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Saini P, Hunt A, Blaney P, Murray A. Recognising and Responding to Suicide-Risk Factors in Primary Care: A Scoping Review. JOURNAL OF PREVENTION (2022) 2024:10.1007/s10935-024-00783-1. [PMID: 38801507 DOI: 10.1007/s10935-024-00783-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
The cost of one suicide is estimated to be £1.67 million (2 million euros) to the UK economy. Most people who die by suicide have seen a primary care practitioner (PCP) in the year prior to death. PCPs could aim to intervene before suicidal behaviours arise by addressing suicide-risk factors noted in primary care consultations, thereby preventing suicide and promoting health and wellbeing. This study aimed to conduct a rapid, systematic scoping review to explore how PCPs can effectively recognise and respond to suicide-risk factors. MedLine, CINAHL, PsycINFO, Web of Science and Cochrane Library databases were searched for three key concepts: suicide prevention, mental health and primary care. Two reviewers screened titles, abstracts and full papers independently against the eligibility criteria. Data synthesis was achieved by extracting and analysing study characteristics and findings. Forty-two studies met the eligibility criteria and were cited in this scoping review. Studies were published between 1990 and 2020 and were of good methodological quality. Six themes regarding suicide risk assessment in primary care were identified: Primary care consultations prior to suicide; Reasons for non-disclosure of suicidal behaviour; Screening for suicide risk; Training for primary care staff; Use of language by primary care staff; and, Difference in referral pathways from general practitioners or primary care practitioners. This review focused on better recognition and response to specific suicide-risk factors more widely such as poor mental health, substance misuse and long-term physical health conditions. Primary care is well placed to address the range of suicide-risk factors including biological, physical-health, psychological and socio-economic factors and therefore these findings could inform the development of person-centred approaches to be used in primary care.
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Affiliation(s)
- Pooja Saini
- School of Psychology, Faculty of Health, Suicide and Self-Harm Prevention, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK.
| | - Anna Hunt
- School of Psychology, Faculty of Health, Suicide and Self-Harm Prevention, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK
| | - Peter Blaney
- School of Psychology, Faculty of Health, Suicide and Self-Harm Prevention, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK
| | - Annie Murray
- Department of Health and Social Care, Office for Health Improvement and Disparities, Piccadilly Place 3, Manchester, M1 3BN, UK
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Candon M, Benjamin Wolk C, Kattan Khazanov G, Oslin DW, Pieri MF, Press MJ, Anderson E, Jager-Hyman S. Treating individuals with suicidal ideation in primary care: Patient-level characteristics associated with follow-up in the Collaborative Care Model. Suicide Life Threat Behav 2024; 54:15-23. [PMID: 37916734 PMCID: PMC10922361 DOI: 10.1111/sltb.13012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/26/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION The Collaborative Care Model (CoCM) is an evidence-based approach which embeds behavioral health providers (BHPs) into primary care. Whether patients with suicidal ideation (SI) are willing to engage in CoCM is unclear. METHODS Using Patient Health Questionnaire-9 (PHQ-9) administrative data from primary care practices within an urban academic health system, we identified patients with and without SI who were referred to a CoCM BHP. We compared engagement, defined as attendance at ≥1 CoCM visit, across groups. RESULTS Between 2018 and 2022, 7391 primary care patients were referred to a CoCM BHP. Eight hundred and ninety-two of these patients reported SI on the PHQ-9 (754 on "several days" during the previous 2 weeks and 138 on "more than half or most days"). Across groups, most patients engaged in CoCM. Patients reporting SI on several days engaged at a lower rate (61.4%) than those reporting SI on more than half or most days (65.9%). Both SI groups engaged at a lower rate than the 6499 patients who did not report SI (67.5%). CONCLUSION Most patients referred to a CoCM BHP engaged in ≥1 visit. Rates were lower for patients with SI, with the lowest rate among those reporting SI on several days.
