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Brousseau-Paradis C, Genest C, Maltais N, Séguin M, Rassy J. Emergency department care experience of suicidal patients: A qualitative analysis of patients' perspectives. Int Emerg Nurs 2024; 74:101449. [PMID: 38669791 DOI: 10.1016/j.ienj.2024.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/24/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Individuals experiencing suicidal ideation or behavior frequently seek assistance at the emergency department (ED), yet the care they receive does not consistently align with their needs. This study explores the ED care experience of suicidal patients from their own perspective and offers recommendations to improve ED care for this population. METHOD This qualitative study uses a descriptive interpretative design. Semi-structured interviews were conducted with 7 individuals who sought care in an ED due to suicidal ideation or behavior. Transcripts were analyzed using thematic analysis. FINDINGS Participants' experiences were marked by an unsuited physical environment described as uncomfortable, noisy, and depressing. The organization of care was perceived as inadequate as patients complained about limited front-line access to mental health expertise, long waiting times, overworked staff, and inequities between patients with physical injuries and those with mental health concerns. Participants reported feelings of being trapped, left on their own and mistreated during their ED stay. Most found their care experience unhelpful or distressing, leaving them reluctant to reconsult. Specific recommendations based on patients' testimonials and literature are provided to enhance the ED care experience of suicidal patients. CONCLUSION This study highlights several areas for improvement of the ED care experience of suicidal patients. Changes in current practices are needed to offer suicidal patients the satisfying care experience they deserve.
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Affiliation(s)
- Camille Brousseau-Paradis
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Pavillon Roger-Gaudry, 2900 boul. Édouard-Montpetit, bureau S-750, H3T 1J4 Montreal, QC, Canada; Research Center of the University Institute in Mental Health of Montreal, 7331 Hochelaga Street, Montreal H1N 3V2, QC, Canada.
| | - Christine Genest
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada; Research Center of the University Institute in Mental Health of Montreal, Trauma Study Center, Montreal, QC, Canada; Center for Research and Intervention on Suicide, Ethical Issues and End-of- Life Practices, Montreal, QC, Canada.
| | - Nathalie Maltais
- Department of Health Sciences, University of Quebec at Rimouski, Rimouski, QC, Canada; Department of Psychoeducation and Psychology, University of Quebec at Outaouais, Gatineau, QC, Canada.
| | - Monique Séguin
- Department of Psychoeducation and Psychology, University of Quebec at Outaouais, Gatineau, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - Jessica Rassy
- Research Center of the University Institute in Mental Health of Montreal, 7331 Hochelaga Street, Montreal H1N 3V2, QC, Canada; Quebec Network on Suicide, Mood Disorders and Associated Disorders, Montreal, QC, Canada; Quebec Network on Nursing Intervention Research, Montreal, QC, Canada; School of Nursing, University of Sherbrooke, Longueuil, QC, Canada.
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Caron MÈ, Maltais N, Corriveau S, Rassy J. The use of information and communication technologies by adolescents living with a mental illness in the past 5 years: Scoping review. Int J Ment Health Nurs 2024. [PMID: 38590128 DOI: 10.1111/inm.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/08/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
The use of information and communication technologies (ICT) is a huge part of adolescents' lives, especially by those living with a mental illness. However, very few studies explore their experience with the use of ICT and how it affects their health. The purpose of this study was to better understand the use of ICT by adolescents living with a mental illness. A scoping review was undertaken using Arksey and O'Malley's method to explore this understudied topic. The following databases were searched: Medline, CINAHL and Psychology and Behavioural Sciences Collection. Studies published between 2017 and 2022 were included. Data were analysed using a data extraction and an analysis grid developed by the research team. Of 1984 articles, only seven met the inclusion criteria. These articles allowed for a better understanding of the type of mental illness these young ICT users had, the type of ICT they use and their overall experience using ICT. The diagnoses most associated with the use of these ICT were suicidal ideation, depression, anxiety and eating illnesss. Types of ICT used were very diverse and adolescents had both positive and negative experiences using these ICT. Very few interventions using ICT were developed according to the needs of adolescents with mental illness. These adolescents often cope with the help of ICT and can have an overall positive experience. Their experience can also be negative as some of them were exposed to suicide-related and violent content. Future research is needed to better understand the best ICT interventions for these young people.
