1
|
Lascelles KM, Davey Z, Jackson D, Aveyard H. Experiences and needs of adult informal carers of adults at risk of suicide: A systematic review with mixed methods analysis. J Adv Nurs 2024; 80:1686-1718. [PMID: 38010822 DOI: 10.1111/jan.15940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]
Abstract
AIM To systematically review and synthesize primary research on experiences and needs of adult informal caregivers of adults at risk of suicide. DESIGN Systematic review with a data-based convergent synthesis. DATA SOURCES MEDLINE, PsychINFO and CINAHL were searched in April 2022 and February 2023. English language research focusing on experiences of adult carers of adults was included. METHODS Articles were screened by title (n = 9077) and abstract (n = 132) with additional articles (n = 6) obtained via citation and hand searching. Thirty-one included studies were quality assessed using the Mixed Methods Appraisal Tool and study data were systematically extracted prior to thematic synthesis. RESULTS Five interconnected themes resulted: transitions; living with fear and uncertainty; changing relationships; interface with healthcare professionals and services; what carers need and want. Caring impacts mental, physical and social wellbeing. Relationships are affected in ways which might not be evident when caring for a minor. Repeated suicidal behaviour is particularly challenging with ongoing hypervigilance contributing to burden, burnout and interpersonal strain. Poor carer support exacerbates negative effects; carers need to feel informed, educated, involved and holistically supported. CONCLUSION Timely support for carers is essential. Interventions should address emotional responses, relational changes and effective care recipient support. Longitudinal research is required to understand effects of ongoing caring where there are multiple suicide attempts. IMPLICATIONS Nurses can provide carers with early support and information and longer term psychosocial interventions. If carers are adequately equipped and supported patient safety and wellbeing will be improved. IMPACT Findings of this systematic review include relational changes due to carer hypervigilance reducing autonomy and living with the possibility of suicide. Clinician awareness of the potential for relational shifts will help them prepare and support carers. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
Collapse
Affiliation(s)
| | - Zoe Davey
- Oxford Institute of Nursing Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Debra Jackson
- University of Sydney, Sydney, New South Wales, Australia
| | | |
Collapse
|
2
|
Hennipman-Herweijer C, Amerongen-Meeuse JVN, Schaap-Jonker H, Boonstra N. The experiences of living with a suicidal family member, and the impact on daily life: A systematic review and meta-aggregation. J Psychiatr Ment Health Nurs 2024. [PMID: 38470095 DOI: 10.1111/jpm.13045] [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] [Received: 07/05/2023] [Revised: 11/22/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Because of the pivotal role that family members play in caring for their suicidal relative, insight into their experiences is necessary to develop good support for them. AIM This systematic review aimed to aggregate qualitative research examining the experiences of family members living with their suicidal relative, and their impact on daily life. METHODS Systematic searches, covering the period 2000-2022, were conducted in Medline, Embase, PsycINFO, Ovid Nursing database and CINAHL. The JBI-QARI meta-aggregation approach and the PRISMA guidelines were followed. RESULTS Eleven studies met the inclusion criteria. Six themes were identified: The hard job of managing the risk of suicide; contributing to the relative's survival; struggling with professional care; being in a lonely position; pressure on relationships; and disruption of well-being. DISCUSSION The constant worry of losing their relative and ever-present vigilance dominates their lives in such a way that their well-being may be decreased. Professionals often overlook family members, which leads to feelings of powerlessness and loneliness. IMPLICATIONS FOR PRACTICE Collaborating with families in treatment, allowing them to share information and supporting them in the care at home may lead to better outcomes for both the family and their suicidal relative.
