Near-Fatal Self-Harm Among Canadian Adolescents

2021 ◽  
pp. 070674372110586
Author(s):  
Rachel HB Mitchell ◽  
Cornelius Ani ◽  
Claude Cyr ◽  
James Irvine ◽  
Ari R Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Prevention ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Case Definition ◽  
Surveillance Program ◽  
Female Age ◽  
Prevention Interventions ◽  
Working Age ◽  
Self Harm

Objective To evaluate the clinical features of Canadian adolescents admitted to the intensive care unit (ICU) for medically serious self-harm. Methods 2700 Canadian paediatricians were surveyed monthly over two years (January 2017 to December 2018) through the Canadian Paediatric Surveillance Program to ascertain data from eligible cases. Results Ninety-three cases (73 female; age 15.2 ± 1.5) met the case definition. Four provinces reported the majority of cases: Quebec (n = 27), Ontario (n = 26), Alberta (n = 21), and British Columbia (n = 8). There were 10 deaths, 9 by hanging. Overdose and hanging were the most frequently reported methods of self-harm (74.2% and 19.4%, respectively). Overdose was more common in females (80.8% females vs. 50% males; χ2 = 7.8 (1), p = .005), whereas hanging was more common in males (35% males vs. 15.1% females, χ2 = 3.9 (1), p = .04). More females than males had a past psychiatric diagnosis (79% vs. 58%; χ2 = 4.1 (1), p = .06), a previous suicide attempt (55.9% vs. 29.4%, χ2 = 3.8 (1), p = .05), and prior use of mental health service (69.7% vs. 27.8%, χ2 = 10.4 (1), p = .001). Family conflict was the most commonly identified precipitating factor (43%) of self-harm. Conclusions Among Canadian adolescents admitted to the ICU with medically serious self-harm, females demonstrate a higher rate of suicide attempts and prior mental health care engagement, whereas males are more likely to die by suicide. These findings are consistent with data from other adolescent samples, as well as data from working-age and older adults. Therefore, a sex-specific approach to suicide prevention is warranted as part of a national suicide prevention strategy; family conflict may be a specific target for suicide prevention interventions among adolescents.

scholarly journals 109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Mitchell ◽  
Cornelius Ani ◽  
James Irvine ◽  
Claude Cyr ◽  
Ari Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Suicide Attempt ◽  
Mental Health Care ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Suicide Mortality ◽  
Prevention Interventions ◽  
History Of ◽  
Self Harm

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

scholarly journals Global systematic review of the effects of suicide prevention interventions in Indigenous peoples

2020 ◽  
pp. jech-2019-212368
Author(s):  
Stuart Leske ◽  
Elise Paul ◽  
Mandy Gibson ◽  
Brock Little ◽  
Mark Wenitong ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Indigenous Peoples ◽  
Randomised Controlled Trials ◽  
Suicide Attempts ◽  
Risk Of Bias ◽  
Indigenous Populations ◽  
Controlled Trials ◽  
Prevention Interventions ◽  
Self Harm ◽  
Randomised Controlled

ObjectiveSuicide rates are often higher in Indigenous than in non-Indigenous peoples. This systematic review assessed the effects of suicide prevention interventions on suicide-related outcomes in Indigenous populations worldwide.MethodsWe searched CINAHL, Embase, PubMed, PsycINFO, ProQuest Dissertations & Theses and Web of Science from database inception to April 2020. Eligible were English language, empirical and peer-reviewed studies presenting original data assessing the primary outcomes of suicides and suicide attempts and secondary outcomes of suicidal ideation, intentional self-harm, suicide or intentional self-harm risk, composite measures of suicidality or reasons for life in experimental and quasi-experimental interventions with Indigenous populations worldwide. We assessed the risk of bias with the Cochrane Risk of Bias Tool and the Risk of Bias Assessment for Non-randomised Studies.FindingsWe included 24 studies from Australia, Canada, New Zealand and the USA, comprising 14 before–after studies, 4 randomised controlled trials (RCTs), 3 non-randomised controlled trials, 2 interrupted time-series designs and 1 cohort study. Suicides decreased in four and suicide attempts in six before–after studies. No studies had a low risk of bias. There was insufficient evidence to confirm the effectiveness of any one suicide prevention intervention due to shortage of studies, risk of bias, and population and intervention heterogeneity. Review limitations include language bias, no grey literature search and data availability bias.ConclusionFor the primary outcomes of suicides and suicide attempts, the limited available evidence supports multilevel, multicomponent interventions. However, there are limited RCTs and controlled studies.

scholarly journals The National Institute of Mental Health: Research Agenda and Priorities in Geriatrics and Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 621-621
Author(s):  
Elizabeth Necka
Keyword(s):  
Mental Health ◽  
Social Isolation ◽  
Suicide Prevention ◽  
Research Agenda ◽  
Behavioral Science ◽  
Late Life ◽  
Mental Health Research ◽  
Preclinical Research ◽  
Affective Science ◽  
Prevention Interventions