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Affiliation(s)
- Marie-Ève Caron
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - Nathalie Maltais
- Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, Quebec, Canada
- Centre de recherche sur le suicide, enjeux éthiques et pratiques de fin de vie (CRISE), Montreal, Quebec, Canada
- Réseau de recherche en interventions en sciences infirmières du Québec (RRISIQ), Montreal, Quebec, Canada
| | - Stacy Corriveau
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jessica Rassy
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de recherche sur le suicide, enjeux éthiques et pratiques de fin de vie (CRISE), Montreal, Quebec, Canada
- Réseau de recherche en interventions en sciences infirmières du Québec (RRISIQ), Montreal, Quebec, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Longueuil, Quebec, Canada
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Brousseau-Paradis C, Lesage A, Larue C, Labelle R, Giguère CÉ, Rassy J. Suicidality and mood disorders in psychiatric emergency patients: Results from SBQ-R. Int J Ment Health Nurs 2023; 32:1301-1314. [PMID: 37150928 DOI: 10.1111/inm.13161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 05/09/2023]
Abstract
Patients with mood disorders are at high risk of suicidality, and emergency departments (ED) are essential in the management of this risk. This study aims to (1) describe the suicidal thoughts and behaviours of patients with mood disorders who come to ED; (2) assess the psychometric properties of the Suicidal Behaviours Questionnaire-Revised (SBQ-R) in a psychiatric ED; and (3) determine the best predictors of suicidality for these patients. A total of 300 participants with mood disorders recruited for the Signature Bank of the Institut universitaire en santé mentale de Montréal (IUSMM) were retained. Suicidality was assessed using the SBQ-R. Other clinical and demographic details were recorded. Bivariate analyses, correlations and multivariate regression analyses were conducted. SBQ-R's internal consistency, construct and convergent validities were also tested. In the Patient Health Questionnaire-9 (PHQ-9), 53.3% of the sample stated they had suicidal or self-harm thoughts in the last 2 weeks. The mean score obtained at the SBQ-R was 8.3. Multivariate analysis found that SBQ-R scores were associated with depressive symptoms and substance use, especially alcohol, accounting for 44.3% of the model variance. Cronbach's alpha was 0.81 [0.78, 0.84] and factor loadings for items 1-4 were 0.68, 0.88, 0.54, and 0.85, respectively. The confirmatory factor analysis indicated that the model fit the data well. The SBQ-R is a brief and valid instrument that can easily be used in busy emergency departments to assess suicide risk. Depressive symptoms and alcohol use shall also be assessed, as they are determinants of increased risk of suicidality.
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Affiliation(s)
- Camille Brousseau-Paradis
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada
| | - Alain Lesage
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada
- Quebec Network on Suicide, Mood Disorders and Associated Disorders, Montréal, Quebec, Canada
| | - Caroline Larue
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
- Faculty of Nursing, University of Montreal, Montréal, Quebec, Canada
- Quebec Network on Nursing Intervention Research, Montréal, Quebec, Canada
| | - Réal Labelle
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Quebec, Canada
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Charles-Édouard Giguère
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
| | - Jessica Rassy
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
- Quebec Network on Suicide, Mood Disorders and Associated Disorders, Montréal, Quebec, Canada
- Quebec Network on Nursing Intervention Research, Montréal, Quebec, Canada
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, Quebec, Canada
- School of Nursing, University of Sherbrooke, Montréal, Quebec, Canada
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Montreuil M, Camden C, Genest C, Gilbert E, Laberge-Perrault E, Piché G, Rassy J, Bogossian A, Gendron-Cloutier L, Barbo G. Children and adolescents' mental health in pandemics and confinement: A scoping review of vulnerability factors and repercussions. J Child Health Care 2023:13674935231165554. [PMID: 37146991 PMCID: PMC10164454 DOI: 10.1177/13674935231165554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Children and adolescents are a population at particular risk of experiencing adverse mental health repercussions related to pandemics. To understand vulnerability factors and repercussions of pandemics and related sanitary measures on children and adolescents' mental health, we performed a scoping review to examine and synthesize literature. In total, 66 articles were included. Results present: (1) factors that increase vulnerability to adverse mental health repercussions (e.g., having a pre-existing mental health condition, social isolation, low socio-economic status, parental distress, and overexposure to media content) and (2) specific mental health repercussions (e.g., anxiety, fear, depression, and externalizing behaviors). Addressing concerns underlined in this review could contribute to preventing further negative mental health repercussions of pandemics for children and adolescents and better prepare governments and professionals to address these highly challenging situations. Recommendations for practice include enhancing healthcare professionals' awareness about possible detrimental repercussions pandemics and sanitary measures have on children and adolescents' mental health, assessing changes for those with pre-existing mental health conditions, allocating funding for telehealth research, and providing greater support to healthcare providers.
