Development and Evaluation of Online Suicide Preventive Tool iAlive to Increase Competences in Engaging With a Suicidal Person

Background: Online implementation of suicide prevention interventions offers many advantages, facilitating the dissemination of large-scale suicide prevention interventions. An online tool iAlive aimed at raising awareness and increasing suicide prevention competences in lay people was developed and implemented in Slovenia. Aims: To develop, implement, and evaluate the iAlive tool. Method: Following the development and implementation of the tool, a nonrandomized controlled study with 310 participants was conducted. One hundred fifty-six of them fully completed the study [intervention group (used the iAlive tool): N = 85, control group (did not use the tool): N = 71]. Perceived competences in engaging with a suicidal person were assessed in both groups at baseline and at follow-up (3-4 weeks apart), which also represents the time of the intervention. Results: A significant effect of time and condition [F(1,149) = 6.62, p = .011, ηp2 = .043] showed that the intervention group assessed their perceived competences on intervention exposure more positively compared to the control group. Limitations: Additional data on different populations and people's engagement with the tool in relation to perceived competences are needed. Conclusion: The study suggests that the interactive online tool iAlive effectively increases perceived competences in engaging with a suicidal person. These results provide a background for further dissemination of the tool.

A Lonelier World after COVID-19: Longitudinal Population-Based Study of Well-Being, Emotional and Social Loneliness, and Suicidal Behaviour in Slovenia

Background and Objectives: The impact of coronavirus disease 2019 (COVID-19) goes beyond the consequences of the infectious disease, especially as the measures taken to prevent the spread of the virus have had a very profound impact on people's social relationships and everyday lives. Several studies have investigated these effects, but there is a lack of longitudinal studies in Central Europe. Objective: The aim of our study was to observe changes in well-being, loneliness, and suicidal behaviour before, during, and after the COVID-19 pandemic using the same population-based cohort. Materials and Methods: A representative sample of 440 participants completed online questionnaires at four time points: 2019 (wave 0), 2021 (wave 1), 2022 (wave 2), and 2023 (wave 3). Results: The results show significant changes in the levels of well-being and loneliness over these periods. In particular, both social and emotional loneliness increased during the pandemic, while emotional loneliness increased to a greater extent without further decreases. Well-being appeared to increase after pandemic-related restrictions diminished but decreased again one year later. No significant changes concerning suicidal ideation were observed. Conclusions: Our study suggests that the COVID-19 pandemic changed the way in which people perceive their well-being and especially their relationships with others. From the data, we can conclude that people's worldview is now lonelier than before the pandemic.

Perception of Personal Participation of the Nurses in Resuscitation Procedures: A Qualitative Study

Background and Objectives: Resuscitation is one of the most stressful tasks in emergency medicine. The participation of nurses in this procedure can have specific effects on them. In this research, we wanted to find out what these effects are. Materials and Methods: A qualitative approach by conducting semi-structured interviews was used, and a thematic data analysis of the recorded interviews was carried out. The collected data were transcribed verbatim, with no corrections to the audio recordings. The computer program ATLAS.ti 22 was used for the qualitative data analysis. Results: Eleven male registered nurses were interviewed, with an average of 18.5 years of experience working in a prehospital environment (max. 32/min. 9). A total of 404 min of recordings were analyzed, and 789 codes were found, which were combined into 36 patterns and 11 themes. As the most stressful situations, the interviewees pointed out the resuscitation of a child, familiar persons, conflicts with the environment, conflicts within the resuscitation team, nonfunctioning or insufficient equipment, complications during resuscitation, and resuscitating a person only for training. As positive effects, the interviewees cited successful resuscitations or their awareness that, despite an unsuccessful resuscitation, they did everything they could. Conclusions: Participation in these interventions has a specific positive or negative impact on the performers. The interviewees shared the opinion that they can cope effectively with the adverse or stressful effects of resuscitation. Yet, despite everything, they allow the possibility of subconscious influences of this intervention on themselves.