Collapse
Affiliation(s)
- Christina Hennipman-Herweijer
- Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop, Hoevelaken, The Netherlands
- Eleos Mental Health Care, Bosch en Duin, The Netherlands
- Nursing Sciences, Program in Clinical Health Sciences, Utrecht University, Utrecht, The Netherlands
| | - Joke van Nieuw Amerongen-Meeuse
- Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop, Hoevelaken, The Netherlands
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Hanneke Schaap-Jonker
- Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop, Hoevelaken, The Netherlands
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Nynke Boonstra
- Nursing Science in Mental Health Care, UMC Utrecht, Utrecht, The Netherlands
- NHL Stenden University of Applied Science, Leeuwarden, The Netherlands
- KieN Early Intervention Service, Leeuwarden, The Netherlands
| |
Collapse
|
3
|
Macdonald D, Nicolopoulos A, Habak S, Christensen H, Boydell K. Suicidal Emotions, Motivations and Rationales in Australian Men: A Qualitative Exploration. Glob Qual Nurs Res 2024; 11:23333936241242915. [PMID: 38572389 PMCID: PMC10989048 DOI: 10.1177/23333936241242915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/10/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Suicide has a devasting and far-reaching effect on our communities. In developed countries, most people who die by suicide are male. Understanding men's mental health and what they experience in a suicidal state is key to preventing future attempts. Our paper explores how a group of 37 men in Australia describe the leadup to their suicidality. Underpinned by interpretive phenomenological analysis, interview transcripts were examined for phrases that the investigative team subjectively identified as profound. Our approach considered language and expression that evoke reactions to the sometimes contradictory nature of suicide. The process enabled our team to identify the emotions, rationales, and motivations for and against suicide that give rise to and arise during suicidal states. One man's source of strength may be another's cause of anguish, so any single, one-size-fits-all pathway to suicide prevention is unlikely to succeed, signaling the need for a tailored approach to suicide prevention.
Collapse
Affiliation(s)
- Diane Macdonald
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | | | - Stephanie Habak
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | - Helen Christensen
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | - Katherine Boydell
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| |
Collapse
|
4
|
Castro Moreno LS, Fuertes Valencia LF, Pacheco García OE, Muñoz Lozada CM. Risk factors associated with suicide attempt as predictors of suicide, Colombia, 2016-2017. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:176-184. [PMID: 37863768 DOI: 10.1016/j.rcpeng.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/23/2021] [Indexed: 10/22/2023]
Abstract
BACKGROUND Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and the fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. MATERIAL AND METHODS Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a χ2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. RESULTS Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR = 2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR = 2.38; 95% CI, 1.90-2.99), living in a rural area (HR = 2.56; 95% CI, 2.04-3.20), chronic disease history (HR = 2.43; 95% CI, 1.66-3.57) and depression disorder (HR = 1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. CONCLUSIONS The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.
Collapse
Affiliation(s)
- Luz Stella Castro Moreno
- Entrenamiento Programa de Epidemiología de Campo (FETP), Instituto Nacional de Salud, Bogotá, Colombia.
| | | | - Oscar Eduardo Pacheco García
- Grupo de Formación de Talento Humano para la Vigilancia en Salud Pública, Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
| | - Claudia Marcela Muñoz Lozada
- Grupo de Formación de Talento Humano para la Vigilancia en Salud Pública, Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
| |
Collapse
|
5
|
Lavers G, Andriessen K, Krysinska K. A Systematic Review of the Experiences and Support Needs of Informal Caregivers for People Who Have Attempted Suicide or Experienced Suicidal Ideation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095181. [PMID: 35564578 PMCID: PMC9102006 DOI: 10.3390/ijerph19095181] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 02/04/2023]
Abstract
Informal caregivers include family, friends, and significant others who provide important support for people who have attempted suicide or experienced suicidal ideation. Despite the prevalence of suicidal behaviour worldwide, they remain an understudied population. This review aimed to synthesise the literature on the experiences and support needs of informal caregivers of people who have attempted suicide or experienced suicidal ideation. We conducted a systematic review according to PRISMA guidelines. Searches of peer-reviewed literature in Medline, Emcare, Embase, EBM Reviews, and PsycINFO identified 21 studies (4 quantitative and 17 qualitative), published between 1986 and 2021. Informal carers commonly reported symptoms of depression and anxiety, for which they receive little assistance. They also expressed a desire for more involvement and education in the professional care of suicidality. Together, the studies indicated a need to improve the way informal caregiving is managed in professional healthcare settings. This review identified potential avenues for future research, as well as broad areas which require attention in seeking to improve the care of suicidal people and their caregivers.