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Affiliation(s)
| | - Chantal Camden
- School of rehabilitation, Université de Sherbrooke (Universite de Sherbrooke), Sherbrooke QC, Canada
| | - Christine Genest
- School of Nursing, Université de Montréal (Universite de Montreal), Montreal, QC, Canada
| | - Elsa Gilbert
- Department of Health Sciences, Université du Québec à Rimouski, Lévis (Universite du Quebec a Rimouski, Levis), Lévis, QC, Canada
| | | | - Geneviève Piché
- Department of Psychology and Psychoeducation, Université du Québec en Outaouais, Saint-Jérôme (Universite du Quebec en Outaouais, Saint-Jerome), Saint-Jérôme, QC, Canada
| | - Jessica Rassy
- School of rehabilitation, Université de Sherbrooke (Universite de Sherbrooke), Sherbrooke QC, Canada
| | - Aline Bogossian
- School of Nursing, Université de Montréal (Universite de Montreal), Montreal, QC, Canada
| | | | - Geneveave Barbo
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
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Lesage A, Fortin G, Ligier F, Van Haaster I, Doyon C, Brouillard C, Daneau D, Rassy J. Implementing a Suicide Audit in Montreal: Taking Suicide Review Further to Make Concrete Recommendations for Suicide Prevention. Arch Suicide Res 2023; 27:29-42. [PMID: 34470592 DOI: 10.1080/13811118.2021.1965058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A suicide audit was pilot implemented in order to generate recommendations on how to improve suicide prevention. METHODS Thirty-nine consecutive suicides that occurred in Montreal, Canada from January to October 2016 were audited. A retrospective analysis of their life trajectory and service utilization was conducted using the psychological autopsy method, which included interviewing suicide-bereaved survivors and examining health and social services records and the coroner's investigation file. A psychosocial and service utilization profile was drawn for each decedent. A multidisciplinary panel reviewed each case summary to identify gaps in terms of individual intervention, provincial public health and social services, and regional programs. RESULTS Five main suicide prevention recommendations were made to prevent similar suicides: (1) deploy mobile crisis intervention teams (short-term, high-intensity, home-based treatment) in hospital emergency departments; (2) train primary and specialized mental health care professionals to screen for and manage substance use disorders; and (3) implement public awareness campaigns to encourage help seeking for depression and substance use disorders; (4) access for all, regardless of age, to an effective psychosis treatment program; and (5) provide universal access to a general practitioner, especially for men. CONCLUSIONS The suicide audit procedure was implemented effectively and targeted recommendations were generated to prevent similar suicides. However, resistance from medical and hospital quality boards arose during the process, though these could be allayed if regional and provincial authorities actively endorsed the multidisciplinary and multi stakeholders suicide audit process. HighlightsA bottom-up approach to generate recommendations for suicide prevention.Implementation was challenging with resistance to our interdisciplinary approach.The audit needs the support of the regional health department to lift barriers.
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Montreuil M, Gendron‐Cloutier L, Laberge‐Perrault E, Piché G, Genest C, Rassy J, Malboeuf‐Hurtubise C, Gilbert E, Bogossian A, Camden C, Mastine T, Barbo G. Children and adolescents' mental health during the COVID-19 pandemic: A qualitative study of their experiences. J Child Adolesc Psychiatr Nurs 2022; 36:65-74. [PMID: 36566357 PMCID: PMC9880751 DOI: 10.1111/jcap.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/03/2022] [Accepted: 12/04/2022] [Indexed: 12/26/2022]
Abstract
TOPIC Public health measures implemented in response to the COVID-19 pandemic severely disrupted children and adolescents' (C&A) lives, affecting their sense of structure, predictability, and security. PURPOSE To examine C&A' experiences during the COVID-19 pandemic to better understand how this context and its associated public health measures affected them and their mental health, and to identify helpful coping strategies. SOURCES USED The study was guided by a participatory hermeneutic framework. Semistructured interviews were conducted with 25 C&A aged 6-17 years during the first and second pandemic waves. Participants' interviews were analyzed following a narrative synthesis approach, through which C&A' experiences were contrasted and contextualized to highlight relevant themes. CONCLUSIONS Participants described a distinct pattern related to their mental health as the pandemic unfolded, which followed the severity of the pandemic in the province. Negative repercussions on their mental health were linked to the loss of social activities, imposed public health measures, transition to online learning, and challenges with family relationships. Certain youth shared positive societal and moral reflections triggered by the pandemic context. Coping strategies reported include: having a variety of hobbies; expressing their emotions; and accessing financial and material resources. This study highlights the importance of supporting C&A' mental health during crisis situations such as a pandemic. Their perspectives are vital for clinical practice and policy improvement, particularly to find means for social engagement while maintaining safety.
