Celine Larkin

• PhD
• Senior HTA Analyst at Health Information and Quality Authority

Importance: Suicide is a leading cause of deaths in the US. Although the emergency department (ED) is an opportune setting, ED-initiated interventions remain underdeveloped and understudied. Objective: To determine if an ED process improvement package, with a subfocus on improving the implementation of collaborative safety planning, reduces subs...

Background: Many individuals with suicide risk present to acute care settings such as emergency departments (EDs). However, staffing and time constraints mean that many EDs are not well equipped to deliver evidence-based interventions for patients experiencing suicidality. An existing intervention initiated in the ED for patients with suicide risk...

Suicide prevention is an emotive, complex goal for clinicians and health systems. Effective interventions for suicidality do exist; however, many patients do not receive them because implementation efforts tend to be time-limited and unsystematic. Implementation science is the study of methods to promote the systematic uptake of research findings a...

Background Suicide remains the 10th leading cause of death in the United States. Many patients presenting to healthcare settings with suicide risk are not identified and their risk mitigated during routine care. Our aim is to describe the planned methodology for studying the implementation of the Zero Suicide framework, a systems-based model design...

Background Emergency departments increasingly serve patients who prefer a language other than English. Honoring patients’ language preferences is crucial for quality and cultural appropriateness of care. We sought to assess whether time spent in caring for patients who preferred a language other than English differed from patients whose language pr...

Primary care clinics serve many patients experiencing latent or evident suicide risk and may benefit from implementing suicide care improvements such as the Zero Suicide model. However, little is known about the readiness of clinics to implement such initiatives. We interviewed a range of clinicians (e.g., medical providers, behavioral health provi...

Objectives: We tested an adapted version of an effective U.S.-based peer-texting intervention to promote Quitline use and smoking cessation among rural participants in Vietnam. Methods: We conducted a two-arm randomized trial with participants recruited at four rural community centers. The intervention included peer messages sent for six months tha...

Objective: The authors aimed to assess clinicians' attitudes toward suicide-related practices and their implementation, across roles and settings, before implementation of the Zero Suicide model in a health care system. Methods: Clinicians (N=5,559) were invited to complete a survey assessing demographic characteristics; confidence and self-report...

BACKGROUND Emergency departments (EDs) manage many patients with suicide risk, but effective interventions for suicidality are challenging to implement in this setting. ReachCare is a technology-facilitated version of an evidence-based intervention for suicidal ED patients. Here, we present findings on the acceptability and quality of ReachCare in...

Background Emergency departments (EDs) manage many patients with suicide risk, but effective interventions for suicidality are challenging to implement in this setting. ReachCare is a technology-facilitated version of an evidence-based intervention for suicidal ED patients. Here, we present findings on the acceptability and quality of ReachCare in...

Objective: Accurate measurement of physicians' time spent during patient care stands to inform emergency department (ED) improvement efforts. Direct observation is time consuming and cost prohibitive, so we sought to determine if physician self-estimation of time spent during patient care was accurate. Methods: We performed a prospective, conven...

Purpose: To explore pediatrician and child/adolescent psychiatrists’ perspectives of the role of coordinated care for emerging adults with serious mental health conditions, particularly as they transition to adult care. Methods: Semi-structured individual interviews of a purposive sample of 10 pediatricians and 11 child/adolescent psychiatrists in...

Objective: This study explored follow-up after hospitalization and emergency room (ER) use for mental health among youths and young adults with private insurance. Methods: The IBM MarketScan commercial database (2013-2018) was used to identify people ages 12-27 with a mental health hospitalization (N=95,153) or ER use (N=108,576). Factors associ...

Technology-Assisted Systems Change for Suicide Prevention (TASCS) is a study to develop a technology-facilitated version of the ED-SAFE intervention, to address suicidal ideation and behavior in ED patients. We applied a user persona development process to explore the needs and characteristics of patients presenting to the ED with suicide risk, cre...

Abstract Purpose: To explore pediatrician and child/adolescent psychiatrists’ perspectives of the role of coordinated care in caring for emerging adults with serious mental health conditions, particularly as they transition to adult care. Methods: We interviewed a purposive sample of 10 pediatricians and 11 child/adolescent psychiatrists in Massac...

Background The objective of this study is to describe age-related patterns of outpatient healthcare utilization in youth and young adults with mental health disorders. Method We used the IBM® MarketScan® Commercial Database to identify 359,413 youth and young adults (12–27 years) with a mental health disorder continuously enrolled in private healt...

