Disorders - suicide or self-harm behaviours
Agyapong, B., Shalaby, R., Vuong, W., Gusnowski, A., Surood, S., Greenshaw, A. J., Wei, Y., Agyapong, V. I. O.
BACKGROUND: Chronic stress,
anxiety, and depression are psychological problems that can hurt young adults, interfering with their everyday function, academic achievement, and
interpersonal relationships. This study aimed to assess the impact of Text4Hope, an online mental health service, on the psychological well-being of
young adults.\rMETHODS: This study adopted both longitudinal and naturalistic controlled trial designs. It examined clinical outcomes in young adult
(<=26 years old) subscribers of Text4Hope who completed surveys at baseline and six weeks and compared clinical parameters in two groups of
subscribers. The first group comprised the intervention group (IG) (young adult subscribers who received once-daily supportive text messages for six
weeks and completed sixth-week evaluation measures between 26 April and 12 July 2020), and the second group was the control group (CG) (young adult
subscribers who joined Text4Hope in the same time frame and completed a baseline survey and were yet to receive any text messages). The prevalence of
moderate to high stress, anxiety, and depression was measured at baseline and six weeks in the longitudinal study and between the two groups for the
naturalistic controlled study using the Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health
Questionnaire-9 (PHQ-9). Inferential statistics, including the t-test, McNemar test, chi-square, and binary logistic regression analyses, were used
to evaluate the differences in the prevalence and severity of the psychological symptoms.\rRESULTS: In the longitudinal study, of the 9214
subscribers to Text4Hope who completed the baseline survey, 1047 (11.4%) were identified as youth. For the young adult subscribers who completed both
the baseline and sixth-week surveys (n = 114), a significant reduction in the prevalence of moderate to high stress (8%) and likely GAD (20%) from
baseline to six weeks was reported. Similarly, there was a significant reduction in the mean scores on the PSS-10, GAD-7, and Composite Mental Health
score but not the PHQ-9 from baseline to six weeks. The largest reduction in mean scores was for the GAD-7 scale (18.4%), with a small effect size
overall. For the naturalistic study, the IG included 173 young adult subscribers of Text4Hope who completed the sixth-week survey compared to 92
subscribers in the CG who completed the baseline survey during the designated period. There was a significantly lower prevalence for likely Moderate
Depressive Disorder (MDD) (25.2%) and suicidal thoughts/thoughts of self-harm (48.4%), with a small effect size in the IG compared to the CG.
Similarly, lower mean scores were reported for all outcome variables in the IG compared to the CG, with a small to medium effect size. The receipt of
daily supportive text messages for six weeks resulted in significantly lower odds of both likely GAD and experiencing thoughts of self-harm or death
wish while controlling for sociodemographic characteristics.\rCONCLUSIONS: The Text4Hope service is an effective tool for mental health support for
young adult subscribers. Young adults receiving the service exhibited a reduction in psychological symptoms, including thoughts of self-harm or death
wish. This population-level intervention program can be used to effectively support young adult mental health and in suicide prevention programs.
Journal of Clinical
Medicine, 12(5) : 01
- Year: 2023
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Zhang, Y., Huang, K., Cong, H., Wang, M.
Background: The
depression of college students requires psychological intervention based on clinical drug treatment. Group psychological counseling is an effective
psychological intervention. This study aims to explore the effect of group psychological counseling on negative emotions and Nonsuicidal Self-injury
(NSSI) behaviors of college students with depression. Subjects and methods: A total of 84 students with depression by screening diagnosis at Qingdao
University in March 2018 were divided into the control group (n=42) and the intervention group (n=42). Students in the control group only received
drug therapy, whereas the intervention group underwent group psychological counseling intervention based on drug therapy. A comparison between
depression, self-injury behaviors, and sense of life purpose of the two groups before and after the intervention was performed. Result(s): The post-
test Self-Rating Depression Scale (SDS) standard score of students in both groups was significantly lower than the pre-test SDS standard score
(P<0.05). The SDS standard scores of the post-test and the trace test in the intervention group were significantly lower than those in the control
group (P<0.05). Compared with the pre-test value, the total scores in the Meaning in Life Questionnaire (MLQ) of the post-test in both groups
significantly increased. The intervention group received significantly higher scores in the MLQ of the post-test and trace test compared with the
control group (P<0.05). Both groups also received significantly higher scores in the post-test in the Quality System Audit (QSA) compared with the
pre-test (P<0.05). The intervention group also received higher scores on the post-test and trace test in some dimensions in the QSA compared with
those of the control group (P<0.05). Conclusion(s): Group psychological counseling intervention for college students with depression can alleviate
their depressive symptoms, improve their sense of life meaning, reduce the risk of suicide, and control their NSSI behaviors. Copyright © 2022
Medicinska Naklada Zagreb. All rights reserved.