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Affiliation(s)
- Marjorie Montreuil
- Ingram School of NursingMcGill UniversityMontrealQuebecCanada,Centre de recherche de l'Institut universitaire en santé mentale de MontréalMontréalQuebecCanada,Centre de recherche de l'Institut universitaire en santé mentale DouglasMontréalQuebecCanada
| | | | | | - Geneviève Piché
- Université du Québec en Outaouais, Campus de Saint‐JérômeGatineauQuebecCanada
| | - Christine Genest
- Centre d'étude sur le trauma du Centre de recherche de l'Institut universitaire en santé mentale de Montréal et le Centre de recherche et d'intervention sur le suicide, les enjeux éthiques et pratiques de fin de vie, Faculté des sciences infirmièresUniversité de MontréalMontrealQuebecCanada
| | - Jessica Rassy
- École des sciences infirmièresUniversité de Sherbrooke, Campus de LongueuilLongueuilQuebecCanada
| | | | - Elsa Gilbert
- Département des sciences de la santéUniversité du Québec à RimouskiRimouskiQuebecCanada
| | - Aline Bogossian
- École de travail socialUniversité de MontréalMontrealQuebecCanada
| | - Chantal Camden
- School of Physical and Occupational TherapySherbrooke UniversitySherbrookeQuebecCanada
| | | | - Geneveave Barbo
- Ingram School of NursingMcGill UniversityMontrealQuebecCanada
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Lafontaine S, Rassy J, Duval-Martin AL, Girard A, Marceau M, Gallagher F, Hébert M, Jacques MC. Nursing Interventions Designed to Improve Healthcare in General Healthcare Settings for Adults Living with Mental Illness: A Scoping Review. Issues Ment Health Nurs 2022; 43:955-970. [PMID: 35658729 DOI: 10.1080/01612840.2022.2083736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
People living with mental illness have difficulty obtaining quality physical care services. Nurses find it hard to fully assume their role and adopt a person-centered approach when they care for people with both physical and mental health problems. A scoping review was carried out to document the breadth and depth of literature on nurse interventions designed to improve nursing care in general healthcare settings for adults living with mental illness. Two researchers independently screened titles, abstracts and full documents to obtain publications, and the relevant data was extracted from individual studies. Of the 384 studies identified, 16 documents were included in the study. Few interventions have been the subject of scientific publications and they are scattered in their objectives and very heterogeneous in their content. Interventions are often included in a large program that may be difficult to apply in various care settings. There are many different nursing roles and activities in care-management and in support of behavioral changes although their main measured outcomes differ. This study highlights a tendency for interventions to relegate people with mental health problems to specialized services, which reinforces the dichotomization of services and does not favor a holistic and person-centered approach. There is an urgent need to develop and evaluate nursing interventions in general healthcare settings for adults living with mental illness. The development of relevant continuing education and training must take into account both the point of view of the people living with mental illness and that of nurses.