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Affiliation(s)
- Molly Candon
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Courtney Benjamin Wolk
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Gabriela Kattan Khazanov
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - David W. Oslin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Matteo F. Pieri
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Matthew J. Press
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Eleanor Anderson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shari Jager-Hyman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Gallagher K, O’ Brien C, O’ Driscoll M, Ní Dhálaigh D, Corcoran P, Griffin E. Suicide prevention curriculum development for health and social care students: Protocol for a scoping review. PLoS One 2023; 18:e0285231. [PMID: 38060488 PMCID: PMC10703193 DOI: 10.1371/journal.pone.0285231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
Suicide has become a serious public health concern and international research has shown that the majority of individuals who die by suicide had receive healthcare in the year prior to their death. This presents an opportunity for suicide prevention by strategically training healthcare students in suicide prevention knowledge and skills. The objective of this scoping review is to identify literature that describes the design, development, implementation and/or evaluation of suicide prevention training for healthcare and/or social care students in higher education settings. Studies will only be considered eligible for inclusion if they describe the design, development, implementation and/or evaluation of suicide prevention curricula being delivered to healthcare or social care degree students in higher education. Quantitative, qualitative, and mixed method studies published between 2011 and 2023 (inclusive) and in the English language will be considered eligible. This scoping review will be conducted according to the PRISMA guidelines for scoping reviews (PRISMA-ScR). The developed search strategy will be implemented across six databases: PubMed, ERIC (Education Resources Information Center), PsycINFO, Embase, CINAHL and Web of Science. Several grey literature sources will also be consulted. Further potential results will be located by hand-searching the reference lists of included articles. The search strategy will include variations of the terms: 'student', 'suicide prevention' and 'education'. The search will be limited to titles, abstracts, and keywords in databases that allow it. Two reviewers will complete the screening using the predefined inclusion criteria. A third reviewer will resolve any conflicts during the screening and eligibility appraisal processes. Results will be presented in the form of tabulated results and an accompanying narrative summary, describing key findings and context related to learning outcomes, methodologies employed and implementation of the identified programmes.
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Affiliation(s)
| | | | | | | | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Eve Griffin
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
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Sullivan JL, Burns B, O'Malley K, Mlinac M. An Environmental Scan of Suicide Prevention Resources for Older Veterans in Primary Care. Clin Gerontol 2023:1-9. [PMID: 37433058 DOI: 10.1080/07317115.2023.2234901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
OBJECTIVES 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. METHODS We searched four academic databases, Google Scholar, and Google to identify available suicide prevention resources. Data from 64 resources was extracted and summarized; 15 were general resources and did not meet inclusion criteria. RESULTS Our scan identified 49 resources with three resources specifically developed for older veterans in primary care. Identified resources shared overlapping content, including implementing a safety plan and lethal means reduction. CONCLUSION Although only 10 of the identified resources were exclusively primary care focused, many of the resources had content applicable to suicide prevention in primary care. CLINICAL IMPLICATIONS Primary care providers can use this compendium of resources to strengthen suicide prevention work within their clinics including: safety planning, lethal means reduction, assessing for risk factors that place older veteran at increased risk of suicide, and mitigating risk factors through referral to programs designed to support older adult health and well-being.