Psychiatria Danubina, 34
(2) : 229-235
- Year: 2022
- Problem: Depressive Disorders, Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Other Psychological Interventions
Wu, Q., Zhang, J., Walsh, L., Slesnick, N.
Illicit drug use and cognitive distortions confer
significant risks to youth suicidal thoughts and behaviors. However, there has been limited evidence regarding the efficacy of suicide prevention
interventions with homeless youth, especially studies testing whether such interventions can reduce the risk for suicidal ideation associated with
illicit drug use. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a drop-in center. Youth were randomly
assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their illicit drug use, cognitive
distortions, and suicidal ideation 4 times over 9 months. A multiple-group multilevel structural equation model showed that higher illicit drug use
at baseline predicted a slower reduction in cognitive distortions and suicidal ideation in the TAU group. These associations were not found in the
CTSP + TAU group, suggesting an interruption of such risk from illicit drug use. Findings suggest that CTSP can reduce the risk of illicit drug use
as a treatment barrier towards cognitive distortions and suicidal ideation among homeless youth, with implications to improve treatment efforts and
to reduce premature mortality in a vulnerable population. Copyright © 2021
, 53(1) : 92-
104
- Year: 2022
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Walsh, E. H., McMahon, J., Herring, M. P.
BACKGROUND: Globally, suicide is the fourth highest cause of adolescent mortality (Suicide:
https://www.who.int/news-room/fact-sheets/detail/suicide). The effects of post-primary school-based suicide prevention (PSSP) on adolescent suicidal
thoughts and behaviours (STBs) have not been comprehensively synthesised. We aim to estimate the population effect for PSSP interventions on
adolescent STBs and explore how intervention effects vary based on intervention and contextual moderators. METHOD(S): Searches of PsycINFO, Medline,
Education Source, ERIC, Web of Science, and the Cochrane Central Register of Controlled Trials identified cluster randomised trials examining the
effectiveness of PSSP on adolescent STBs. The Cochrane Risk of Bias tool assessed bias. Crude and adjusted back-transformed odds ratios (ORs) were
calculated. Multilevel random-effects models accounted for dependencies of effects. Univariate meta-regression explored variability of intervention
and contextual moderators on pooled effects. RESULT(S): There were 19 and 12 effects for suicidal ideation (SI) and suicide attempts (SA). Compared
with controls, interventions were associated with 13% (OR=0.87, 95%CI [0.78, 0.96]) and 34% (OR=0.66, 95%CI [0.47, 0.91]) lower crude odds reductions
for SI and SA, respectively. Effects were similar for adjusted SI (OR = 0.85, 95%CI [0.75, 0.95]) and SA (OR = 0.72, 95%CI [0.59, 0.87]) models.
Within-study (0.20-9.10%) and between-study (0-51.20%) heterogeneity ranged for crude and adjusted SA models and SI heterogeneity was 0%. Moderator
analyses did not vary SA effects (ps>.05). CONCLUSION(S): This meta-analysis contributes to the PSSP evidence-base by demonstrating that PSSP
targeting STBs as both primary intervention outcomes and with other health and well-being outcomes reduced SI and SA among 33,155 adolescents
attending 329 schools, compared to controls. The number needed to treat estimates suggests the potential of reducing the incidence of SA and SI in
one adolescent by implementing PSSP in 1-2 classrooms, supporting PSSP as a clinically relevant suicide prevention strategy. Although moderator
analyses were nonsignificant and contained a small number of trials, larger SA effect sizes support particular effectiveness for interventions of a
duration of <=1week, involving multiple stakeholders and with a 12-month follow-up. Copyright © 2022 The Authors. Journal of Child Psychology and
Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Journal of child
psychology and psychiatry, and allied disciplines, 63(8) : 836-845
- Year: 2022
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any)
Viswanathan, M., Wallace, I. F., Cook-Middleton, J., Kennedy, S. M., McKeeman, J., Hudson, K., Rains, C., Vander-Schaaf, E. B., Kahwati, L.
