This study found impulsiveness and depression to be risk factors for adolescent nonsuicidal self-injury and play a crucial role between cumulative ecological risk and NSSI in adolescents. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
"The evidence in this article suggests the suicide prevention potential of prioritising the issue at hand and helping men solve problems with practical advice first, before addressing any underlying psychological issues that may have exacerbated the crisis."
"The authors highlight that clinicians could focus on depression for those who present with suicidal ideation and loneliness; but that if clients report experiencing romantic loneliness, reduction in ideation may be resistant to lessening." It isn't just older people who experience loneliness - younger people do too.
Initial psychological assessments, formulation and interventions should take into account service users’ socio-economic backgrounds and potential systemic changes that can be made in order to reduce the risk of self-harm. The established links between how area-level and individual characteristics may influence the risk of self-harm can help clinicians conceptualise the service users’ difficulties and develop initial hypotheses to drive their action plan and intervention, as well as explore more in-depth the systems surrounding the individual. The study offers insights for policymakers, as reducing deprivation and social inequalities can be proven an important strategy in suicide prevention (Hawton et al., 2001). This could be done by ensuring access to practical support for vulnerable groups, such as employment and financial assistance, or advocating on their behalf when needed (i.e., writing letters of support to access benefits or safe housing).
Psychotherapy for self-harm - Hannah Wallace summarises a systematic review exploring people's experiences of psychotherapy for self-harming behaviours.
The COVID-19 pandemic and associated lockdowns were predicted to have a major impact on suicidal behaviour, including self-harm. However, current studies have produced contradictory findings with limited trend data. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Suicidal behavior is heritable and is a major cause of death worldwide. Two large-scale genome-wide association studies (GWASs) recently discovered and cross-validated genome-wide significant (GWS) loci for suicide attempt (SA). The present study leveraged the genetic cohorts from both studies to conduct the largest GWAS meta-analysis of SA to date. Multi-ancestry and admixture-specific meta-analyses were conducted within groups of significant African, East Asian, and European ancestry admixtures. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Authors concluded in-school peer friendships are associated with self harm thoughts and behaviour but can also be positive. Implications for practice include increasing sense of community within schools (staff and peers care about students as individuals, not just about learning); identify friendship groups where one or more individuals have known self harm; have school-based interventions in place to address self-harm
The authors identified several important clinical practice implications and opportunities for youth suicide prevention:
- realise importance of positive experiences when seeking help
- aware that early suicidal thoughts can progress and represent an opportunity for early intervention
- not assume shared meanings of language - work with the young person to examine the language and find shared meaning together
- take an individualisd, person-centred approach to work with young people
The authors suggest that psychoeducation could help prisoners recognise and identify emotions, as a precursor to communicating them to others. Drawing on the findings from this study in particular, experiencing either a turmoil of mixed emotions or an emotional void may be an indicator of a risk of subsequent violence to themselves or others. Lastly, the drawing task supports other research indicating that art therapy could be helpful for prisoners (Gussak, 2009).
In this editorial we, as members of the 2022 NICE Guideline Committee, highlight and discuss what, in our view, are the key guideline recommendations (generated through evidence synthesis and consensus) for mental health professionals when caring for people after self-harm, and we consider some of the implementation challenges. https://onlinelibrary.wiley.com/doi/10.1002/cpp.2893?af=R
Suicide and suicide-related incidents have increased within women’s prisons in the UK. This paper aims to synthesise the findings of qualitative literature, to gain a deeper understanding of the how women and staff in English prisons experience and explain the causes of their suicidal behaviours. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The purpose of this paper is to discuss the response of the relevant authorities to evidence that female primary schoolteachers have an elevated suicide risk in the UK. The paper situates the recent tragic death of a primary school head teacher, following an Ofsted inspection at her school, within the wider context of teacher suicide deaths and asks what, if any, action the authorities have taken to prevent avoidable suicide deaths from occurring. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Young people who present to services should be routinely asked about online self-harm image viewing behaviour; clinicians or other frontline staff working with young people should be aware of the potential for harm. The eight areas of impact identified could guide routine clinical assessment. However, the findings clearly point to the complex, fluid and individual nature of interaction and response, and that there are potentially important gains not least in terms of social connection, support and recovery that should not be overlooked. In fact, boundaries between positive and negative impacts can be blurred. For whom are they harmful or beneficial? When? Why? All impacts and functions should be explored in practice with a young person to identify vulnerabilities and protective factors.
Suicide self-harm children - meta-analysis estimates prevalence rates of self-harm behaviours and suicidal ideation in children aged 12 years and under.