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Affiliation(s)
- Jennifer L Sullivan
- Center of Innovation in Long Term Services and Supports (LTSS COIN), VA Providence Healthcare System, Capt. Jonathan H. Harwood Jr. Center for Research, Rhode Island, USA
- School of Public Health, Department of Health Service, Policy and Practice, Research Track, Brown University, Rhode Island, USA
| | - Benjamin Burns
- College of Arts and Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Kelly O'Malley
- VA Boston Healthcare System, Harvard Medical School, Brockton, Massachusetts, USA
| | - Michelle Mlinac
- VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts, USA
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Dobscha SK, Newell SB, Elliott VJ, Rynerson AL, Rabin S, Bahraini N, Post EP, Denneson LM. Primary Care and Mental Health Staff Perspectives on Universal Suicide Risk Screening and Care Coordination. Psychiatr Serv 2023; 74:305-311. [PMID: 35959535 DOI: 10.1176/appi.ps.20220087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Little is known about staff or patient perspectives on suicide risk screening programs. The objectives of this study were to characterize Veterans Health Administration (VHA) primary care and mental health staff perspectives regarding the VHA Suicide Risk Identification Strategy screening and assessment program and to describe coordination of suicide prevention-related care following positive screening results. Qualitative interviews were conducted with 40 primary care and mental health staff at 12 VHA facilities. An inductive-deductive hybrid approach was used to conduct a thematic analysis. Several key themes were identified. Primary care and mental health staff participants accepted having a structured process for screening for suicidal ideation and conducting risk assessments, but both groups noted limitations and challenges with initial assessment and care coordination following screening. Mental health staff reported more concerns than primary care staff about negative impacts of the screening and assessment process on treatment. Both groups felt that better training was needed for primary care staff to effectively discuss and evaluate suicide risk. The results suggested that additional modifications of the screening and assessment process are needed for patients already known to have elevated risk of suicide or chronic suicidal ideation.
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Affiliation(s)
- Steven K Dobscha
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
| | - Summer B Newell
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
| | - Victoria J Elliott
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
| | - Annabelle L Rynerson
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
| | - Sarah Rabin
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
| | - Nazanin Bahraini
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
| | - Edward P Post
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
| | - Lauren M Denneson
- Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Dobscha, Newell, Elliott, Rynerson, Rabin, Denneson); Department of Psychiatry, Oregon Health & Science University, Portland (Dobscha, Denneson); VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, and Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora (Bahraini); Center for Clinical Management Research, VA Ann Arbor, and Department of Medicine, University of Michigan Medical School, Ann Arbor (Post)
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Wärdig RE, Hultsjö S, Lind M, Klavebäck I. Nurses' Experiences of Suicide Prevention in Primary Health Care (PHC) - A Qualitative Interview Study. Issues Ment Health Nurs 2022; 43:903-912. [PMID: 35793075 DOI: 10.1080/01612840.2022.2089789] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIM The purpose was to describe nurses' experiences of suicide prevention work in primary health care (PHC). BACKGROUND Suicide is the tenth most common cause of death among adults. PHC has an important role in suicide prevention work, as patients often had contact with PHC before their suicide rather than with specialist psychiatric care. Nurses often have the first contact with the patient and are responsible for triage and assessment, making them important in suicide prevention work. Previous studies shed light on suicide prevention in a primary care context, but the nurses' voices are missing. METHODS Fifteen qualitative interviews were conducted with nurses in primary health care. Data was analyzed according to conventional content analysis techniques. FINDINGS Nurses may avoid asking questions about suicidality for fear of what to do with the answer. To support the nurses' ability in suicide prevention work, both educational and practical experience are fundamental. There was a lack of clarity about who is carrying responsibility for the patient, and it turned out to be difficult to help the patient move further to the next care institution. There was a need for guidelines as well as routines for collaboration with other care actors in suicide prevention work. CONCLUSION The PHC organization does not support nurses in suicide prevention, therefore they need the right conditions for their work. Suicide prevention needs to be given greater focus and space within education as well as training in the ongoing clinical work, which can be performed with less extensive efforts.