Importance:
Depression, suicidal ideation, and self-harm behaviors in youth are associated with functional impairment and suicide. Objective(s): To review the
evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force (USPSTF). Data
Sources: PubMed, Cochrane Library, PsycINFO, CINAHL, and trial registries through July 19, 2021; references, experts, and surveillance through June
1, 2022. Study Selection: English-language, randomized clinical trials (RCTs) of screening for depression or suicide risk; diagnostic test accuracy
studies; RCTs of psychotherapy and first-line pharmacotherapy; RCTs, observational studies, and systematic reviews reporting harms. Data Extraction
and Synthesis: Two reviewers assessed titles/abstracts, full-text articles, and study quality and extracted data; when at least 3 similar studies
were available, meta-analyses were conducted. Main Outcomes and Measures: Test accuracy, symptoms, response, remission, loss of diagnosis, mortality,
functioning, suicide-related events, and adverse events. Result(s): Twenty-one studies (N = 5433) were included for depression and 19 studies (N =
6290) for suicide risk. For depression, no studies reported on the direct effects of screening on health outcomes, and 7 studies (n = 3281) reported
sensitivity of screening instruments ranging from 0.59 to 0.94 and specificity from 0.38 to 0.96. Depression treatment with psychotherapy was
associated with improved symptoms (Beck Depression Inventory pooled standardized mean difference, -0.58 [95% CI, -0.83 to -0.34]; n = 471; 4 studies;
and Hamilton Depression Scale pooled mean difference, -2.25 [95% CI, -4.09 to -0.41]; n = 262; 3 studies) clinical response (3 studies with
statistically significant results using varying thresholds), and loss of diagnosis (relative risk, 1.73 [95% CI, 1.00 to 3.00; n = 395; 4 studies).
Pharmacotherapy was associated with improvement on symptoms (Children's Depression Rating Scale-Revised mean difference, -3.76 [95% CI, -5.95 to -
1.57; n = 793; 3 studies), remission (relative risk, 1.20 [95% CI, 1.00 to 1.45]; n = 793; 3 studies) and functioning (Children's Global Assessment
Scale pooled mean difference, 2.60 (95% CI, 0.78 to 4.42; n = 793; 3 studies). Other outcomes were not statistically significantly different.
Differences in suicide-related outcomes and adverse events for pharmacotherapy when compared with placebo were not statistically significant. For
suicide risk, no studies reported on the direct benefits of screening on health outcomes, and 2 RCTs (n = 2675) reported no harms of screening. One
study (n = 581) reported on sensitivity of screening, ranging from 0.87 to 0.91; specificity was 0.60. Sixteen RCTs (n = 3034) reported on suicide
risk interventions. Interventions were associated with lower scores for the Beck Hopelessness Scale (pooled mean difference, -2.35 [95% CI, -4.06 to
-0.65]; n = 644; 4 RCTs). Findings for other suicide-related outcomes were mixed or not statistically significantly different. Conclusion and
Relevance: Indirect evidence suggested that some screening instruments were reasonably accurate for detecting depression. Psychotherapy and
pharmacotherapy were associated with some benefits and no statistically significant harms for depression, but the evidence was limited for suicide
risk screening instruments and interventions.. Copyright © 2022 American Medical Association. All rights reserved.
JAMA, 328(15) : 1543-1566
- Year: 2022
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs), Antidepressants
(any), Other biological interventions, Psychological Interventions
(any)
Virk, F., Waine, J., Berry, C.
BACKGROUND: Suicidal ideation is an increasingly common presentation to the paediatric
emergency department. The presence of suicidal ideation is linked to acute psychiatric hospital admission and increased risk of suicide. The
paediatric emergency department plays a critical role in reducing risk of suicide, strengthening protective factors and encouraging patient
engagement with ongoing care.\rAIMS: This rapid review aims to synthesise evidence on interventions that can be implemented in the paediatric
emergency department for children and adolescents presenting with suicidal ideation.\rMETHOD: Six electronic databases were searched for studies
published since January 2010: PubMed, Web of Science, Medline, PsycINFO, CINAHL and Cochrane. Outcomes of interest included suicidal ideation,
engagement with out-patient services, incidence of depressive symptoms, hopelessness, family empowerment, hospital admission and feasibility of
interventions. The Cochrane risk-of-bias tool was used to evaluate the quality of studies.\rRESULTS: Six studies of paediatric emergency department-
initiated family-based (n = 4) and motivational interviewing interventions (n = 2) were narratively reviewed. The studies were mainly small and of
varying quality. The evidence synthesis suggests that both types of intervention, when initiated by the paediatric emergency department, reduce
suicidal ideation and improve patient engagement with out-patient services. Family-based interventions also showed a reduction in suicidality and
improvement in family empowerment, hopelessness and depressive symptoms.\rCONCLUSIONS: Paediatric emergency department-initiated interventions are
crucial to reduce suicidal ideation and risk of suicide, and to enhance ongoing engagement with out-patient services. Further research is needed;
however, family-based and motivational interviewing interventions could be feasibly and effectively implemented in the paediatric emergency
department setting.