Abstract The Geriatrics and Aging Processes Research Branch of the National Institute of Mental Health (NIMH) supports research on the etiology, pathophysiology, and trajectory of late life mental disorders. The branch encourages research using neuroscience, cognitive and affective science, and social and behavioral science to translate basic and preclinical research to clinical research. The branch prioritizes research that investigates neuropsychiatric disorders of aging, how they interact with neurodevelopment/neurodegeneration, and how to assess, treat, and prevent them. Of particular interest is research on social isolation and suicide. Suicide prevention research is an urgent priority: NIMH’s portfolio includes projects aimed at identifying those at risk for suicide, understanding causes of suicide risk, developing suicide prevention interventions, and testing the effectiveness of these interventions and services in real-world settings. In this talk, a NIMH program official will discuss the NIMH research agenda in the domain of late-life mental illness, social isolation, and suicide.

scholarly journals Self-harm and suicidal behaviour in Ghana: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053144
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Kwaku Oppong Asante ◽  
Johnny Andoh-Arthur
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Global Health ◽  
Protective Factors ◽  
Suicide Prevention ◽  
Suicidal Behaviour ◽  
Observational Studies ◽  
Risk And Protective Factors ◽  
Prevalence Estimates ◽  
Self Harm

IntroductionSelf-harm and suicidal behaviour represent major global health problems, which account for significant proportions of the disease burden in low-income and middle-income countries, including Ghana. This review aims to synthesise the available and accessible evidence on prevalence estimates, correlates, risk and protective factors, the commonly reported methods and reasons for self-harm and suicidal behaviour in Ghana.Methods and analysisWe will conduct a systematic review reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (2009) recommendations. Regional and global electronic databases (African Journals OnLine, African Index Medicus, APA PsycINFO, Global Health, MEDLINE and PubMed) will be searched systematically up to December 2021 for observational studies and qualitative studies that have reported prevalence estimates, correlates, risk and protective factors, methods and reasons for self-harm and suicidal behaviour in Ghana. The electronic database searches will be supplemented with reference harvesting and grey literature searching in Google Scholar and ProQuest Dissertations & Theses Global for postgraduate dissertations. Only records in English will be included. The Mixed Methods Appraisal Tool (2018) will be used to assess the methodological quality of included studies. Meta-analysis or narrative synthesis or both will be used, contingent on the extent of heterogeneity across eligible observational studies.Ethics and disseminationConsidering that this is a systematic review of accessible and available literature, we will not seek ethical approval. On completion, this review will be submitted to a peer-reviewed journal, be disseminated publicly at (mental) health conferences with focus on self-harm and suicide prevention. The important findings would also be shared with key national stakeholder groups in Ghana: Ghana Association for Suicide Prevention, Ghana Mental Health Authority, Ghana Psychological Association, Centre for Suicide and Violence Research, Accra and the Parliamentary Select Committee on Health.Prospero registration numberCRD42021234622.

scholarly journals Trends in mental health, non‐suicidal self‐harm and suicide attempts in 16–24-year old students and non-students in England, 2000–2014

2019 ◽  
Vol 55 (1) ◽  
pp. 125-128 ◽  
Author(s):  
S. McManus ◽  
D. Gunnell
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Disorder ◽  
Suicide Attempts ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Female Students ◽  
Self Harm ◽  
Using Data ◽  
Over Time

Abstract There are concerns about high levels of mental ill-health amongst university students, but little is known about the mental health of students compared to non-students over time. Using data on young people (16–24) from three UK National Psychiatric Morbidity Surveys (2000, 2007, and 2014), we found no evidence that the overall prevalence of common mental disorder (CMD), suicide attempts, or non-suicidal self-harm (NSSH) differed between students and non-students, although there was an indication that CMDs rose markedly in female students between 2007 and 2014. A rise in NSSH is apparent in both students and non-students.

Rising Indigenous suicide rates in Kimberley and implications for suicide prevention

2016 ◽  
Vol 24 (6) ◽  
pp. 561-564 ◽  
Author(s):  
Anita Campbell ◽  
Murray Chapman ◽  
Cate McHugh ◽  
Adelln Sng ◽  
Sivasankaran Balaratnasingam
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Suicide Prevention ◽  
Indigenous Australians ◽  
Indigenous Youth ◽  
Suicide Rates ◽  
Culturally Informed ◽  
Retrospective Audit ◽  
Prevention Interventions