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Affiliation(s)
| | - Jessica Rassy
- School of Nursing, Université de Sherbrooke, Longueuil, Canada
| | | | - Ariane Girard
- School of Nursing, Université de Sherbrooke, Sherbrooke, Canada
| | - Mélanie Marceau
- School of Nursing, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Maude Hébert
- School of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Rassy J, Lesage A, Labelle R, Saadi F, Goulet MH, Genest C, Maltais N, Larue C. Assessment and care of individuals at risk of suicide in Emergency Department: The SecUrgence protocol. Int Emerg Nurs 2022; 64:101199. [PMID: 36027701 DOI: 10.1016/j.ienj.2022.101199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022]
Abstract
Almost half (48,5%) of all individuals who die by suicide visited the Emergency Department (ED) in the year preceding their death by suicide and for almost a third (29,5%) of these individuals, the ED visit occurred within the month preceding their death by suicide. The ED is a key location for suicide prevention. The aim of this study was to develop and reach a consensus on the SecUrgence Protocol, a clinical protocol that intends to assess and provide care for individuals at risk of suicide that present themselves to the ED. This project was conducted in 3 stages: 1) Review of the literature, 2) Development of the list of the protocol statements by a first panel of experts, and 3) Validation, using the Delphi consensus method, on the final statements to include in the SecUrgence Protocol by a second panel of experts. Two rounds of the Delphi questionnaire were conducted until a final consensus of over 75% was reached. The SecUrgence Protocol is a first scientific step towards improving suicide prevention in the ED in Quebec as it was validated by a rigorous research process that included a consensus by all key stakeholders.
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Affiliation(s)
- Jessica Rassy
- Research Centre, Institut universitaire en santé mentale de Montréal, QC, Canada; School of Nursing, University of Sherbrooke, QC, Canada; Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, QC, Canada; Quebec Network on Nursing Intervention Research, QC, Canada; Quebec Network on Suicide, Mood Disorders and Associated Disorders, QC, Canada; Charles-Le Moyne Research Centre, QC, Canada.
| | - Alain Lesage
- Research Centre, Institut universitaire en santé mentale de Montréal, QC, Canada; Department of Psychiatry, University of Montreal, QC, Canada; Quebec Network on Suicide, Mood Disorders and Associated Disorders, QC, Canada
| | - Réal Labelle
- Research Centre, Institut universitaire en santé mentale de Montréal, QC, Canada; Department of Psychiatry, University of Montreal, QC, Canada; Department of Psychology, Université du Québec à Montréal, QC, Canada; Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, QC, Canada
| | - Farida Saadi
- Faculty of Nursing, University of Montreal, QC, Canada; CEMTL Maisonneuve Rosemont Hospital, CIUSSS de l'Est-de-l'île-de-Montréal, QC, Canada
| | - Marie-Hélène Goulet
- Research Centre, Institut universitaire en santé mentale de Montréal, QC, Canada; Faculty of Nursing, University of Montreal, QC, Canada
| | - Christine Genest
- Research Centre, Institut universitaire en santé mentale de Montréal, QC, Canada; Faculty of Nursing, University of Montreal, QC, Canada; Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, QC, Canada; Quebec Network on Nursing Intervention Research, QC, Canada
| | - Nathalie Maltais
- Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, QC, Canada; Department of Health Sciences, Université du Québec à Rimouski, QC, Canada
| | - Caroline Larue
- Research Centre, Institut universitaire en santé mentale de Montréal, QC, Canada; Faculty of Nursing, University of Montreal, QC, Canada; Quebec Network on Nursing Intervention Research, QC, Canada
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Rassy J, Daneau D, Larue C, Rahme E, Low N, Lamarre S, Turecki G, Bonin JP, Racine H, Morin S, Dasgupta K, Renaud J, Lesage A. Measuring Quality of Care Received by Suicide Attempters in the Emergency Department. Arch Suicide Res 2022; 26:81-90. [PMID: 32715983 DOI: 10.1080/13811118.2020.1793043] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONTEXT Audits conducted on medical records have been traditionally used in hospitals to assess and improve quality of medical care but have yet to be properly integrated and used for suicide prevention purposes. We aimed to (1) revise a quality of care grid and adapt it to an adult population of suicide attempters and (2) identify quality of care deficits in managing adult suicide attempters at the emergency department (ED) in two different Montreal university hospitals. METHODS An existing checklist for quality of medical and social care in the ED was adapted. A systematic search and data extraction of all suicide attempters in two different Montreal university hospitals were then conducted. All identified individuals who attempted suicide were fully reviewed and quality of care was assessed. RESULTS Eleven criteria were kept by the expert focus group in the revised grid that was then used to rate 369 individuals that attempted suicide. Suicide risk assessment was only present in 63% of attempters before discharge. Although family history was documented for 90% of attempters, in only 41% of the cases were interviews conducted with relatives. Most discharged patient lacked proper follow-up considering 11% of their relatives received written information on resources in case of need. DISCUSSION Paper records may be used to systematically assess the quality of care for suicide attempters seen in ED. Results reiterate the need for better suicide prevention strategies for these individuals. The checklist proved to be an excellent assessment of best practices or identification of possible improvements.