BJPsych Open, 8(2) : e56
- Year: 2022
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Motivational interviewing, includes Motivational Enhancing Therapy
Torok, M., Han,
J., McGillivray, L., Wong, Q., Werner-Seidler, A., ODea, B., Calear, A., Christensen, H.
BACKGROUND: Suicidal ideation is a major risk for a suicide attempt in younger
people, such that reducing severity of ideation is an important target for suicide prevention. Smartphone applications present a new opportunity for
managing ideation in young adults; however, confirmatory evidence for efficacy from randomized trials is lacking. The objective of this study was to
assess whether a therapeutic smartphone application (\"LifeBuoy\") was superior to an attention-matched control application at reducing the severity
of suicidal ideation.\rMETHODS AND FINDINGS: In this 2-arm parallel, double-blind, randomized controlled trial, 455 young adults from Australia
experiencing recent suicidal ideation and aged 18 to 25 years were randomly assigned in a 2:2 ratio to use a smartphone application for 6 weeks in
May 2020, with the final follow-up in October 2020. The primary outcome was change in suicidal ideation symptom severity scores from baseline (T0) to
postintervention (T1) and 3-month postintervention follow-up (T2), measured using the Suicidal Ideation Attributes Scale (SIDAS). Secondary outcomes
were symptom changes in depression (Patient Health Questionnaire-9, PHQ-9), generalized anxiety (Generalized Anxiety Disorder-7, GAD-7), distress
(Distress Questionnaire-5, DQ5), and well-being (Short Warwick-Edinburgh Mental Well-Being Scale, SWEMWBS). This trial was conducted online, using a
targeted social media recruitment strategy. The intervention groups were provided with a self-guided smartphone application based on dialectical
behavior therapy (DBT; \"LifeBuoy\") to improve emotion regulation and distress tolerance. The control group were provided a smartphone application
that looked like LifeBuoy (\"LifeBuoy-C\"), but delivered general (nontherapeutic) information on a range of health and lifestyle topics. Among 228
participants randomized to LifeBuoy, 110 did not complete the final survey; among 227 participants randomized to the control condition, 91 did not
complete the final survey. All randomized participants were included in the intent-to-treat analysis for the primary and secondary outcomes. There
was a significant time x condition effect for suicidal ideation scores in favor of LifeBuoy at T1 (p < 0.001, d = 0.45) and T2 (p = 0.007, d = 0.34).
There were no superior intervention effects for LifeBuoy on any secondary mental health outcomes from baseline to T1 or T2 [p-values: 0.069 to
0.896]. No serious adverse events (suicide attempts requiring medical care) were reported. The main limitations of the study are the lack of sample
size calculations supporting the study to be powered to detect changes in secondary outcomes and a high attrition rate at T2, which may lead efficacy
to be overestimated.\rCONCLUSIONS: LifeBuoy was associated with superior improvements in suicidal ideation severity, but not secondary mental health
outcomes, compared to the control application, LifeBuoy-C. Digital therapeutics may need to be purposefully designed to target a specific health
outcome to have efficacy.\rTRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619001671156.
PLoS Medicine / Public Library of
Science, 19(5) : e1003978
- Year: 2022
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Dialectical behavioural therapy
(DBT), Technology, interventions delivered using technology (e.g. online, SMS)
Ramaiya, M. K., McLean, C. L., Pokharel, M., Thapa, K., Schmidt, M. A., Berg, M., Simoni, J. M., Rao, D., Kohrt, B. A.