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Affiliation(s)
- Rikard Erik Wärdig
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Sally Hultsjö
- Department of Psychiatry, Ryhov County Hospital and Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Malin Lind
- Department of Psychiatry, Ryhov County Hospital and Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Isabella Klavebäck
- Department of Psychiatry, Ryhov County Hospital and Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
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Johnson EM, Poleshuck E, Possemato K, Hampton B, Funderburk JS, Grewal H, Cerulli C, Wittink M. Practical and Emotional Peer Support Tailored for Life's Challenges: Personalized Support for Progress Randomized Clinical Pilot Trial in a Veterans Health Administration Women's Clinic. Mil Med 2022; 188:usac164. [PMID: 35714103 DOI: 10.1093/milmed/usac164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/06/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Women Veterans experience a broad range of stressors (e.g., family, relationship, and financial) and high rates of mental health and physical health conditions, all of which contribute to high levels of stress. Personalized Support for Progress (PSP), an evidence-based intervention, is well suited to support women Veterans with high stress as it involves a card-sort task to prioritize concerns as well as pragmatic and emotional support to develop and implement a personalized plan addressing those concerns. Our aims were to explore the population and context for delivery and evaluate the feasibility, acceptability, and utility of PSP delivered by a peer specialist to complement existing services in a Veterans Health Administration (VHA) Women's Wellness Center. MATERIALS AND METHODS This randomized controlled pilot trial compared treatment as usual plus PSP to treatment as usual and used the a priori Go/No-Go criteria to establish success for each outcome. We interviewed staff regarding the population and delivery context at a VHA Women's Wellness Center and analyzed interviews using a rapid qualitative approach. For the rapid qualitative analysis, we created templated summaries of each interview to identify key concepts within each a priori theme, reviewed each theme's content across all interviews, and finally reviewed key concepts across themes. We evaluated feasibility using recruitment and retention rates; acceptability via Veteran satisfaction, working relationship with the peer, and staff satisfaction; and utility based on the proportion of Veterans who experienced a large change in outcomes (e.g., stress, mental health symptoms, and quality of life). The Syracuse VA Human Subjects Institutional Review Board approved all procedures. RESULTS Staff interviews highlight that women Veterans have numerous unmet social needs and concerns common among women which increase the complexity of their care; call for a supportive, consistent, trusting relationship with someone on their health care team; and require many resources (e.g., staff such as social workers, services such as legal support, and physical items such as diapers) to support their needs (some of which are available within VHA but may need support for staffing or access, and some of which are unavailable). Feasibility outcomes suggest a need to modify PSP and research methods to enhance intervention and assessment retention before the larger trial; the recruitment rate was acceptable by the end of the trial. Veteran acceptability of PSP was high. Veteran outcomes demonstrate promise for utility to improve stress, mental health symptoms, and quality of life for women Veterans. CONCLUSIONS Given the high acceptability and promising outcomes for utility, changes to the design to enhance the feasibility outcomes which failed to meet the a priori Go/No-Go criteria are warranted. These outcomes support future trials of PSP within VHA Women's Wellness Centers.
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Affiliation(s)
- Emily M Johnson
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
| | - Ellen Poleshuck
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Kyle Possemato
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
| | - Brittany Hampton
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
| | - Jennifer S Funderburk
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Harminder Grewal
- Women's Wellness Center, Syracuse VA Medical Center, Syracuse, NY 13210, USA
- Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Catherine Cerulli
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
- Susan B. Anthony Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Marsha Wittink
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
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La Guardia AC, Wright-Berryman J, Cramer RJ, Kaniuka AR, Tufts KA. Interprofessional Suicide Prevention Education. CRISIS 2021; 43:531-538. [PMID: 34519541 DOI: 10.1027/0227-5910/a000813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The COVID-19 pandemic has raised concerns regarding possible spikes in suicidal behavior in light of heightened risk factors such as social isolation and financial strain; thus, comprehensive suicide prevention training for emerging health service providers is increasingly vital. This article summarizes an interprofessional education (IPE) suicide prevention course delivered in-person in Spring 2020. Pilot data demonstrate that despite the impact of COVID-19 on higher education, this course had long-term impacts on trainee suicide prevention efficacy, IPE attitudes, and use of course content in practice. Discussion serves to address enhancements for interprofessional and suicide prevention education during and after the pandemic. Emphasis is placed on adaptable training strategies, considerations in the delivery format, guidelines for intensive virtual meetings with trainee teams, and future directions in IPE suicide prevention training research.