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Lane J, Côté LP, Gaudreault J, Massicotte L, Manceau LM, Labelle R, Bardon C, Bazinet J, Rassy J, Rembert M. Processus d’élaboration de la nouvelle Stratégie québécoise numérique en prévention du suicide : Suicide.ca. Santé mentale au Québec 2022. [DOI: 10.7202/1094157ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Rassy J, Bardon C, Dargis L, Côté LP, Corthésy-Blondin L, Mörch CM, Labelle R. Information and Communication Technology Use in Suicide Prevention: Scoping Review. J Med Internet Res 2021; 23:e25288. [PMID: 33820754 PMCID: PMC8132980 DOI: 10.2196/25288] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/10/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The use of information and communication technology (ICT) in suicide prevention has progressed rapidly over the past decade. ICT plays a major role in suicide prevention, but research on best and promising practices has been slow. OBJECTIVE This paper aims to explore the existing literature on ICT use in suicide prevention to answer the following question: what are the best and most promising ICT practices for suicide prevention? METHODS A scoping search was conducted using the following databases: PubMed, PsycINFO, Sociological Abstracts, and IEEE Xplore. These databases were searched for articles published between January 1, 2013, and December 31, 2018. The five stages of the scoping review process were as follows: identifying research questions; targeting relevant studies; selecting studies; charting data; and collating, summarizing, and reporting the results. The World Health Organization suicide prevention model was used according to the continuum of universal, selective, and indicated prevention. RESULTS Of the 3848 studies identified, 115 (2.99%) were selected. Of these, 10 regarded the use of ICT in universal suicide prevention, 53 referred to the use of ICT in selective suicide prevention, and 52 dealt with the use of ICT in indicated suicide prevention. CONCLUSIONS The use of ICT plays a major role in suicide prevention, and many promising programs were identified through this scoping review. However, large-scale evaluation studies are needed to further examine the effectiveness of these programs and strategies. In addition, safety and ethics protocols for ICT-based interventions are recommended.
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Affiliation(s)
- Jessica Rassy
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- School of Nursing, Université de Sherbrooke, Longueuil, QC, Canada
- Quebec Network on Nursing Intervention Research, Montréal, QC, Canada
| | - Cécile Bardon
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Luc Dargis
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
| | - Louis-Philippe Côté
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Laurent Corthésy-Blondin
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Carl-Maria Mörch
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Algora Lab, Université de Montréal, Montréal, QC, Canada
- Mila, Quebec Artificial Intelligence Institute, Montréal, QC, Canada
| | - Réal Labelle
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
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Ligier F, Rassy J, Fortin G, van Haaster I, Doyon C, Brouillard C, Séguin M, Lesage A. Being pro-active in meeting the needs of suicide-bereaved survivors: results from a systematic audit in Montréal. BMC Public Health 2020; 20:1534. [PMID: 33036601 PMCID: PMC7547412 DOI: 10.1186/s12889-020-09636-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/30/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Suicide is a major public health concern. In 2017, the suicide rate in Canada was 11 per 100,000 inhabitants. According to literature, 1 in 5 people have experienced a death by suicide during their lifetime. The aim of this study was to describe the met and unmet needs of suicide-bereaved survivors and to provide postvention recommendations. METHODS Further to an exploratory mixed-method audit of 39 suicides that occurred in Montreal (Canada) in 2016, suicide-bereaved survivors (n = 29) participated in semi-structured interviews and completed instruments to discuss and assess potential pathological grief, depression (PHQ-9), and anxiety (GAD-7), as well as health and social services utilization. A panel then reviewed each case and provided recommendations. The mean age of participants was 57.7 years and 23 were women. RESULTS Although help was offered initially, in most cases by a health professional or service provider (16/29), 22 survivors would have liked to be contacted by telephone in the first 2 months post suicide. Four categories of individual unmet needs (medical/pharmacological, information, support, and outreach) and one collective unmet need (suicide pre/postvention training and delivery) emerged. CONCLUSIONS Although Quebec provincial services have been developed and offered to suicide-bereaved survivors in the past decade, many dwindled over time and none has been applied systematically. Recommendations for different stakeholders (Ministry of Health and Social Services, coroners, NGOs, and representatives of suicide-bereaved survivors) outlined in this study could be an interesting first step to help develop a suicide pre/postvention strategy.