Background: Child and adolescent mental health problems are major contributors to the global burden of
disease in low- and middle-income country (LMIC) settings. To advance the evidence base for adolescent mental health interventions in LMICs, we
evaluated the feasibility and acceptability of a school-based emotion regulation prevention intervention (READY-Nepal) for adolescents who had a
recent exposure to a humanitarian disaster. Method(s): A mixed-method, non-randomized controlled trial was conducted with Nepali secondary school
students in one heavily affected post-earthquake district. Students (N = 102; aged 13 to 17 years) were enrolled in the intervention (n = 42) and
waitlist control (n = 60) conditions. Feasibility and acceptability were examined via attendance, and by qualitative interviews with a subset of
students (n = 15), teachers (n = 2), and caregivers (n = 3). Preliminary efficacy was examined on primary outcome (emotion regulation) and secondary
outcomes (anxiety symptoms, posttraumatic stress symptoms, functional impairment, resilience, coping skills), which were measured at baseline and
post-intervention (four weeks). Result(s): Delivering the intervention was feasible and acceptable, as demonstrated by low dropout (8%) and high
program attendance (6.7 of 8 sessions). Qualitative data suggested high uptake of anger regulation skills, but lower uptake of mindfulness skills.
Despite this, there were no significant differences by condition on primary or secondary outcomes at four-week follow-up. Students provided
suggestions for improvement of the program. Conclusion(s): Further research on longitudinal outcome measurement, use of alternatives to retrospective
self-report data, and rigorous development of culturally grounded models of emotion regulation is necessary to explore the utility of school-based
emotion regulation interventions in Nepal and other LMICs. Copyright © 2022 by the authors.
International Journal of Environmental Research
and Public Health, 19(21) (no pagination) :
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Dialectical behavioural therapy
(DBT), Skills training, Other Psychological Interventions
Pashak, T. J., Percy, C. S., Trierweiler, E. J., Bradley, S. M., Conley, M. A., Weaver, J. S.
OBJECTIVE: Suicide prevention
campaigns commonly employ brief informational materials aimed at emerging adults. Are such programs helpful, and do design characteristics yield
differences in user outcomes? Literature is reviewed from the interpersonal theory of suicide, escape theory, and terror management theory, to inform
our experimental design. METHOD(S): Participants (n = 977 MTurk emerging adults) reported demographics and suicide histories and were randomized to
one of nine experimental cells with varying video and journaling conditions to approximate suicide prevention materials. Participants were surveyed
on perceptions of the materials' risk reduction effectiveness, indicated their suicidality risk factors (e.g., hopelessness, depressiveness,
purposelessness, and non-belongingness), and conducted an implicit association test of suicidality. RESULT(S): Suicide risk factors did not differ
between experimental and control conditions, but certain conditions were rated as more effective (i.e., essay conditions prompting reflection, and
the video condition featuring a personal/affective narrative). While there was no actual comparative reduction of risk, there was a perception that
certain designs were more helpful. CONCLUSION(S): Real-world suicide prevention campaigns often feel justified despite lacking impact. Effective
suicide risk reduction requires greater time investment and deeper personal connection than brief campaigns can offer, as well as systemic changes
from a public health policy perspective. Copyright © 2022 The American Association of Suicidology.
Suicide & life threatening behavior., 25 :
- Year: 2022
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Montgomery, P., Knerr, W., Ross, D. A., Patterson, J.
Purpose:
Comprehensive school-based health services were reviewed as part of preparing World Health Organization guidelines. Method(s): Six databases were
searched for controlled trials with schoolchildren aged 5-19 years, involving school-linked health services incorporating 4 of 7 health areas.
Result(s): Seventeen quasi-experimental studies conducted in high-income countries found school health services associated with reductions in suicide
planning (male: 7.1% vs. 7.7%, p < .01), hospitalization (relative risks 3.403, 95% confidence interval [CI] 1.536 to 8.473, p < .05), emergency
department visits (odds ratio .85, 95% CI .75 to .95, p = .006), school absence (odds ratio .78, 95% CI .69 to .87, p < .0001), carrying weapons
(male: 16.1% vs. 25.1%, p < .01), fighting (male: 32.6% vs. 43.1%, p < .01), sexual activity (53.5% vs. 60.5%, p < .05), drinking alcohol (60.1% vs.