Background According to the Centers for Disease Control and Prevention, suicidality and suicidal behavior among youth continues to increase significantly each year. Many of those who die by suicide interact with health services in the year before death. This systematic review sought to identify and describe empirically tested screening tools for su...

Background: A range of factors including mental disorders and adverse life events can increase the risk of suicide. The objectives of this study were to examine psychosocial and psychiatric factors and service engagement among suicide decedents compared with living controls. Methods: A case-control study using multiple sources was conducted. Inf...

Background The clinical champion approach is a highly utilized implementation strategy used to mitigate barriers and improve outcomes of implementation efforts. Clinical champions are particularly effective at addressing provider-level barriers and promoting provider-behavior change. Yet, the specific causal pathways that explain how clinical champ...

Objective: Early identification of individuals who are at risk for suicide is crucial in supporting suicide prevention. Machine learning is emerging as a promising approach to support this objective. Machine learning is broadly defined as a set of mathematical models and computational algorithms designed to automatically learn complex patterns betw...

Background Audit and feedback (A&F) has been used as a strategy to modify clinician behavior with moderate success. Although A&F is theorized to work by improving the accuracy of clinicians’ estimates of their own behavior, few interventions have included assessment of clinicians’ estimates at baseline to examine whether they account for interventi...

Research indicates that suicidal behavior, which is one of the leading causes of death in the United States, can be effectively prevented through technology. The popularity and prevalence of mobile technologies provides many opportunities for suicide prevention through smartphone interventions. For example, smartphone applications facilitate a ubiq...

Research indicates that suicidal behavior, which is one of the leading causes of death in the United States, can be effectively prevented through technology. The popularity and prevalence of mobile technologies provides many opportunities for suicide prevention through smartphone interventions. For example, smartphone applications facilitate a ubiq...

Background Tobacco kills more than 8 million people each year, mostly in low- and middle-income countries. In Vietnam, 1 in every 2 male adults smokes tobacco. Vietnam has set up telephone Quitline counseling that is available to all smokers, but it is underused. We previously developed an automated and effective motivational text messaging system...

Background Patient satisfaction is a focus for emergency department (ED) and hospital administrators. ED patient satisfaction studies have tended to be single‐site and focused on patient and clinician factors. Inclusion of satisfaction scores in a large, national operations database provided an opportunity to conduct an investigation that included...

The isolation that youth and young adults have faced during the COVID-19 pandemic has negatively impacted their mental health. This tip sheet offers some ideas and supports that youth and young adults can use to connect with others and help them feel better.

In this tip sheet, the iSPARC Stakeholder Engagement Program offers advice on how to run an advisory council virtually. It also talks about some of the benefits of having your council meet virtually. Learn more about the iSPARC Stakeholder Engagement Program here.

PurposeThere is limited research on the associations between factors relating to mental and physical health in people who died by suicide.Methods Consecutive suicide cases were included in a psychological autopsy study as part of the Suicide Support and Information System in southern Ireland. Chi-square tests and logistic regression analysis were u...

Background Emergency departments (EDs) are important for preventing suicide. Historically, many patients with suicide risk are not detected during routine clinical care, and those who are often do not receive suicide-specific intervention. The original Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE 1) study examined the im...

Background : Validated secondary screeners are needed to stratify suicide risk among those with non-negligible risk. This study tested the predictive utility of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) Secondary Screener (ESS), one of the screeners listed by The Joint Commission's Patient Safety Goal 15 resource...

This toolkit provides actionable information, algorithms, and clinical pearls so that obstetric providers and practices can successfully address perinatal mental health conditions.

The ‘European Alliance Against Depression’ community-based intervention approach simultaneously targets depression and suicidal behaviour by a multifaceted community based intervention and has been implemented in more than 115 regions worldwide. The two main aims of the European Union funded project “Optimizing Suicide Prevention Programmes and The...

Every 40 seconds, a person dies by suicide (WHO, 2014). The scale of the problem of suicide, as well as its innumerable causes and consequences, is daunting. However, researchers have worked for decades to identify and overcome some of the most pressing ethical and methodological issues associated with researching and preventing suicidal behaviour....

Background: Suicide has profound effects on families and communities, but is a statistically rare event. Psychological autopsies using a case-control design allow researchers to examine risk factors for suicide, using a variety of sources to detail the psychological and social characteristics of decedents and to compare them to controls. The Suici...

The Implementation Science & Practice-based Advances Research Center (iSPARC) is a new DMH-funded collaborative effort between the former Systems and Psychosocial Advances Research Center, Quantitative Health Sciences and Boston University's Center for Psychiatric Rehabilitation. With 52 core and affiliate investigators, iSPARC features five intera...

