Suicide in the Highlands of Scotland.
ABSTRACT The Highlands have one of the highest suicide rates in Scotland. This paper describes suicide and deliberate self-harm in the Highlands in the last 20 years and explores possible reasons for the differences from the Scottish average.
Retrospective analysis of routine data from the SMRI/SMR01 scheme and information on deaths from the Registrar General. Suicide and undetermined deaths were combined in the analysis.
Highland and Scotland 1978-98.
The high rates in Highland are caused by an excess of male deaths. Highland has had consistently high male suicide rates over the 20 year period compared to Scotland. These differences do not disappear when deaths of non-Highland residents are excluded. By comparison, deliberate self-harm admissions follow a similar pattern to Scotland as a whole. Causes of death differed from Scotland as a whole, with an over-representation of drowning, gases and firearm deaths.
Highland suicide rates are elevated compared to Scotland. This is mainly due to an excess of deaths in men up to the age of 74 years, and is not accounted for by deaths of non-residents. Female deaths are not elevated in comparison to the rest of Scotland. Male attempted suicide rates do not differ from Scotland. Lethality of method--drowning, car exhausts and firearms--may contribute to the elevated male death rates.
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ABSTRACT: This paper focuses on suicide reduction and prevention. It considers what the United Kingdom government and associated bodies such as Department of Health, the National Health Service and Prison Service could do and are considering doing to prevent suicide in Britain. UK suicide statistics for the period 1971 and 1997 are compared and the Highland Health Board suicide prevention strategy for the 1990s is considered. The articles in this symposium are introduced and the recent UK legal cases involving Ms B and Diane Pretty are included. Counsellors and psychotherapists have always been concerned, to varying degrees, about clients committing or attempting suicide . It is a topic which can trigger much concern and interest with both neophyte and experienced therapists . In the past decade there has been a growth in individual membership of counselling and psychotherapeutic professional bodies with more therapists becoming accredited and/or registered as qualified practitioners. Thus there has been additional pressure on therapists to adhere to professional codes of practice and ethics.To take the correct action and to be seen to take the correct action within client-therapist relationships is now paramount. It could be argued that this has always been the case. However, therapists not working within a professional framework may have had less incentive to act in a professional manner. A proactive approach may be recommended when seeing clients with suicidal ideation and/or intention (Palmer, 1995). In these cases, inaction can sometimes prove fatal so it is incumbent upon the therapist to support and help the client through the difficult period (Curwen, 1997).British Journal of Guidance and Counselling 11/2002; 30(4):341-352. · 0.75 Impact Factor
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ABSTRACT: As part of a national co-ordinated and multifaceted response to the excess suicide rate, the Choose Life initiative, the Highland Choose Life Group launched an ambitious programme of training for National Health Service (NHS), Council and voluntary organisation staff. In this study of the dissemination and implementation of STORM (Skills-based Training On Risk Management), we set out to explore not only the outcomes of training, but key factors involved in the processes of diffusion, dissemination and implementation of the educational intervention. Participants attending STORM training in Highland Region provided by 12 trained facilitators during the period March 2004 to February 2005 were recruited. Quantitative data collection from participants took place at three time points; immediately before training, immediately post-training and six months after training. Semi-structured telephone interviews were carried out with the training facilitators and with a sample of course participants 6 months after they had been trained. We have utilized the conceptual model described by Greenhalgh and colleagues in a Framework analysis of the data, for considering the determinants of diffusion, dissemination and implementation of interventions in health service delivery and organization. Some 203 individuals completed a series of questionnaire measures immediately pre (time 1) and immediately post (time 2) training and there were significant improvements in attitudes and confidence of participants. Key factors in the diffusion, dissemination and implementation process were the presence of a champion or local opinion leader who supported and directed the intervention, local adaptation of the materials, commissioning of a group of facilitators who were provided with financial and administrative support, dedicated time to provide the training and regular peer-support. Features that contributed to the success of STORM were related to both the context (the multi-dimensional support provided from the host organisation and the favourable policy environment) and the intervention (openness to local adaptation, clinical relevance and utility), and the dynamic interaction between context and the intervention.BMC Health Services Research 01/2009; 8:246. · 1.66 Impact Factor
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