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Affiliation(s)
- Fabienne Ligier
- Centre Psychothérapique de Nancy, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, 1 rue du Dr Archambault, F-54520, Laxou, France. .,EA 4360 APEMAC, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
| | - Jessica Rassy
- School of Nursing, Université de Sherbrooke, Longueuil, Canada.,Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Gabrielle Fortin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Ian van Haaster
- CIUSSS de l'Est de l'Ile de Montréal, CLSC St-Michel, Montreal, Canada
| | - Claude Doyon
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Charlie Brouillard
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Monique Séguin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada.,Centre intégré de santé et service social de l'Outaouais (CISSSO), Outaouais, Quebec, Canada
| | - Alain Lesage
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry, Université de Montréal, Quebec, Canada
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Rassy J, Mathieu L, Michaud C, Monday T, Raymond S, Bonin JP. La théorie de la noyade émotive virtuelle : une théorisation ancrée sur le processus de recherche d’aide d’adolescents à risque de suicide. smq 2019. [DOI: 10.7202/1060274ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
De plus en plus d’adolescents à risque de suicide se tournent vers les technologies de l’information et de la communication (TIC) pour chercher de l’aide. Or, à ce jour, aucune étude n’a exploré le processus de recherche d’aide par les TIC chez des adolescents à risque de suicide. Afin de pallier cette situation, une étude par théorisation ancrée a été menée afin de comprendre le processus de recherche d’aide par les TIC des adolescents ayant un risque suicidaire pour trouver des ressources concernant le suicide. La collecte de données a été effectuée à partir d’entrevues individuelles semi-structurées, d’un questionnaire sur la recherche d’aide par les TIC et d’observations d’une recherche d’aide réelle via les TIC par les adolescents de l’étude. Un n de 15 adolescents âgés de 13 à 17 ans a été atteint par saturation théorique. Les résultats ont permis l’émergence de la théorie de la noyade émotive virtuelle. Cette théorie permet d’abord de mieux comprendre le contexte initial de cette recherche d’aide, soit l’état du jeune, l’environnement social, les facteurs aggravants ainsi que le désir d’utiliser les TIC. Elle permet aussi de comprendre les différentes stratégies par les TIC utilisées par les jeunes (se distraire, s’informer, se dévoiler et aider les autres) ainsi que les conséquences engendrées (la croissance émotive, l’obtention d’aide, le soulagement temporaire, aucun changement, l’exacerbation des idées suicidaires ou le passage à l’acte). Des recommandations pour la clinique, la formation et la recherche sont ensuite émises.
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Affiliation(s)
- Jessica Rassy
- Infirmière, Ph. D., professeure à l’École des sciences infirmières de l’Université de Sherbrooke, Longueuil, Canada
| | - Luc Mathieu
- Infirmier, D.B.A., professeur à l’École des sciences infirmières de l’Université de Sherbrooke, Sherbrooke, Canada
| | - Cécile Michaud
- Infirmière, Ph. D., professeure à l’École des sciences infirmières de l’Université de Sherbrooke, Longueuil, Canada
| | - Tim Monday
- T.S., Clinique des troubles de l’humeur, CIUSSS du Nord-de-l’Île-de-Montréal
| | - Sylvie Raymond
- Infirmière, Clinique des troubles de l’humeur, CIUSSS du Nord-de-l’Île-de-Montréal
| | - Jean-Pierre Bonin
- Infirmier, Ph. D., professeur à la Faculté des sciences infirmières de l’Université de Montréal, Montréal, Canada
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Tougas AM, Rassy J, Frenette-Bergeron É, Marcil K. “Lost in Transition”: A Systematic Mixed Studies Review of Problems and Needs Associated with School Reintegration After Psychiatric Hospitalization. School Mental Health 2019. [DOI: 10.1007/s12310-019-09323-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rassy J, Mathieu L, Michaud C, Monday T, Raymond S, Bonin JP. [The Virtual Emotional Drowning Theory: a Grounded Theory on Information and Communication Technologies (ICT) Help-Seeking Process of Adolescents at Risk of Suicide]. Sante Ment Que 2019; 44:31-46. [PMID: 32338677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The use of Information and Communication Technologies (ICT) for help-seeking is becoming more and more common for adolescents at risk of suicide. Objectives The aim of this current study was to better understand the help-seeking process of adolescents at risk for suicide. Methods A grounded theory methodology was used to describe the experience of adolescents at risk of suicide and gain a deeper understanding