Objectives: This audit examined the demographics of Indigenous Australians dying by suicide in the Kimberley region of Western Australia during the period 2005–2014. Methods: This is a de-identified retrospective audit of reported suicide deaths provided to Kimberley Mental Health and Drug Service during the period 2005–2014. Variables such as age, sex, method of suicide, previous engagement with mental health services, locality and ethnicity were assessed. Results: Indigenous suicide rates in the Kimberley region have dramatically increased in the last decade. There is also an overall trend upwards in Indigenous youth suicide and Indigenous female suicides. Conclusions: These findings highlight the need for culturally informed, and youth focussed, suicide prevention interventions within the Kimberley region.

scholarly journals Emergency Department Re-Presentations Following Intentional Self-Harm

2021 ◽  
Author(s):  
◽  
Silke Kuehl
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Suicide Attempts ◽  
Assessment Tool ◽  
Consumer Involvement ◽  
Mental Health Consultation ◽  
Care Needs ◽  
Admission Rates ◽  
Self Harm ◽  
One Year

<p>Repeat intentional self-harm (ISH) episodes are strongly correlated to suicide. Intentional self-harm for this thesis includes suicide attempts, deliberate self-harm and suicidal ideation. The aim was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Descriptive and inferential analyses were undertaken using the Statistical Programme for Social Science (SPSS). Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present ED with intentional self-harm. Such care needs to be provided in a safe way with the intent on reducing the distress experienced by people who intentionally self-harm.</p>

Monitoring Deliberate Self-Harm Presentations to General Hospitals

Crisis ◽  
2006 ◽  
Vol 27 (4) ◽  
pp. 157-163 ◽  
Author(s):  
Keith Hawton ◽  
Liz Bale ◽  
Deborah Casey ◽  
Anna Shepherd ◽  
Sue Simkin ◽  
...  
Keyword(s):  
Data Collection ◽  
Suicide Prevention ◽  
Ethical Issues ◽  
Strong Association ◽  
Case Definition ◽  
Prevention Policy ◽  
General Hospitals ◽  
Deliberate Self Harm ◽  
Policy Initiatives ◽  
Self Harm

Monitoring of deliberate self-harm (DSH) presentations to hospitals (and in other settings) is receiving increased attention in many countries. This is due to greater recognition of the size of the problem and awareness of its relevance to suicide prevention policy initiatives, because of the strong association between DSH and suicide. A system for monitoring all DSH presentations has been in place in the general hospital in Oxford for 30 years. Based on our experience, in this paper we describe procedures for monitoring, including case definition and identification, linkage of persons and episodes in order to investigate repetition of DSH and other outcomes (including deaths), and data protection and ethical issues. We also provide details of how to carry out monitoring, including different models of data collection, and what data to collect. Finally we consider the potential uses of the data for both clinical and research purposes, including evaluation of national suicide prevention initiatives.

scholarly journals Association of Suicide Prevention Interventions With Subsequent Suicide Attempts, Linkage to Follow-up Care, and Depression Symptoms for Acute Care Settings

2020 ◽  
Vol 77 (10) ◽  
pp. 1021 ◽  
Author(s):  
Stephanie K. Doupnik ◽  
Brittany Rudd ◽  
Timothy Schmutte ◽  
Diana Worsley ◽  
Cadence F. Bowden ◽  
...  
Keyword(s):  
Acute Care ◽  
Suicide Prevention ◽  
Suicide Attempts ◽  
Depression Symptoms ◽  
Follow Up Care ◽  
Prevention Interventions ◽  
Acute Care Settings

scholarly journals Socio-economic differentials in mental disorders and suicide attempts in Australia

2004 ◽  
Vol 185 (6) ◽  
pp. 486-493 ◽  
Author(s):  
Richard Taylor ◽  
Andrew Page ◽  
Stephen Morrell ◽  
Greg Carter ◽  
James Harrison
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Economic Status ◽  
Occupational Status ◽  
Health And Wellbeing ◽  
Socio Economic Status ◽  
Working Age ◽  
Urban Rural

BackgroundResponses to mental disorders usually focus on treatment; socio-economic conditions are less likely to be considered.AimsTo examine social determinants of mental disorders and attempted suicide in Australia.MethodData from the 1997 Australian National Survey of Mental Health and Wellbeing (n=10 641) were used to estimate associations between socio-economic status, mental disorders and attempted suicide. Logistic regression was used to adjust for age, urban/rural residence and country of birth. Socio-economic status differentials in suicide attempts were also adjusted for mental disorders.ResultsSignificant increasing gradients from high to low levels of education and occupational status (employed) were evident for affective disorders and anxiety disorders in both men and women and for substance use disorders in men. Similar gradients were found for suicide attempts, which decreased after adjusting for mental disorders, but remained significant in the working-age employed.ConclusionsThese findings suggest social causation of mental disorders and suicide attempts, and the need for social and economic responses beyond provision of mental health services.

Sign in / Sign up

Export Citation Format

Share Document