Psychologist Therapeutic Communication in Handling Clients with Deliberate Self-Harm

This study aims to find out psychologist therapeutic communication in dealing with deliberate self-harm clients in 3 research question. This study uses a phenomenological approach. In collecting data, researchers used an interview technique with five informants who were psychologists that practiced and domiciled in Bandung. The results of this study indicate the meaning of a DSH client for a psychologist into three meanings, those who have irrational thoughts, people that have fragile emotion, and those whose emotions are hidden or looking for attention. The experience of psychologist therapeutic communication in dealing with DSH clients is found in 4 major themes: techniques for building therapeutic relationships with clients, the key to understanding clients: active listening, being careful with non- verbal messages, feedback: reserved question. The psychologist's way of handling DSH clients is by handling it like a tailormade (adjusted to the personality and problems of the clients)

Obstructive Sleep Apnea and Risk of Suicide and Self-Harm: A Danish Nationwide Cohort Study

Study Objectives In this nationwide study, we used the unique Danish registries to estimate the risk of suicide and deliberate self-harm in patients with obstructive sleep apnea (OSA). Methods We identified all Danish citizens receiving a diagnosis of OSA between 1995 and 2015. As a reference cohort, we randomly selected 10 citizens for each patient, matched by sex and birth year. Using the Fine and Gray competing risk regression, we estimated the cumulative incidences of suicide, and Cox proportional regression analysis was used to compare the risk of suicide and deliberate self-harm in patients with OSA with the reference cohort. Results We identified 48,168 patients with OSA. A total of 135 patients had died by suicide, compared with 999 suicides in the reference cohort. Patients with OSA had an increased risk of dying by suicide when compared with the reference cohort (hazard ratio, 1.29; 95%CI, 1.07–1.55; and subhazard ratio, 1.23; 95%CI, 1.10-1.45). We identified 1,004 events of self-harm among patients with OSA, and 5,270 events in the reference group. The overall risk of self-harm was increased in patients with OSA when compared with the reference group (hazard ratio, 1.28; 95%CI, 1.19–1.37). Conclusion This is the first study to estimate the risk of suicide and deliberate self-harm in patients with OSA. We found that patients with OSA have an increased risk of both suicide and deliberate self-harm when compared with a large reference cohort, thereby highlighting the importance of a mental health screening in these patients.

Predictors of deliberate self-harm among adolescents: Answers from a cross-sectional study on India

Background Although existing research supports the correlation of hereditary and psychological factors with an adolescent’s deliberate self-harm, there is a dearth of research that focus on their socio-economic characteristics. This paper intends to identity the potential risk factors that influence an adolescent’s deliberate self-harm. Methods Data for this study was obtained from Understanding the Lives of Adolescents and Young Adults (UDAYA) study conducted in 2015–16 with sample of 5,969 adolescent boys and 9,419 girls aged 10–19 years. The outcome variable was deliberate self-harm among adolescents. The explanatory variables added in the study were age, current schooling status, working status, media exposure, access to internet, parental abuse, involvement in fights, substance use, depressive symptoms, caste, religion, wealth index, residence and states. Bivariate analysis along with binary logistic regression analysis was done to fulfill the study objectives. Results About 4.5% and 3.2% of adolescent boys and girls, respectively had deliberate self-harm. The odds of deliberate self-harm were 50 per cent more likely among adolescent girls who had internet access [OR 1.50; CI 1.05–2.16]. The likelihood of deliberate self-harm was 49 per cent and 61 per cent significantly more likely among adolescent boys [OR 1.49; CI 1.11–2.0] and girls [OR 1.61; CI 1.27–2.04] who experienced parental physical abuse respectively. With reference to minimal/mild depressive symptoms, adolescents who had moderate [boys-OR 2.10; CI 1.29–3.4 and girls-OR 2.50; CI 1.774–3.59] or moderately high/severe [boys-OR 4.58; CI 2.88–7.29 and girls-OR 4.18; CI 3.1–5.63] depressive symptoms had significantly higher odds of deliberate self-harm. Conclusions Internet access, parental abuse, involvement in fights, and depressive symptoms emerged as significant predictors of deliberate self-harm among adolescent boys and girls. Results suggest that an early identification of the predictors and intervention might prevent deliberate self-harm among adolescents. Since parents play a major role in the lives and development of adolescents, it is highly recommended that they initiate open and supportive communication with their children.