A group of MSc students at UCL summarise a study exploring the secondary mental health care treatment patients with comorbid PTSD and suicidality receive.
Loneliness is prevalent among individuals with mental illnesses. This cross-sectional survey study examined the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression in individuals with schizophrenia. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Interpersonal factors play an important role in the etiology and treatment of depression. Social support derives from compassionate words and helpful actions provided by family, friends or a significant other. The present study was designed to examine various sources of social support as they relate to the severity of depressive symptoms, hopelessness and suicide risk in adult psychiatric outpatients.
Suicide is the most common cause of death for young people in the UK and around 50% of completed suicides in young people have previous self-harm as a theme. Hence, robust management of young people presenting with self-harm to the emergency department is crucial. Guidelines published by the National Institute for Health and Care Excellence (NICE) and the Royal College of Psychiatrists advise an overnight admission for under-16s with self-harm, which is a challenge during winter pressures or bed shortages. In this editorial we discuss the difficulties faced when navigating NICE 2004 guidance documents with the realities of the coalface and consider the prospects for current practice and the future with the NICE 2022 guidance.
Previous research has identified the critical role of primary care for suicide prevention. Although several suicide prevention resources for primary care already exist, it is unclear how many have been created specifically for older veterans. This environmental scan sought to assemble a compendium of suicide prevention resources to be utilized in primary care.
To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The study highlights a need for more studies on differences within racial/ethnic groups and other marginalised groups in society (e.g. people from the LGBTQ+ community). Without sufficient evidence, these groups may have consistently high rates of suicidal thoughts and behaviours, but won’t be targets for interventions.
For policymakers and funders, although the evidence suggests that rates of suicidal thoughts and behaviours aren’t increasing, they also aren’t improving and more needs to be done to reduce this, particularly through interventions and funding of more research in specific groups within society and in more granular detail, as opposed to countrywide trends.
The authors highlight the genetic basis of suicide and report a significant association between genetic risk for suicide and childhood suicidal attempts, independent of the genetic influences of other mental health difficulties, such as major depressive disorder, and the presence of other psychosocial risk factors. This new evidence could facilitate the identification of children at higher risk of attempting suicide sooner and, thus, inform country-wide prevention strategies and targeted interventions.
A very high prevalence of autistic adults reported suicidal thoughts in their lifetime. This study illustrates the complex interplay between the factors that connect autism and suicidal thoughts, which highlights autism as a distal risk marker for suicidal thoughts and behaviours.
Suicidal thoughts and behaviours (STBs) are significant public health challenges that affect a variety of individuals and communities. Despite numerous efforts to discover and refine psychotherapy treatments to minimize STBs, the efficacy of STB treatments remains unclear. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Suicide is a leading cause of death for children and young people and its prevention is a global priority. Many Mental Health Services employ safety planning as a brief intervention. There is some evidence of safety planning effectiveness for adults, but little is known about its effectiveness with young people.
The literature supports the notion that our online interactions and the content that we are exposed to have an impact on our mental health, both positively and negatively. As mentioned above, our work has taken a harm minimisation approach by upskilling and empowering young people to post about these topics safely and feel better able to navigate harmful content when they are exposed to it (see Robinson et al., 2018; La Sala et al., 2021; La Sala et al., In Press; Thorn et al., 2020). However, whilst upskilling young people to keep themselves and others safe online is important, it is unfair to expect them to hold this responsibility alone. Therefore, it is time to consider what more governments and the social media industry can be doing to protect young people when interacting online.
Suicide risk is elevated among individuals at clinical high risk for psychosis (CHR-P). The current study examined variability in suicidal ideation during treatment for individuals at CHR-P.
Governments and non-governmental organisations are increasingly adopting a ‘zero-suicide’ goal, but what such a goal precisely involves is unclear. Ostensibly it strongly prioritises the prevention and elimination of all suicide. We argue that, so understood, a societal goal of zero suicide risks contravening several ethical principles. In terms of beneficence and non-maleficence, a ‘zero-suicide’ goal risks being inefficient and may burden or harm many people. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Case studies have linked SARS-CoV-2 infection to suicidal behaviour. However, conclusive evidence is lacking. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Self-harm and suicidality are associated with substantial social and economic burden, especially among children, adolescents and young adults. The aim of this review was to systematically synthesize the literature on the association between health-related quality of life and self-harm/suicidality in children, adolescents and young adults. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Ben Hannigan explores a recent systematic review exploring the prevalence, risk factors and interventions for suicide and self-harm in nurses and midwives.