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

The Influence of Insecure Attachment to Parents on Adolescents' Suicidality

Insecure attachment has been identified as a risk factor for adolescent psychopathology and, consequently, for suicidal behavior. We aimed to highlight the relationship between the attachment styles of adolescents and their suicidal behavior and to investigate the role of each parent in the suicidality pathway of adolescents. The sample consisted of 217 adolescent inpatients who were at the highest risk for suicidal behavior and who were hospitalized in the Unit for Intensive Child and Adolescent Psychiatry. Self-report questionnaires assessing their attachment to their parents, their acquired capability for attempting suicide, their suicidality, and a number of traumatic life events were administered. The results showed a higher level of attachment avoidance rather than attachment anxiety among the most at-risk adolescents. An acquired capability for suicide (ACS) mediated the positive correlation between adolescents' attachment avoidance in relation to the mother or father and their suicidality. The suppressive mediating effect of an ACS on the association between attachment anxiety in relation to the father and suicidality was detected. The odds ratio for attempted suicide was more than two times higher for adolescents who were insecurely attached to their father compared to adolescents who were insecurely attached to their mother. Our results confirmed the importance of attachment, especially paternal attachment, in developing suicidality during adolescence. Preventive and clinical interventions should target these important domains with the aim of decreasing suicidality among adolescents.

Individual and collective protective responses during the early phase of the COVID-19 pandemic in 10 different countries: Results from the EUCLID online survey

BACKGROUND

In times of unprecedented infectious disease threats, it is essential to understand how to increase individual protective behaviors and support for collective measures. The present study therefore examines factors associated with individual and collective pathways.

METHODS

Data was collected through an online survey from 4483 participants (70.8% female, M = 41.2 years) across 10 countries from April 15, 2020 to June 2, 2020 as part of the "EUCLID" project (https://euclid.dbvis.de). Structural equation modeling was used to examine individual and collective pathways across and within countries.

RESULTS

Overall, the adoption of individual protective behaviors and support for collective measures were high. Risk perception on the individual level and perceived effectiveness at the collective level were positively associated with both individual protective behaviors and support for collective measures. Furthermore, the model explained considerable variance in individual (40.7%) and collective protective behaviors (40.8%) and was largely replicated across countries.

CONCLUSIONS

The study extends previous research by demonstrating that individual risk perception and perceived effectiveness of collective measures jointly affect individual protective health behaviors and support for collective measures. These findings highlight the need to jointly consider a variety of behavioral actions against infectious disease threats, acknowledging interactions between individual and collective pathways.

Emotional and Social Loneliness as Predictors of Suicidal Ideation in Different Age Groups

Loneliness and suicidal ideation (SI) are relevant issues. This study aimed to examine the prevalence of death ideation (DI) and SI in the general population across four age groups and to determine the extent to which emotional and social loneliness are associated with SI. Data were collected via an online panel in Slovenia in February 2019 on a representative sample of 991 participants (50.5% men) aged 18 years and over. Participants completed a series of questionnaires on loneliness, suicidality, stress, and well-being. DI, SI, and previous suicide attempts were most common among younger participants. In each age group, several factors appeared as important predictors of SI, with emotional loneliness being a significant factor in all groups. Given the role of emotional loneliness in SI, prevention programs should address loneliness and its correlates across age groups.

Slovenian Validation of the Mental Health Literacy Scale (S-MHLS) on the General Population: A Four-Factor Model

The aim of the present validation study is to determine the psychometric properties of the Slovenian version of the Mental Health Literacy Scale. For this purpose, the factorial structure, internal consistency, cross-cultural, convergent and discriminant validity were assessed. The measure was translated and adapted to Slovenian context through a blind back-translation process. It was applied to a representative sample of the Slovenian adult population via an online research panel. A total of 1189 participants (598 women), aged between 18 and 95 years (M = 46.7, SD = 16.2) completed the survey. Confirmatory and exploratory factor analyses, reliability analyses, hypothesis testing, and correlational analyses were conducted. The analyses rejected a hypothesised unidimensional model and demonstrated that a four-factor model with 27 items was the most theoretically and psychometrically adequate. The Slovenian version of Mental Health Literacy Scale (S-MHLS) consists of the following factors: (1) Attitudes Towards People With Mental Health Problems, (2) General Attitudes Towards Mental Health Problems and Help-Seeking, (3) Recognition of Mental Health Disorders and (4) Knowledge About Seeking Mental Health Information. The factors have adequate construct validity and internal consistency, which is also adequate for the entire S-MHLS. However, a decreased scope of the content might result in an inadequate representation of the construct of mental health literacy. In addition, the psychometric interpretation of the MHLS varies widely in validation studies across different linguistic contexts. Therefore, we propose a further improvement of the instrument with a psychometrically and theoretically sound multifactorial structure that demonstrates strong cross-cultural validity.