Suicide and deliberate self-harm among women in Nepal: a scoping review

Background Suicide is a growing public health problem globally. Suicide accounts for 70% of violent deaths among women in low and middle income countries. In Nepal suicide is the single leading cause of death among women of reproductive age. The aim of this scoping review is to explore and understand the various contexts related to vulnerability of Nepalese woman towards suicide and deliberate self-harm. Methods A scoping review based on Arksey and O’Malley’s methodological framework including a combination of peer-reviewed publications and grey literature was conducted. The National Library of Medicine’s PubMed and Google Scholar search engines were used during July 2019 applying a Boolean search strategy. Results Suicide incidence was found to be higher among younger age group and married women, with poisoning as the most common means of suicide. Psychosocial and economic factors such as abuse, interpersonal conflicts, marital disputes, relationship problems, adjustment problems, unpaid loans and financial losses; and mental health conditions such as mood disorder, adjustment disorder and substance abuse disorder were found to be contributing factors for suicide and deliberate self-harm among women in Nepal. Conclusion Socio-cultural and economic factors shape family and marital relationships which impacts psycho-social and mental wellbeing of women in Nepal inciting suicidal attempts and deliberate self-harm. However, very few studies were found that explore the context of poverty, social exclusion, gender inequality, education, traditional/cultural and patriarchal system in which suicide among women in Nepal occurs.

Impact Evaluation of a 'Brief Intervention Program' for Clients who Deliberately Self-Harm

<p>Deliberate self harm (DSH) and suicide rates are recognised internationally, nationally and locally as an increasing trend. The financial and emotional cost to society highlights the need for providing services that aim to reduce the likelihood of further deliberate self harm. The emergency department (ED) is often the entry point for service provision to clients who deliberate self harm. A reduction in re-presentations for acts of DSH to the ED would greatly reduce the strain on this essential part of the public healthcare system. It is vital that the services developed to address DSH are evaluated to facilitate informed decisions regarding program sustainability or improvement. Study aim: This study aims to evaluate a 'brief intervention program' (BIP) designed to address the needs of clients who presented with or were at risk of engaging in act(s) of deliberate self harm. The intention of the program was to reduce repetitive acts of DSH and to assist the clients in developing better coping strategies. Study design: This study uses a pluralistic evaluation research design to conduct a program evaluation. The 'line of enquiry' is guided by the Impact Evaluation framework by Owen (2006).The seven steps of the framework were used to organise, categorise, analyse and discuss the program's outcomes in this study. The pluralistic or mixed design used pre-existing quantitative client file data and qualitative data collected from a staff questionnaire. A total number of 40 client files were examined for the data analysis. Six out of the ten staff members agreed to participate in a survey that sought information about the program's implementation. Findings: Results from the quantitative data analysis found that 82.1% of clients did not re-present to the ED with a repeated act of DSH for a period of six months following initial referral and treatment. The mean average of days to follow up was 5.54. Outcome measurements via pre and post PANSI scores found an improvement in the client's resiliency. Results from the repeated measures t-test: p< .05. Qualitative data analysis found that by expanding the referral base that stakeholders perceived it was more difficult for clients to be followed up within five days from their referral date. Other suggestions pertained to increasing the resources of the program for sustainability. Contribution: The use of program evaluation strategies compliments current trends in healthcare to employ pluralistic or mixed method designs. Broader lines of enquiry lead to more informed decisions regarding program sustainability or improvement.</p>

Impact Evaluation of a 'Brief Intervention Program' for Clients who Deliberately Self-Harm

<p>Deliberate self harm (DSH) and suicide rates are recognised internationally, nationally and locally as an increasing trend. The financial and emotional cost to society highlights the need for providing services that aim to reduce the likelihood of further deliberate self harm. The emergency department (ED) is often the entry point for service provision to clients who deliberate self harm. A reduction in re-presentations for acts of DSH to the ED would greatly reduce the strain on this essential part of the public healthcare system. It is vital that the services developed to address DSH are evaluated to facilitate informed decisions regarding program sustainability or improvement. Study aim: This study aims to evaluate a 'brief intervention program' (BIP) designed to address the needs of clients who presented with or were at risk of engaging in act(s) of deliberate self harm. The intention of the program was to reduce repetitive acts of DSH and to assist the clients in developing better coping strategies. Study design: This study uses a pluralistic evaluation research design to conduct a program evaluation. The 'line of enquiry' is guided by the Impact Evaluation framework by Owen (2006).The seven steps of the framework were used to organise, categorise, analyse and discuss the program's outcomes in this study. The pluralistic or mixed design used pre-existing quantitative client file data and qualitative data collected from a staff questionnaire. A total number of 40 client files were examined for the data analysis. Six out of the ten staff members agreed to participate in a survey that sought information about the program's implementation. Findings: Results from the quantitative data analysis found that 82.1% of clients did not re-present to the ED with a repeated act of DSH for a period of six months following initial referral and treatment. The mean average of days to follow up was 5.54. Outcome measurements via pre and post PANSI scores found an improvement in the client's resiliency. Results from the repeated measures t-test: p< .05. Qualitative data analysis found that by expanding the referral base that stakeholders perceived it was more difficult for clients to be followed up within five days from their referral date. Other suggestions pertained to increasing the resources of the program for sustainability. Contribution: The use of program evaluation strategies compliments current trends in healthcare to employ pluralistic or mixed method designs. Broader lines of enquiry lead to more informed decisions regarding program sustainability or improvement.</p>