Self-harm is a major public health concern. Lifetime prevalence is high, and rates of self-harm are rising; however, available interventions do not benefit everyone, and engagement with therapy can be low. Qualitative accounts allow for a greater understanding of what is helpful to individuals. This study aimed to synthesize the experiences of interventions for self-harm, from participants who have participated in these themselves.
Given the high rates of mental health comorbidity among opioid users, and increasing rates of opioid prescription for chronic pain, psychiatrists and mental health clinicians are likely to treat patients who are dependent on opioids. Among such patients, many will have histories of opioid overdose or suicide attempts. It is tempting to assume that these are related behaviours and that ‘accidental’ overdoses are actually suicide attempts. We provide evidence here to demonstrate that while some overdoses are intentional, most are not. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
New NICE guidance offers advice on caring for people who have self-harmed, including people with a mental health condition or a learning disability
The National Institute for Health and Care Excellence (NICE) has issued fresh guidance on caring for people who have self-harmed. Its recommendations cover assessment, management and preventing recurrence in children, young people and adults.
People who self-harm tend to find it challenging to accept care and compassion from others and to be compassionate towards themselves. Providing compassionate care to people who self-harm can be a soothing intervention that reduces their distress and/or helps them manage their distress. Nurses can support people who self-harm on their journey towards recovery by delivering interventions informed by compassion-focused therapy and cognitive behavioural therapy. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
In the machine learning subfield of natural language processing, a topic model is a type of unsupervised method that is used to uncover abstract topics within a corpus of text. Dynamic topic modelling (DTM) is used for capturing change in these topics over time. The study deploys DTM on corpus of electronic health record psychotherapy notes. This retrospective study examines whether DTM helps distinguish closely matched patients that did and did not die by suicide. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Suicide exposure warrants further investigation as a risk factor for suicide among military service members. This study aimed to examine associations among suicide exposure, suicidal ideation (SI), and psychological symptoms in a clinical sample of service members (N = 1,565, 64.4% suicide-exposed) and identify how one's relationship with the deceased impacts suicidality and psychological health in exposed individuals.
To examine the relative risk of suicide among healthcare professionals compared to other occupations and examine changes in suicide rates over time. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Prior research suggests there are observable behaviours preceding suicide attempts in public places. However, there are currently no ways to continually monitor such sites, limiting the potential to intervene. In this mixed-methods study, we examined the acceptability and feasibility of using an automated computer system to identify crisis behaviours. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
As a result of experiencing oppression-based stressors and trauma, suicide rates for lesbian, gay, bisexual and transgender (LGBTQ+) individuals are much higher than in the general population, and for trans and gender non-binary (TGNB) individuals specifically, rates of suicidality are even higher. To best understand how to engage in suicide prevention and intervention efforts for TGNB individuals, it is therefore crucial to understand factors that may mitigate suicidality for TGNB individuals. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Perhaps the study tells us something deeper about the discrimination and stigmatisation in mental health that needs to be tackled. The research relied on the psychiatric diagnosis and classification of TGD young people as ‘gender dysphoric’, meaning that their gender identity and/or expression had been pathologised. The authors themselves acknowledge that the diagnostic labels they had to use were ‘pathologising and inappropriate.’
A distinct implication of this study is to promote the need of LGBTQ+ tailored suicide prevention strategies in Canada, confirming that LGBTQ+ adolescents are more likely to be at greater risk than cisgender, heterosexual peers. Such programmes could include gender-affirming care for gender diverse adolescents, which has been associated with reductions in suicidality (Sorbara et al., 2020), as well as focus on bullying and cyberbullying risk among LGBTQ+ adolescents.
Although the analysis pertains to data from the USA, the unconditional acceptance of structural racism in social and health systems is refreshingly welcome. The paper should raise awareness and offer plausible, credible and convincing mechanisms, as well as proposals for how to respond.
In this randomised controlled trial, two infusions of IV ketamine were associated with remission in suicidal ideation at 3 days, compared to placebo, in a group of patients with a mix of diagnoses. The effects were most evident in patients with bipolar affective disorder.
Importantly, there were no increases in symptoms of mania in patients with bipolar disorder. It can be a worry that antidepressant treatment in patients with bipolar disorder can trigger a ‘switch’ to a manic state.
Implications of these findings include the importance of attending to the psychological needs of patients when diagnosing them with a severe life-threatening disease, for at least the two years following the diagnosis. The physical health needs of these patients are obviously important, but their psychological needs should not be ignored.
Case studies have linked SARS-CoV-2 infection to suicidal behaviour. However, conclusive evidence is lacking. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.