Screening as an Approach for Adolescent Suicide Prevention

ArticleinSuicide and Life-Threatening Behavior 36(6):614-37 · January 2007with12 Reads
DOI: 10.1521/suli.2006.36.6.614 · Source: PubMed
Among the provisions of the recently signed Garrett Lee Smith Memorial Act, Congress called for the use of screening to detect adolescents who are at risk for suicide. After a review of the literature, 17 studies involving screening instruments and programs were identified. We addressed the question: What do we know about the demonstrated effectiveness and safety of screening as a tool or program to prevent suicide among adolescents? While youth suicide screening programs offer the promise of improving identification for those who need treatment the most, further research is essential to understand how, when, where, and for whom screening programs can be used effectively and efficiently.
    • "Significant decrease by approximately 50% was observed in the outcome measures both in severe suicidal ideation and suicide attempts [47]. The lack of evidence supporting potential iatrogenic effects has been reported in several other intervention studies on suicidal behaviors [48]. The results from the SEYLE study were in line with those reported by Gould and colleagues, showing no evidence that indicated iatrogenic effects; moreover, the rate of severe suicide ideation and suicide attempts among adolescents significantly decreased. "
    [Show abstract] [Hide abstract] ABSTRACT: Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors.
    Full-text · Article · May 2016
    • "After logarithmic transformation of rates, we fitted a linear regression from 1990 until 2010. We performed these analyses for both sexes and respectively for females and males, and for subjects aged15161718192021222324,25262728293031323334,3536373839404142434445464748495051525354,5556575859606162636465666768697071727374 and 75+ .Figure 1A–C andTable 1 show the changes in suicide mortality in 25 European countries and USA from 1990 to 2010. Over the 20 years, suicide mortality declined by a median of 22.7%, with individual values ranging from a 46% reduction in Estonia to a 26.2% increase in Romania. "
    [Show abstract] [Hide abstract] ABSTRACT: The objective was to examine changes in temporal trends in suicide mortality in 26 Western countries by retrospective trend analysis of the WHO mortality database on causes of deaths. From 1990 to 2010, there was a median reduction in suicide mortality of 22.7%, ranging from a 46% reduction in Estonia to a 26.2% increase in Romania. Suicide mortality decreased by ≥20% in 15 countries, and the reduction tended to be greater in countries with higher mortality in 1990. In most of the central European countries mortality strongly declined. The median changes in the age groups were −25.3% (range −62.9% to 72.6%) in people aged 15–24 years, −36.9% (−60.5% to 32.4%) in 25–34 years, −3.6% (−57.1% to 92%) in 35–54 years, −12.2% (−37% to 65,7%) in 55–74 years and −16.1% (−54.5% to 166.7%) in ≥75 years. Suicide prevention programs in youths and in the elderly seem to be effective (at least in females for the elderly) and efforts should be pursued in this way. However, suicide mortality of the people aged 35–54 years has increased in half of the studied countries between 1990 and 2010. Public policies should further orientate their efforts toward this population.
    Full-text · Article · Feb 2016
    • "School-based screening for suicidal behaviour is potentially a useful means of identifying those at-risk and increasing the number of suicidal young people who come into contact with the health services171819. The available screening programmes have adopted a two-stage process [20]. In the first phase, a screening instrument is used to identify those at-risk, followed by an in depth clinical assessment for those who screen positive [21]. "
    [Show abstract] [Hide abstract] ABSTRACT: To screen and clinically interview European adolescents reporting current suicidality (suicidal ideation and suicide attempt) and investigate attendance at the clinical interview. The Saving and Empowering Young Lives in Europe (SEYLE) Project was carried out in 11 European countries. A baseline questionnaire was completed in school by 12,395 adolescents (mean age 14.9; SD 0.9). Those who screened positive for suicidality (attempting suicide and/or serious suicidal ideation or plans) in the past 2 weeks were invited to a clinical interview with a mental health professional. Of the 12,395 adolescents, 4.2 % (n = 516) screened positive for current suicidality. The prevalence ranged from 1.1 % in Hungary to 7.7 % in Israel (p < 0.001). 37.6 % (n = 194) of those who screened positive subsequently attended the clinical interview. Female students were more likely to attend for interview (42.0 % versus 30.6 %, p = 0.010). The attendance rate varied considerably across countries, from 5.7 % in Italy to 96.7 % in France (p < 0.001). Improved attendance was associated with using school as the only interview setting (Mean attendance rate, MAR = 88 vs. 31 %, p = 0.006) and arranging the interview within 1 week of contacting the student (MAR = 64 vs. 23 %, p = 0.013). The greater the travel time to interview, the lower the attendance rate (Pearson's r = -0.64, p = 0.034). Independent of the variation by country, at the individual level, adolescents with more depressive symptoms and a recent suicide attempt more often attended for interview. A high rate of current suicidality was found amongst European adolescents. However, the majority of these displayed limited help-seeking behaviour. Future studies should investigate ways of making screening programmes and other interventions more acceptable and accessible to young people, especially young males.
    Full-text · Article · Feb 2015
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