70.5%, p < .001), using drugs (28.0% vs. 38.3%, p < .001), and physical activity (female: 57.4% vs. 50.4%, p < .01). They can be cost-saving, were
also associated with smoking and less contraceptive use, and had no effect on depression prevalence. Acceptability/satisfaction was good. The
certainty of evidence was low to moderate. Heterogeneity was high for some outcomes. Conclusion(s): Results suggest moderate desirable and trivial
undesirable effects of school health services in high-income countries. This article compiles evidence on effectiveness, cost-effectiveness, and
acceptability into one review, enabling decision-makers to consider all essential factors. Copyright © 2021 Society for Adolescent Health and
Medicine
Journal of Adolescent Health, 70
(2) : 192-207
- Year: 2022
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Kirchner, S., Till, B., Ploderl, M., Niederkrotenthaler,
T.
Purpose: The \"It Gets Better\" project (IGBP) features video narratives of lesbian, gay, bisexual, transgender, queer
persons or persons with other sexual or gender minority identities (LGBTQ+) of overcoming coming-out-related difficulties. This is the first
experimental study investigating effects of these videos. Method(s): We conducted a double-blind randomized controlled trial on-site in Austria and
online in German-language settings from January to November 2020 with LGBTQ+ youth (14-22 years; n=483), randomized to an IGBP (n=242) or control
video (n=241). Suicidal ideation (primary outcome), help-seeking intentions, hopelessness, mood, and sexual identity were assessed at baseline (T1),
postexposure (T2), and 4-week follow-up (T3). We assessed differences among gender identities, sexual orientations, with regard to depressive
symptoms, and the role of identification. Data were analyzed with linear mixed models and mediation analysis. Result(s): There was no overall effect
on suicidal ideation, but nonbinary/transgender individuals experienced a small-sized improvement (T2: mean change [MC] from baseline MC=-0.06 [95%
confidence interval {CI} -0.16 to 0.05], p=0.60; mean difference [MD] to controls MD=-0.42 [95% CI -0.79 to -0.06], p=0.02, d=-0.10). An indirect
preventive effect on suicidal ideation at T2 through the degree of identification with the protagonist in the video was observed. There was
improvement in help-seeking intentions in the intervention group (T2: MC=0.25 [95% CI 0.15 to 0.35], p<0.001; MD=0.28 [95% CI 0.01 to 0.54], p<0.05,
d=0.09). Conclusion(s): Video narratives featuring coping might have some potential to decrease suicidal ideation and encourage help-seeking among
vulnerable youth identifying with videos, but effects are small and short-lived. Study Registration: German Clinical Trial Registry
(DRKS00019913).
LGBT health, 9(6) : 436-
446
- Year: 2022
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
King, C. A., Eisenberg,
D., Pistorello, J., Coryell, W., Albucher, R. C., Favorite, T., Horwitz, A., Bonar, E. E., Epstein, D., Zheng, K.
Objective: Suicide is the second leading cause of death among college students in the United States, and the percentage of students
reporting suicidal thoughts is increasing. Nevertheless, many students at risk do not seek mental health (MH) services. This randomized controlled
trial (RCT) examined the efficacy of Electronic Bridge to Mental Health for College Students (eBridge) for increasing at-risk students' linkage to
MH services. Method(s): Students from four universities were recruited via email; 40,347 (22.6%) completed the online suicide risk screen; and 3,363
(8.3%) met criteria for randomization based on suicide risk factors and lack of current treatment (62.2% female, 35.0% male, 2.8%
transgender/nonbinary; 73.2% White, 7.0% Black, 19.9% Asian, 11.7% other; 12.4% Hispanic, 76.2% undergraduate). These students were randomized to
eBridge [personalized feedback (PF) with option of online counseling] or Control (PF). The primary outcome was linkage to MH services within 6
months. Result(s): Among students assigned to eBridge, 355 students (21.0%) posted >=1 message, and 168 (10.0%) posted >=2 messages to the counselor.
In intent-totreat analyses, there was no eBridge effect on obtaining MH services. However, within the eBridge group, students who posted >=1 message
were significantly more likely to link to MH services. Conclusion(s): eBridge shows promise for reaching a relatively small subset of college
students at risk for suicide; however, engagement in eBridge was low. This study underscores the urgent need for more effective strategies to engage
young adults in online mental health interventions Copyright © 2022. American Psychological Association
Journal of Consulting and Clinical Psychology, 90(2) : 172-183
- Year: 2022
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Alcohol
Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback, Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement
interventions