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Affiliation(s)
| | | | - Robert J Cramer
- Department of Public Health Sciences, UNC Charlotte, NC, USA
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Hoyt T, Holliday R, Simonetti JA, Monteith LL. Firearm Lethal Means Safety with Military Personnel and Veterans: Overcoming Barriers using a Collaborative Approach. ACTA ACUST UNITED AC 2021; 52:387-395. [PMID: 34421193 DOI: 10.1037/pro0000372] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Suicides by firearm have increased over the past decade among United States service members and veterans. As firearm access is a suicide risk factor, firearm-related lethal means safety is critical to suicide prevention. However, identity, occupational, and cultural barriers may deter efforts to promote lethal means safety with service members and veterans. The current manuscript describes a collaborative framework to guide mental health providers' in conducting firearm-related lethal means safety with service members and veterans, including within the context of Safety Planning. In approaching firearm lethal means safety conversations with patients, clinicians must work to overcome their own reticence, address patient concerns directly, and remain culturally sensitive to the values of the military and veteran communities. This approach is illustrated using case vignettes that encompass addressing firearm-related lethal means safety with service members and veterans.
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Affiliation(s)
- Tim Hoyt
- Psychological Health Center of Excellence, Defense Health Agency
| | - Ryan Holliday
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Veteran Suicide Prevention.,Department of Psychiatry, University of Colorado Anschutz Medical Campus
| | - Joseph A Simonetti
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Veteran Suicide Prevention.,Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Health Administration.,Hospital Medicine Group, Rocky Mountain Regional VA Medical Center
| | - Lindsey L Monteith
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Veteran Suicide Prevention.,Department of Psychiatry, University of Colorado Anschutz Medical Campus
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10
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Bechtel JM, Lepoire E, Bauer AM, Bowen DJ, Fortney JC. Care manager perspectives on integrating an mHealth app system into clinical workflows: A mixed methods study. Gen Hosp Psychiatry 2021; 68:38-45. [PMID: 33310012 DOI: 10.1016/j.genhosppsych.2020.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/24/2020] [Accepted: 10/08/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE mHealth can be a valuable means of monitoring symptoms and supporting care for rural patients, but barriers to implementation remain. This study aimed to examine care manager perspectives on the adoption, use and impact of an mHealth system deployed within a pragmatic Collaborative Care trial for rural patients with PTSD and/or Bipolar Disorder. METHOD Sixteen care managers at 12 Federally Qualified Health Centers in 3 states participated in semi-structured interviews. Interviews were transcribed, coded, and thematically analyzed using the Unified Theory of Adoption and Use of Technology as a conceptual framework. App metadata was used to assess the frequency of a care manager reported phenomenon, clinically disengaged app use. RESULTS 4 themes were identified: infrastructural limitations; redundant and incompatible clinical and mHealth workflows; cross platform and web access; and patient engagement and clinically disengaged app use. Most users had a period of consistently submitting symptom measures via the app while disengaged from care for >4 weeks.
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Affiliation(s)
- Jared M Bechtel
- University of Washington, Department of Psychiatry and Behavioral Sciences, USA.
| | - Erin Lepoire
- University of Washington, Department of Psychiatry and Behavioral Sciences, USA
| | - Amy M Bauer
- University of Washington, Department of Psychiatry and Behavioral Sciences, USA
| | - Deborah J Bowen
- University of Washington, Department of Psychiatry and Behavioral Sciences, USA
| | - John C Fortney
- University of Washington, Department of Psychiatry and Behavioral Sciences, USA
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11
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Haun MW, Stephan I, Wensing M, Hartmann M, Hoffmann M, Friederich HC. Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory. JMIR Ment Health 2020; 7:e23660. [PMID: 33055058 PMCID: PMC7654505 DOI: 10.2196/23660] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/11/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. OBJECTIVE This mixed method preimplementation study aims to assess GPs' intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). METHODS Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. RESULTS This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, P<.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. CONCLUSIONS A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.
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Affiliation(s)
- Markus W Haun
- Department of General Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Isabella Stephan
- Department of General Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Mariell Hoffmann
- Department of General Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
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