Loneliness within the general population of Slovenia

BACKGROUND

While loneliness is recognized as a risk to mental and physical health, there is a lack of data covering a broad age range. This study used a Slovenian adult sample to investigate loneliness.

AIMS

To examine levels of social, emotional and general loneliness within the general population.

METHOD

A survey on a sample representative of the general population (N = 1,189; aged between 18 and 95 years old (M = 46.74, standard deviation (SD) = 16.18); 49.7% were men) was conducted in Slovenia by means of an online questionnaire, covering data on demographic variables and levels of emotional, social and general loneliness.

RESULTS

In general, people experienced more social than emotional loneliness. Demographic variables that were significant for emotional, social and general loneliness were the history of past mental illness, civil status and employment status. Other demographic variables played different roles in different types of loneliness.

CONCLUSIONS

Our study shows that differences in loneliness among demographic subgroups are an important factor in understanding and studying loneliness, especially with regard to the distinction between social and emotional loneliness. Given that loneliness represents today not only a social threat but also a significant health problem, it is important to understand which demographic subgroups are more at risk and how we can help them.

A randomized controlled trial to improve psychological detachment from work and well-being among employees: a study protocol comparing online CBT-based and mindfulness interventions

BACKGROUND

The changing landscape of the work environment, which often encompasses expectations of employees being continuously available, makes it difficult to disengage from work and recover. This can have a negative impact on employees' well-being, resulting in burnout, depression and anxiety, among other difficulties. The current study will test the effectiveness of two different online interventions (i.e., cognitive behavioral therapy; CBT and mindfulness-based stress reduction; MBSR) on employees' psychological detachment, burnout and other variables related to general (e.g., life satisfaction) and work-specific (e.g., work engagement) well-being.

METHODS/DESIGN

The study is designed as a randomized control trial with two intervention groups (i.e., CBT, MBSR) and a waitlist control group. Participants will be full-time employees from a wide range of organizations from Slovenia, who report moderate difficulties with psychological detachment from work and burnout and are not receiving any other form of treatment. The online interventions will encompass 12 sessions over 6 weeks (2 sessions per week); each session will include 1) an active audio-guided session and 2) home assignments, accompanied by handouts and worksheets. The study outcomes (i.e., psychological detachment, burnout, general and work-specific well-being), potential mechanisms (i.e., work-related maladaptive thinking patterns, mindfulness) and moderators (e.g., supervisor support for recovery) will be assessed immediately before and after the interventions (pre and post measurement) and 3 months after intervention completion (follow-up). Additionally, participants will fill out questionnaires for the assessment of the central mechanisms and study outcomes each week.

DISCUSSION

We expect that the CBT-based intervention will lead to greater improvements in psychological detachment from work and burnout compared to the MBSR and the waitlist control group. Additionally, we expect that the CBT-based intervention will also lead to greater enhancement of both general and work-related well-being.

TRIAL REGISTRATION

https://doi.org/10.1186/ISRCTN98347361 [May 19, 2020].

The model of dynamic balance in therapists' experiences and views on working with suicidal clients: A qualitative study

Working with suicidal clients is frequently referred to as one of the most demanding and anxiety-provoking aspects of therapeutic work. The aim of this study was to obtain an in-depth understanding of therapists' experience in treating suicidal individuals and to develop a theoretical model of it. Eleven psychotherapists (four men and seven women) participated in individual semistructured interviews. The interviews were audiotaped, transcribed and analysed by the principles of grounded theory. We developed a model of dynamic balance in therapists' experiences and views on working with suicidal clients. The model includes six core themes, which represent aspects of therapists' experience and views where a dynamic balance is needed between two different poles. The core themes are as follows: (i) understanding of suicidality: the general versus specific; (ii) the role of alliance: protective factor versus no guarantees; (iii) attitudes: acceptant versus life-oriented; (iv) emotional response: worry versus trust; (v) responsibility: therapist's professionality versus client's autonomy; and (vi) focus: suicidality versus individual as a person. The model takes into account other variables that are relevant to the process and outcomes of the therapy: factors, related to the therapist and the client, as well as system regulations and therapeutic setting. The presented model may be helpful for mental health professionals in reflecting on their experiences of working with suicidal clients, describing the relevant topics and the way they relate to each other.

