc.identifier.endpage26en
dc.identifier.issn1932-6203
dc.identifier.issued11en
dc.identifier.journaltitlePLoS ONEen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/9353
dc.identifier.volume14en
dc.language.isoenen
dc.publisherPublic Library of Scienceen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/223138/EU/Optimizing suicide prevention programs and their implementation in Europe/OSPI-EUROPEen
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.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectPreventionen
dc.subjectSuicidal behaviouren
dc.subjectCommunity-baseden
dc.subjectInterventionen
dc.subjectEuropeen
dc.titlePrevention of suicidal behaviour: Results of a controlled community-based intervention study in four European countriesen
dc.typeArticle (peer-reviewed)en
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