Perception of Suicide Risk in Mental Health Professionals.
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ABSTRACT:
SUBMITTER: Gale TM
PROVIDER: S-EPMC4766090 | biostudies-other | 2016
REPOSITORIES: biostudies-other
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Project description:ImportanceBurnout among health care professionals has been increasingly associated with suicide risk. An examination of possible risk factors may help in the prevention of suicide among health care professionals.ObjectiveTo assess suicide risk factors for 3 categories of health care professionals (surgeons, nonsurgeon physicians, and dentists) compared with non-health care professionals.Design, setting, and participantsData from the National Violent Death Reporting System were reviewed to identify all individuals who died by suicide in the United States between January 1, 2003, and December 31, 2016. Individuals were divided into health care professionals and non-health care professionals (general population), with the health care professionals further categorized into surgeons, nonsurgeon physicians, and dentists. The covariates of suicide decedents included demographic characteristics (age, sex, race, and marital status), medical history (mental illness, substance use, and physical health), and documented factors associated with the suicide death (job, intimate partner, financial, legal, and other problems). Data were analyzed from October 2 to December 17, 2019.Main outcomes and measuresIn this analysis, the outcome variable was occupation, with health care professionals overall and by category compared with the general population. Multiple logistic regression analyses with backward stepwise selection were performed.ResultsA total of 170 030 individuals who died by suicide between 2003 and 2016 were identified. Of those, 767 individuals (0.5%) were health care professionals (mean [SD] age, 59.6 [15.6] years; 675 men [88.0%]; 688 white [89.7%]), with the remainder of the sample (95.5%) comprising the general population (mean [SD] age, 46.8 [31.5] years; 77.7% men; 87.8% white). A total of 485 health care professionals (63.2%) were nonsurgeon physicians, 179 professionals (23.3%) were dentists, and 103 professionals (13.4%) were surgeons. Compared with the general population, risk factors for suicide among health care professionals included having Asian or Pacific Islander ancestry (odds ratio [OR], 2.80; 95% CI, 1.96-3.99; P < .001), job problems (OR, 1.79; 95% CI, 1.49-2.17; P < .001), civil legal problems (OR, 1.61; 95% CI, 1.15-2.26; P = .006), and physical health problems (OR, 1.40; 95% CI, 1.19-1.64; P < .001) and currently receiving treatment for mental illness (OR, 1.45; 95% CI, 1.24-1.69; P < .001). Compared with the general population, health care professionals had a lower risk of suicide if they had black ancestry (OR, 0.55; 95% CI, 0.36-0.84; P < .001) or were female (OR, 0.44; 95% CI, 0.35-0.55; P < .001) or unmarried (OR, 0.36; 95% CI, 0.31-0.42; P < .001). Health care professionals who died by suicide were also less likely to have problems with intimate partners (OR, 0.71; 95% CI, 0.60-0.86; P < .001) or alcohol use (OR, 0.58; 95% CI, 0.45-0.73; P < .001) compared with the general population. Surgeons had a higher risk of suicide compared with the general population if they were older, male, married, had Asian or Pacific Islander ancestry, were currently receiving treatment for mental illness, or had problems with their job or alcohol use. Compared with their nonsurgeon physician colleagues, surgeons had a higher risk of suicide if they were male, older, married, or currently receiving treatment for mental illness.Conclusions and relevanceThis study highlights risk factors for suicide among health care professionals, with additional analyses of surgeon-specific risk factors. The results may be useful in improving the detection of burnout and the development of suicide prevention interventions among health care professionals.