Collapse
Affiliation(s)
- George Lavers
- Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia;
- Correspondence:
| |
Collapse
|
6
|
Vandewalle J, Debyser B, Deproost E, Verhaeghe S. Family expectations of inpatient mental health services for adults with suicidal ideation: a qualitative study. Int J Ment Health Nurs 2021; 30:1136-1148. [PMID: 33817944 DOI: 10.1111/inm.12864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 12/15/2022]
Abstract
Involvement of family members of adults with suicidal ideation is a key area of improvement in inpatient mental health services. To support family involvement in this context, it is crucial to understand what care and treatment family members expect for their relative. This qualitative study based on grounded theory involved interviews with 14 family members, including partners, parents, adult children and siblings. The family members' expectations of care and treatment in inpatient mental health services were captured by the core element 'Struggling to remain hopeful while looking through the lens of uncertainty'. This core element interacted with four sub-elements: assuming safety as a priority, looking for a healing approach and environment, counting on continuity of care and wanting to be involved and supported. The family members fluctuated between hope and uncertainty depending on whether their expectations were met or unmet. Unmet expectations were common and underpinned by a sense of being marginalized during the admission of their relative with suicidal ideation. Mental health professionals, including nurses, can be more empathetic towards the family members and attuned to their expectations. This can underpin partnerships that help families to deal with their feelings of uncertainty and disempowerment. Such partnerships can flourish in recovery-oriented mental health services that allow meaningful family involvement.
Collapse
Affiliation(s)
- Joeri Vandewalle
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Centre Sint-Amandus, Beernem, Belgium
| | - Bart Debyser
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy, Clinic Sint-Jozef, Pittem, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
| | - Eddy Deproost
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy, Clinic Sint-Jozef, Pittem, Belgium
| | - Sofie Verhaeghe
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
| |
Collapse
|
7
|
Castro Moreno LS, Fuertes Valencia LF, Pacheco García OE, Muñoz Lozada CM. Risk Factors Associated with Suicide Attempt as Predictors of Suicide, Colombia, 2016-2017. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00070-6. [PMID: 34090686 DOI: 10.1016/j.rcp.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/11/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and the fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. MATERIAL AND METHODS Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a χ2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. RESULTS Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR=2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR=2.38; 95% CI, 1.90-2.99), living in a rural area (HR=2.56; 95% CI, 2.04-3.20), chronic disease history (HR=2.43; 95% CI, 1.66-3.57) and depression disorder (HR=1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. CONCLUSIONS The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.
Collapse
Affiliation(s)
- Luz Stella Castro Moreno
- Entrenamiento Programa de Epidemiología de Campo (FETP), Instituto Nacional de Salud, Bogotá, Colombia.
| | | | - Oscar Eduardo Pacheco García
- Grupo de Formación de Talento Humano para la Vigilancia en Salud Pública, Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
| | - Claudia Marcela Muñoz Lozada
- Grupo de Formación de Talento Humano para la Vigilancia en Salud Pública, Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
| |
Collapse
|
8
|
The Male Experience of Suicide Attempts and Recovery: An Interpretative Phenomenological Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105209. [PMID: 34068854 PMCID: PMC8153566 DOI: 10.3390/ijerph18105209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/14/2022]
Abstract
Suicidal behaviour is a complex phenomenon—its aetiology spans biological, psychological, environmental, social and cultural facets. Men’s deaths by suicide outnumber women in every country in the world. This study explored the male experience of suicide attempts and recovery as well as factors which may be protective for men. Men (n = 12) participated in semi-structured face-to-face interviews which were subjected to Interpretative Phenomenological Analysis (IPA). Four master themes were identified: (1) “characteristics of attempt/volitional factors”, (2) “dealing with suicidal thoughts and negative emotions”, (3) “aftermath” and (4) “protective factors”. The theoretical and clinical implications of this study are discussed, including help seeking, emotional expression, the long-term impact of suicide attempt as well as the applied contribution to established theories.