Objective: Few studies have explored the impact that self-harm has on family members, with none specifically focussing on physical and psychosomatic responses following a family member’s high-risk self-harm Therefore, this study aims to explore the health impact of experiencing a family member’s high-risk self-harm. Methods: Participants represente...

Purpose: Suicide bereavement confers unique risk and distress. In several countries, bereaved family members are called on to attend an inquest, an official public inquiry into deaths caused by external factors. The current study aimed to explore how suicide-bereaved family members (n = 18) experienced the inquest process, through qualitative semi-...

Objective Combine test theory with technology to develop brief, reliable suicide risk measures in the emergency department. Methods A computer adaptive test for suicide risk was built using the Beck Scale for Suicide Ideation and tested among the emergency department population. Data were analyzed from a sample of 1,350 patients in several Massach...

Emergency department (ED) clinicians routinely decide the disposition of patients with suicidal ideation, with potential consequences for patient safety, liability, and system costs and resources. An expert consensus panel recently created a 6-item decision support tool for patients with passive or active suicidal ideation. Individuals scoring a 0...

Background: Many patients treated in the emergency department (ED) for non-psychiatric complaints have elevated suicide risk. Universal screening can detect occult suicide risk, but gold standard risk measurement tools, such as the Beck Scale for Suicidal Ideation (BSS), are too long and cumbersome for ED use. Objective: To test the performance...

Introduction Research shows that suicides are more common among the unemployed and in certain occupations such as elementary occupations, agriculture, construction and health care. Little is known about the specific psychosocial determinants in the occupational environment. Methods A case-control study using psychological autopsy method with multi...

Suicide is the tenth leading cause of death and many of those who die by suicide have visited an emergency department (ED) in the months prior to their death. Patients with lower acuity and non-psychiatric chief complaints may be discharged without additional behavioral health evaluation, intervention, and referral to treatment. To address these is...

Background: Universal suicide screening in emergency departments is a recommended best practice, and was implemented in eight EDs as part of the ED-SAFE study. Fidelity to suicide screening was defined as a patient endorsing being asked a screening ques-tion that was documented in the medical chart as having been asked. We examine the pattern of sc...

Suicide is the tenth leading cause of death and many of those who die by suicide have visited an emergency department (ED) in the months prior to their death. Thus, identification and treatment of suicidal ideation (SI) in the ED is essential to suicide prevention efforts. Although a recent effort to implement universal SI screening has identified...

Introduction: Individuals who die by suicide often make ED contact the year prior to death. In accordance with Joint Commission recommendations, universal suicide screening has been implemented across UMass Memorial Health Care EDs, in an effort to improve quality of care for patients with suicide risk. We developed clinician decision aids, clinica...

Introduction: Universal suicide screening in Emergency Departments (EDs) significantly improves risk detection, but some patients with lower suicide risk may not require a full mental health evaluation. As ED clinicians routinely decide the disposition of patients with suicide risk, with potential consequences for patient safety and system resource...

Objectives Research focussing on the impact of suicide bereavement on family members’ physical and psychological health is scarce. The aim of this study was to examine how family members have been physically and psychologically affected following suicide bereavement. A secondary objective of the study was to describe the needs of family members ber...

Background: Quantitative research has highlighted adverse mental health outcomes of suicide bereavement. However, mixed-methods research specifically focusing on the impact of suicide bereavement on family members’ physical and psychological health is scarce. Methods: A mixed-methods study was conducted, using qualitative interviews and quantitat...

Background: Little research has been conducted into the physical health implications of suicide bereavement compared to other causes of death. There is some evidence that suicide bereaved parents have higher morbidity, particularly in terms of chronic illness. This systematic review aims to examine the physical and psychosomatic morbidities of peo...

Clinician fidelity to suicide screening in the emergency department: Results from the ED-SAFE study

Background: Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior. Aims: This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations. Method: Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide...

Factors affecting processes of care in emergency department patients at suicide risk: Findings from the ED-SAFE study

Predictive utility of an emergency department Decision Support Tool: Secondary data analysis of patients with active suicidal ideation

Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as “heat-not-burn” tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention option...

Background Research indicates that experiencing the suicide of a relative can have a significant impact on family members’ psychological health. However, research incorporating the impact of suicide bereavement on family members’ physical health is sparse. Therefore, the aim of this study was to examine how family members have been physically and p...

Introduction Research indicates that experiencing the suicide of a relative can have a significant impact on family members' emotional health. However, research incorporating the impact of suicide bereavement on family members' physical health is sparse. This paper details the protocol for a mixed-methods study of suicide-bereaved family members. T...