Looking Ahead

Abstract. Across many domains of health and welfare, there have been remarkable advances in prevention where public-health models have had a significant impact. Psychology has much to offer in building on these successes and we describe some excellent examples, but in general, it has not been fully engaged with prevention science and implementation. We set out some of the key challenges and opportunities for psychology and prevention science in contemporary practice, recognizing that often the rhetoric from governments to support prevention interventions do not match up to making the necessary resources available. We argue that psychology must prioritize this area of practice as there is evidence that the gains of recent decades may be under threat without concerted efforts.

Mental health difficulties and suicidal behaviours among young migrants: multicentre study of European adolescents

BACKGROUND

Migration has been reported to be associated with higher prevalence of mental disorders and suicidal behaviour.

AIMS

To examine the prevalence of emotional and behavioural difficulties, suicidal ideation and suicide attempts among migrant adolescents and their non-migrant peers.

METHOD

A school-based survey was completed by 11 057 European adolescents as part of the Saving and Empowering Young Lives in Europe (SEYLE) study.

RESULTS

A previous suicide attempt was reported by 386 (3.6%) adolescents. Compared with non-migrants, first-generation migrants had an elevated prevalence of suicide attempts (odds ratio (OR) 2.08; 95% CI 1.32-3.26; P=0.001 for European migrants and OR 1.86; 95% CI 1.06-3.27; P=0.031 for non-European migrants) and significantly higher levels of peer difficulties. Highest levels of conduct and hyperactivity problems were found among migrants of non-European origin.

CONCLUSIONS

Appropriate mental health services and school-based supports are required to meet the complex needs of migrant adolescents.

DECLARATION OF INTEREST

None.

COPYRIGHT AND USAGE

© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Belongingness and Burdensomeness in Adolescents: Slovene Translation and Validation of the Interpersonal Needs Questionnaire

The Interpersonal Needs Questionnaire (INQ) for assessing thwarted belongingness (TB) and perceived burdensomeness (PB) has not been validated with community adolescents. We translated and administered the INQ to 307 Slovenian adolescents twice over 2-3 months and found that the 15-item version (INQ-15) did not fit without modification. TB and PB scales correlated with concurrent and later suicide ideation and lifetime suicide attempt history. The latent PB factor was associated with concurrent and later ideation controlling for TB, age, gender, depressive symptoms, binge drinking, and peer victimization. Suicide ideation and binge drinking were independently related to attempt history. Assessing and intervening on PB and binge drinking may be promising approaches to suicide prevention with community adolescents.

Attitudes towards help seeking behaviour and professional psychiatric help in Slovenia

Introduction

Knowledge about signs and treatment of mental illnesses is often not enough to seek professional help. Hence, it is important to gain understanding of other determinants, i.e. attitudes, stigma, which influence help-seeking behaviour.

Objectives

Based on Ajzen's theory of planned behaviour, we aimed at collecting data of determinants known to be related to behavioural action, in our case help seeking.

Aims

To examine how attitudes, stigma and normative believes influence help seeking behaviour and whether these determinants differ in relation to demographic data and mental health indicators of the respondents’ region.

Methods

A representative sample of adult Slovene population (n = 594) was recruited via an on-line invitation. They were asked to (i) provide basic demographic data (region, age, gender, mental health history…) and (ii) to complete the inventory of attitudes toward seeking mental health services. The inventory variables (attitudes, knowledge and stigma) were linked to demographic data and mental health indicators in Slovenia.