Collapse
|
9
|
Trauma and Mental Health Awareness in Emergency Service Workers: A Qualitative Evaluation of the Behind the Seen Education Workshops. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094418. [PMID: 33919279 PMCID: PMC8122678 DOI: 10.3390/ijerph18094418] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
Emergency service workers (ESWs) are at high risk of experiencing poor mental health, including posttraumatic stress disorder (PTSD). Programs led by ex-service organizations may play an unrecognized but critical role in mental health prevention and promotion. Behind the Seen (BTS) is an Australian ex-service organization that runs workshops to raise awareness and facilitate conversations around the mental health of ESWs. The purpose of the study is to conduct a qualitative evaluation of workshop participants’ experiences, to understand the acceptability and perceived usefulness over the immediate- (within 1 month), intermediate- (6 months) and longer-terms (12 months). Participants (n = 59 ESWs) were recruited using purposive sampling across five fire and rescue services in metropolitan, regional, and rural locations. Focus groups methodology was used for data collection and data were analyzed using iterative categorization techniques. Participants reported (i) a high perceived need for education about PTSD, (ii) highly salient aspects of the presentation that made for a positive learning experience, including the importance of the lived experiences of the facilitators in the learning process, (iii) key features of changes to intentions, attitudes, and behavior, and (iv) major aspects of the organizational context that affected the understanding and uptake of the program’s key messages. BTS was perceived as an acceptable means of delivering mental health, PTSD, and help-seeking information to ESWs. The program is a promising candidate for scaling-up and further translation.
Collapse
|
10
|
Dadašev S, Grigienė D, Rimkevičienė J, Gailienė D, Latakienė J, Skruibis P, Geležėlytė O, Mažulytė-Rašytinė E. How relatives look back at suicide risk after their close one's death by suicide. DEATH STUDIES 2020; 46:1832-1839. [PMID: 33131457 DOI: 10.1080/07481187.2020.1841848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of the current study is to analyze how relatives understand in retrospect the suicide risk of their next of kin who died by suicide. We interviewed 103 adult relatives who lost their significant others to suicide, using qualitative content analysis to explore the data. Participants expressed difficulties understanding suicide risk by identifying personal traits incompatible with suicide, reasons to doubt the risk, life oriented actions, the situation seemed better than it was, or that the loved one denied suicide risk; only a few recognized suicide risk. Prevalent myths about suicide and denial are possible explanations for these findings.
Collapse
Affiliation(s)
- Said Dadašev
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Dovilė Grigienė
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Jurgita Rimkevičienė
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Danutė Gailienė
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Jolanta Latakienė
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Paulius Skruibis
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Odeta Geležėlytė
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Eglė Mažulytė-Rašytinė
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| |
Collapse
|
11
|
Bilsker D, Fogarty AS, Wakefield MA. Critical Issues in Men's Mental Health. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:590-596. [PMID: 29673272 PMCID: PMC6109879 DOI: 10.1177/0706743718766052] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This narrative review highlights key issues in men's mental health and identifies approaches to research, policy and practice that respond to men's styles of coping. Issues discussed are: 1) the high incidence of male suicide (80% of suicide deaths in Canada, with a peak in the mid-50 s age group) accompanied by low public awareness; 2) the perplexing nature of male depression, manifesting in forms that are poorly recognised by current diagnostic approaches and thus poorly treated; 3) the risky use of alcohol among men, again common and taking a huge toll on mental and physical health; 4) the characteristic ways in which men manage psychological suffering, the coping strengths to be recognised, and the gaps to be addressed; 5) the underutilization of mental health services by men, and the implication for clinical outcomes; and 6) male-specific approaches to service provision designed to improve men's accessing of care, with an emphasis on Canadian programs. The main conclusion is that a high proportion of men in Western society have acquired psychological coping strategies that are often dysfunctional. There is a need for men to learn more adaptive coping approaches long before they reach a crisis point. Recommendations are made to address men's mental health through: healthcare policy that facilitates access; research on tailoring interventions to men; population-level initiatives to improve the capacity of men to cope with psychological distress; and clinical practice that is sensitive to the expression of mental health problems in men and that responds in a relevant manner.