of their ICT help-seeking process. Data was collected through semi-structured interviews, an ICT help-seeking questionnaire and live observations of ICT help-seeking strategies by the adolescents of this study. Theoretical saturation was reached with a total of 15 adolescents, aged 13 to 17, at risk of suicide. Results The grounded theory that emerged gravitated towards the fact that adolescents chose to virtually deal with emotional drowning. A specific context allowed this central category to emerge and included the adolescents' state, their personal triggers, their social environment as well as their desire to use ICT. The ICT strategies used by the adolescents to deal with their emotional drowning were to distract themselves, to get informed, to reveal themselves or to help others. Adolescents in this study used different ways to distract themselves with ICT. This included reading texts, watching online videos, listening to music and playing games. They also increased their literacy by informing themselves on suicide and mental health problems. However, many adolescents also searched for ways to help them commit suicide. Although most of the results were suicide prevention related, the keywords used by the adolescents remain preoccupying. Revealing their thoughts and their feelings about their emotional state seemed to be easier through ICT. They sometimes chose to reveal themselves anonymously but most of the time, they revealed themselves to use ICT to friends they already had in real life. Also, helping friends through ICT seemed to be very rewarding and helpful to the adolescents of our study even when they were in a state of emotional drowning. These different strategies to virtually deal with their emotional drowning hindered many different consequences which were to grow emotionally, to get help, to get temporary relief, to stay indifferent, to worsen their suicidal thoughts or to attempt suicide. Conclusion Although some negative consequences of ICT emerge from this study, a great deal of the consequences was positive and helpful for these adolescents. Overall, this study shows that ICT offer great opportunities for adolescent suicide prevention. Implications for practice, training and research are further discussed.
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Affiliation(s)
- Jessica Rassy
- Professeure à l'École des sciences infirmières de l'Université de Sherbrooke, Longueuil, Canada
| | - Luc Mathieu
- Professeur à l'École des sciences infirmières de l'Université de Sherbrooke, Sherbrooke, Canada
| | - Cécile Michaud
- Professeure à l'École des sciences infirmières de l'Université de Sherbrooke, Longueuil, Canada
| | - Tim Monday
- Clinique des troubles de l'humeur, CIUSSS du Nord-de-l'Île-de-Montréal
| | - Sylvie Raymond
- Clinique des troubles de l'humeur, CIUSSS du Nord-de-l'Île-de-Montréal
| | - Jean-Pierre Bonin
- Professeur à la Faculté des sciences infirmières de l'Université de Montréal, Montréal, Canada
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Rassy J, St-Cyr Tribble D, Bonin JP, Mathieu L. [Looking for help on the Internet by adolescents with suicidal thoughts: a concept analysis]. Rech Soins Infirm 2015:78-87. [PMID: 26510348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The help-seeking concept is largely used in the healthcare system and seems relatively well understood by healthcare professionals even though no consensus on this concept has yet been reached. More specifically, the Internet help-seeking concept by adolescents with suicidal thoughts has yet to be explored. To clarify this concept and eventually develop tools for future research in nursing, a concept analysis using the Walker and Avant method was conducted. Three main help-seeking attributes were identified as a result of the analysis: problem-oriented, intentional action and use of an external mean. The antecedents that precede the concept are: problem recognition and perception influenced by beliefs, desired relief, help-source selection and decision to act. The consequents that follow help-seeking are relef, maintenance or exacerbation of the problem. Many empirical referents are identified but none seem to evaluate or conceptually define the attributes of the concept. Finally, a deeper meaning of Internet help-seeking by adolescents with suicidal thoughts is reached by this concept analysis and further research and practice recommendations are given.
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Rassy J, St-Cyr Tribble D, Bonin JP, Mathieu L, Michaud C. La recherche d’aide sur Internet chez des adolescents ayant des idées suicidaires : une analyse de concept. Rech Soins Infirm 2015. [DOI: 10.3917/rsi.120.0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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