Results

The respondents dispose of good knowledge of where and when to seek help either for themselves or others. However, the readiness to seek help was significantly lower, in particular so in men, younger, single persons and respondents from regions with lower mental health indicators. Accordingly, stigma was significantly higher pronounced in the same groups. More than 50% of respondents have already experienced mental distress, however only 25% have sought help.

Conclusions

Reasons for this “help seeking gap” should be further scrutinized. Future interventions shall be focused on changing attitudes and destigmatization mental health issues.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Physical activity in European adolescents and associations with anxiety, depression and well-being

In this cross-sectional study, physical activity, sport participation and associations with well-being, anxiety and depressive symptoms were examined in a large representative sample of European adolescents. A school-based survey was completed by 11,110 adolescents from ten European countries who took part in the SEYLE (Saving and Empowering Young Lives in Europe) study. The questionnaire included items assessing physical activity, sport participation and validated instruments assessing well-being (WHO-5), depressive symptoms (BDI-II) and anxiety (SAS). Multi-level mixed effects linear regression was used to examine associations between physical activity/sport participation and mental health measures. A minority of the sample (17.9 % of boys and 10.7 % of girls; p < 0.0005) reported sufficient activity based on WHO guidelines (60 min + daily). The mean number of days of at least 60 min of moderate-to-vigorous activity in the past 2 weeks was 7.5 ± 4.4 among boys and 5.9 days ± 4.3 among girls. Frequency of activity was positively correlated with well-being and negatively correlated with both anxiety and depressive symptoms, up to a threshold of moderate frequency of activity. In a multi-level mixed effects model more frequent physical activity and participation in sport were both found to independently contribute to greater well-being and lower levels of anxiety and depressive symptoms in both sexes. Increasing activity levels and sports participation among the least active young people should be a target of community and school-based interventions to promote well-being. There does not appear to be an additional benefit to mental health associated with meeting the WHO-recommended levels of activity.

The adaptation and implementation of guidelines for responsible media reporting on suicide in Slovenia

Introduction

The existing literature provides evidence of the link between media reporting and suicide in terms of either preventive or provocative effects. Hence, working with media representatives on responsible reporting on suicide is of great importance. Until recently in Slovenia, there has been an obvious lack of communication between media representatives and suicidologists. The aims of the present study were twofold; firstly, to introduce the adaptation and dissemination of intervention on responsible media reporting, and secondly, to evaluate the effectiveness of the implemented intervention on suicide reporting.

Methods

We used a pre-post research design. Newspaper articles were retrieved over two 12-month periods: the baseline period and the follow-up period. In between, we had a year of implementation of our intervention program (launching and disseminating the Guidelines via workshops). Each retrieved article was rated qualitatively with respect to its adherence to the Guidelines.

Results

The comparison of baseline and follow-up periods revealed some significant differences. Reporting in the follow-up period was less sensationalistic, there was less reporting about specific cases of suicides and more about causes of suicide and pathways out of mental distress. Furthermore, in the follow-up period, there was a significant improvement related to headlines of media articles. Contact information about where to seek help was more often included in the articles.

Conclusion

The findings are promising, but working with the media needs to be continuous and ongoing if sustainable results are to be achieved.

Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: results from the SEYLE project

There is expedient evidence showing that differences in adolescent alcohol consumption and other risk-behaviour depend on both family structure and family member drunkenness exposure. Data were obtained among adolescents (N = 12,115, mean age 14.9 ± 0.89) in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy,Romania, Slovenia and Spain within the European Union'ss 7th Framework Programme funded project, 'Saving and Empowering Young Lives in Europe (SEYLE)’. The current study reveals how adolescents' alcohol consumption patterns are related to their family structure and having seen their family member drunk. The results revealed statistically significant differences in adolescent alcohol consumption depending on whether the adolescent lives in a family with both birth parents, in a single-parent family or in a family with one birth parent and one step-parent. The study also revealed that the abstaining from alcohol percentage among adolescents was greater in families with both birth parents compared to other family types. The study also showed that the more often adolescents see their family member drunk the more they drink themselves. There is no difference in adolescent drinking patterns whether they see their family member drunk once a month or once a week. This study gives an insight on which subgroups of adolescents are at heightened risk of alcohol abuse and that decrease of family member drunkenness may have positive effects on the drinking habits of their children.