Collapse
Affiliation(s)
- Dan Bilsker
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Andrea S. Fogarty
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Matthew A. Wakefield
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| |
Collapse
|
12
|
Berzins K, Baker J, Brown M, Lawton R. A cross-sectional survey of mental health service users', carers' and professionals' priorities for patient safety in the United Kingdom. Health Expect 2018; 21:1085-1094. [PMID: 30120809 PMCID: PMC6250880 DOI: 10.1111/hex.12805] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2018] [Indexed: 11/30/2022] Open
Abstract
Background Establishing patient safety priorities in psychiatry has received less international attention than in other areas of health care. This study aimed to identify safety issues as described by people in the United Kingdom identifying as mental health service users, carers and professionals. Methods A cross‐sectional online survey was distributed via social media. Identified safety issues were mapped onto the Yorkshire Contributory Factors Framework (YCFF) which categorizes factors that contribute to patient safety incidents in general hospital settings. Service user and carer responses were described separately from professional responses using descriptive statistics. Results One hundred and eighty‐five responses from 95 service users and carers and 90 professionals were analysed. Seventy different safety issues were identified. These were mapped onto the 17 existing categories of the YCFF and two additional categories created to form the YCFF‐MH. Most frequently identified issues were as follows: “Individual characteristics” (of staff) which included competence and listening skills; “Service process” that contained concerns about waiting times; “Management of staff and staffing levels” dominated by staffing levels; and “External policy context” which included the overall resourcing of services. Professionals identified staffing levels and inadequate community provision more frequently than service users and carers, who in turn identified crisis care more frequently. Conclusions This study updates knowledge on stakeholder perceived safety issues across mental health care. It shows a far broader range of issues relating to safety than has previously been described. The YCFF was successfully modified to describe these issues and areas for further coproduced research are suggested.
Collapse
Affiliation(s)
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | | | | |
Collapse
|
13
|
Fogarty AS, Spurrier M, Player MJ, Wilhelm K, Whittle EL, Shand F, Christensen H, Proudfoot J. Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data. Health Expect 2017; 21:261-269. [PMID: 28806484 PMCID: PMC5750756 DOI: 10.1111/hex.12611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2017] [Indexed: 12/02/2022] Open
Abstract
Background Men generally have higher rates of suicide, despite fewer overt indicators of risk. Differences in presentation and response suggest a need to better understand why suicide prevention is less effective for men. Objective To explore the views of at‐risk men, friends and family about the tensions inherent in suicide prevention and to consider how prevention may be improved. Design Secondary analysis of qualitative interview and focus group data, using thematic analysis techniques, alongside bracketing, construction and contextualisation. Setting and participants A total of 35 men who had recently made a suicide attempt participated in interviews, and 47 family and friends of men who had made a suicide attempt took part in focus groups. Participants recounted their experiences with men's suicide attempts and associated interventions, and suggested ways in which suicide prevention may be improved. Results Five tensions in perspectives emerged between men and their support networks, which complicated effective management of suicide risk: (i) respecting privacy vs monitoring risk, (ii) differentiating normal vs risky behaviour changes, (iii) familiarity vs anonymity in personal information disclosure, (iv) maintaining autonomy vs imposing constraints to limit risk, and (v) perceived need for vs failures of external support services. Conclusion Tension between the different perspectives increased systemic stress, compounding problems and risk, thereby decreasing the effectiveness of detection of and interventions for men at risk of suicide. Suggested solutions included improving risk communication, reducing reliance on single source supports and increasing intervention flexibility in response to individual needs.
Collapse
Affiliation(s)
- Andrea S Fogarty
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Michael Spurrier
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Michael J Player
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Kay Wilhelm
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Faces in the Street, St Vincent's Hospital, St Vincent's Urban Mental Health Research Institute, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Erin L Whittle
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Fiona Shand
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Helen Christensen
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Judith Proudfoot
- Black Dog Institute and Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|