Healthcare learning collaboration to prevent suicide: Data from the ED-SAFE and SOS studies

Objective Information on factors associated with suicide among young individuals in Ireland is limited. The aim of this study was to identify socio-demographic characteristics and circumstances of death associated with age among individuals who died by suicide. Methods The study examined 121 consecutive suicides (2007–2012) occurring in the southe...

Background Gatekeeper training for community facilitators, to identify and respond to those at risk of suicide, forms an important part of multi-level community-based suicide prevention programmes. Aims This study examined the effects of gatekeeper training on attitudes, knowledge and confidence of police officers in dealing with persons at risk o...

Dignity has been described as ‘the inherent and inalienable worth of all human beings irrespective of social status such as race, gender, physical or mental state. Dignity is, therefore, at the core of psychological well-being, social connection and humanity. Mental health interventions that explicitly promote and preserve dignity for people experi...

Data sources in psychological autopsy research: Assessing the consistency of information obtained through the Suicide Support and Information System in Ireland

The overall aim of the study was to compare factors associated with completed suicide among young people and adults focusing on methods of suicide and clinical characteristics.

Background Alcohol misuse is a significant risk factor for both self-harm and suicide, and alcohol is often involved in self-harm acts and present at time of deaths by suicide. This study sought to identify factors associated with alcohol consumption in both non-fatal self-harm presentations and cases of suicide. Methods This study included suicide...

Background: Depression incurs significant morbidity and confers increased risk of suicide. Many individuals experiencing depression remain untreated due to systemic and personal barriers to care. Guided Internet-based psychotherapeutic programs represent a promising means of overcoming such barriers and increasing the capacity for self-management o...

Alcohol in suicides and self-harm: Findings from the Suicide Support and Information System and the National Registry of Deliberate Self-Harm Ireland

The main objective of the study was to compare factors associated with suicide among young people and adults in Ireland on socio-demographic characteristics, toxicology — alcohol and drugs at time of death — and methods of suicide.

[This corrects the article on p. e84282 in vol. 9.]. Correction: An affiliation for the last author is incorrectly omitted. In addition to institution number 1, Ella Arensman is also affiliated with the following institution: Department of Epidemiology & Public Health, University College Cork, Ireland.

BACKGROUND: Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic revi...

Background Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic revie...

Background: Risk assessment forms a key component in self-harm management. Among self-harm presentations generally, lethality of an index act is a poor predictor of future non-fatal repetition. However, no study has examined whether severity of an index self-cutting episode is associated with prospective repetition. Aims: To examine factors asso...

Suicidologi. 09/2013; 18(Supplement 1):287-8. Objective: By the year 2020, depression is set to take 2nd place in the ranking of Disability Adjusted Life Years (DALYs) for all ages and both sexes. Already unipolar depression ranks first when considering the index “years lived with disability” (YLD) in high income countries but only a minority of p...

Background Self-harm places an individual at increased risk of future self-harm and suicide, and indicates distress and maladaptive coping. Those who present to hospital with self-cutting form a significant minority of self-harm patients who are at increased risk of prospective repetition of self-harm and suicide compared with those presenting with...

Research suggests that patients presenting to hospital with self-cutting differ from those with intentional overdose in demographic and clinical characteristics. However, large-scale national studies comparing self-cutting patients with those using other self-harm methods are lacking. We aimed to compare hospital-treated self-cutting and intentiona...

Individuals who present to emergency departments with self-harm are at elevated risk of further self-harm and suicide, and these risks are yet higher among patients who self-cut. Repetitive self-injury has previously been explained using a behaviourist approach focussing on operant conditioning, but we propose that the increased risk of self-harm r...

Dozens of quantitative studies have examined risk factors for repetition of self-harm, but few studies have examined the lived experience of repeated self-harm among those presenting to emergency departments with self-harm. The current study uses Interpretative Phenomenological Analysis to explore the experiences of young self-harm repeaters who pr...

Dozens of quantitative studies have examined risk factors for repetition of self-harm, but few studies have examined the lived experience of repeated self-harm among those presenting to emergency departments with self-harm. The current study uses Interpretative Phenomenological Analysis to explore the experiences of young self-harm repeaters who pr...

Dozens of quantitative studies have examined risk factors for repetition of self-harm, but few studies have examined the lived experience of repeated self-harm among those presenting to emergency departments with self-harm. The current study uses Interpretative Phenomenological Analysis to explore the experiences of young self-harm repeaters who pr...