How to adjust media recommendations on reporting suicidal behavior to new media developments

This study examines the inclusion of preventive factors and new media developments in media recommendations on suicide reporting. Of the 193 member states of the United Nations screened for media recommendations, information was available for 74 countries. Similarities and differences in their contents were analyzed by cluster analysis. Results indicate that of these 74 countries, 38% have national suicide prevention programs, 38% have media recommendations, and 25% have press codes including suicide reporting. Less than 25% of the media recommendations advise against mentioning online forums, suicide notes, pacts, clusters, hotspots, details of the person, and positive consequences. No more than 15% refer to self-help groups, fictional and online reporting. We conclude that media recommendations need to be revised by adding these preventive factors and by including sections on new media reporting.

Exploration of factors associated with social worker attitudes toward suicide

BACKGROUND

Social workers are expected to play important roles in suicide intervention. Caregiving behaviours of medical personnel to suicidal individuals have been reported to be influenced by their own attitudes toward suicide. In this context, only a limited number of studies have examined social workers' attitudes toward suicide.

AIM

The purpose of this study was to explore associations between personal or occupational factors of social workers and their attitudes toward suicide.

METHODS

A self-administered questionnaire was mailed to 2,999 study participants registered with the Tokyo chapter of the Japanese Association of Certified Social Workers. We adopted the Attitudes Toward Suicide Scale (ATTS) to measure attitudes toward suicide. MANCOVA was used to test for the effects of demographic, personal and occupational factors on ATTS sub-scale scores.

RESULTS

Participants with a history of suicidal thoughts had stronger attitudes regarding the right to suicide than those with no history; these attitudes were not affected by a history of participating in suicide-prevention training.

CONCLUSIONS

Our findings suggest that suicide education should incorporate programmes directed at altering permissive attitudes toward suicide.

Suicide prevention for youth--a mental health awareness program: lessons learned from the Saving and Empowering Young Lives in Europe (SEYLE) intervention study

Background

The Awareness program was designed as a part of the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) intervention study to promote mental health of adolescents in 11 European countries by helping them to develop problem-solving skills and encouraging them to self-recognize the need for help as well as how to help peers in need.

Methods

For this descriptive study all coordinators of the SEYLE Awareness program answered an open-ended evaluation questionnaire at the end of the project implementation. Their answers were synthesized and analyzed and are presented here.

Results

The results show that the program cultivated peer understanding and support. Adolescents not only learned about mental health by participating in the Awareness program, but the majority of them also greatly enjoyed the experience.

Conclusions

Recommendations for enhancing the successes of mental health awareness programs are presented. Help and cooperation from schools, teachers, local politicians and other stakeholders will lead to more efficacious future programs.

Let's talk about suicide: Primary prevention programmes focusing on youth, elderly and media

Introduction

Slovenia is a country with a very high suicide rate. Unfortunately, there is a lack of primary suicide prevention programmes.

Objectives

Our main objective was to develop suicide prevention programmes, which would decrease suicide rate in Slovenia. We would achieve that by increasing awareness and knowledge of different professionals, who address or come in contact with the most vulnerable risk groups.

Methods

Firstly we identified school counselors, family doctors and media as professionals to target. School counselors have an important gatekeeper’s role in youth suicide prevention and family doctors are of a similar importance for elderly population. Besides, media has a significant influence on any at-risk person regarding suicide prevention. Secondly, we prepared manuals with practical guidelines: for school counselors - how to recognize and deal with suicidal youth, for family doctors - how to recognize and treat depression and suicidal behavior among elderly, and for media representatives - how to responsibly report about suicide. Lastly, we performed 1-day workshops for all gatekeepers’ groups covering the contents of the manuals.

Results

All the initiatives received highly positive expert-reviews and a lot of encouraging feedbacks from participants. An evaluation with pre-post questionnaire showed that participants’ feelings of competency in dealing with suicidal person have improved after the involvement in programmes’ workshops and reading the manuals.

Conclusions

Experiences showed that primary suicide prevention programmes are highly appreciated and we believe that is necessary to continue and deepen the work in this area also in the future.