| S-EPMC7287947 | biostudies-literature
Project description:ObjectiveAlthough mental health conditions are risk factors for suicide, limited data are available on suicide mortality associated with specific mental health conditions in the U.S. population. This study aimed to fill this gap.MethodsThis study used a case-control design. Patients in the case group were those who died by suicide between 2000 and 2013 and who were patients in eight health care systems in the Mental Health Research Network (N=2,674). Each was matched with 100 general population patients from the same system (N=267,400). Diagnostic codes for five mental health conditions in the year before death were obtained from medical records: anxiety disorders, attention deficit-hyperactivity disorder (ADHD), bipolar disorder, depressive disorders, and schizophrenia spectrum disorder.ResultsAmong patients in the case group, 51.3% had a recorded psychiatric diagnosis in the year before death, compared with 12.7% of control group patients. Risk of suicide mortality was highest among those with schizophrenia spectrum disorder, after adjustment for age and sociodemographic characteristics (adjusted odds ratio [AOR]=15.0) followed by bipolar disorder (AOR=13.2), depressive disorders (AOR=7.2), anxiety disorders (AOR=5.8), and ADHD (AOR=2.4). The risk of suicide death among those with a diagnosed bipolar disorder was higher in women than men.ConclusionsHalf of those who died by suicide had at least one diagnosed mental health condition in the year before death, and most mental health conditions were associated with an increased risk of suicide. Findings suggest the importance of suicide screening and providing an approach to improve awareness of mental health conditions.
| S-EPMC6718299 | biostudies-literature
Project description:BackgroundAdolescence is a phase of many physical and psychological developments. This stage is also vulnerable to the development of mental illness. Anxiety is one of the most prevalent disorders among adolescents, which mostly onsets before puberty. This study aimed to understand the perception on anxiety among adolescents and mental health professionals and develop a comic strip on anxiety.MethodsThis qualitative study involved focus group discussions (FGDs) among mental health professionals and pre-university college students. The FGD data were analyzed through direct content analysis according to the predetermined broad themes.ResultsAwareness regarding anxiety was poor among adolescents, and in certain situations they were found to be reluctant to seek professional help. The comic strip on anxiety was developed based on the findings of FGD based on the themes, general awareness, factors responsible, symptoms and coping, management, and barriers to seeking professional help.ConclusionsAdolescents perceived mental health as very important for their overall health. The adolescents did not know that they were going through anxiety, but they noticed that they had some mental health issues and wanted to get out of it. The development of comic strip on anxiety for adolescents was an attempt to overcome these barriers.
| S-EPMC10159561 | biostudies-literature
Project description:Exposure to suicide is a major factor for suicidality. Mental health professionals and first responders are often exposed to suicide while on-duty. The objective of this scoping review is to describe the state of current research on exposure to suicide among mental health professionals and first responders, focusing on the prevalence and impact of exposure to suicide, and to identify current gaps in the literature. We searched MEDLINE, Scopus, PsychNET, and Web of Science and identified 25 eligible papers. Between 31.5-95.0% of professionals had been exposed to suicide. Exposure to suicide had impacts on personal life, professional life, and mental health; and caused emotional distress. There was little research investigating exposure to suicide among police officers, firefighters, and paramedics. More research existed on mental health professionals, but none assessed exposure to suicide as a risk for suicide amongst this group. The review concludes that exposure to suicide is distressing for mental health professionals, and likely to be for first responder however, more research on these groups, especially paramedics, is required.
| S-EPMC8087020 | biostudies-literature
Project description:BackgroundPhysical functioning indexed multimorbidity is strongly associated with long-term mortality, but its role in poor mental health has not been quantified.MethodsA total of 252 002 community-dwelling adults in the Nurses' Health Study (NHS), NHS II, and Health Professionals Follow-up Study (HPFS) prospective cohorts reported physician-diagnosed diseases and the Short Form-36 over 8 years and had 24-year follow-up for suicide mortality. We quantified multimorbidity using a multimorbidity-weighted index (MWI). We used multivariable-adjusted proportional hazards models with competing risks for suicide mortality and mixed-effects models to estimate mental health-related quality of life (HRQOL).ResultsMultimorbidity was associated with an increased risk of suicide mortality in an approximately linear manner, with roughly two- to threefold higher risk in adults with the highest vs lowest quartile MWI in adjusted models: NHS hazard ratio (HR) = 3.01 (95% confidence interval [CI] = 1.48-6.11); NHS II HR = 3.04 (95% CI = 1.82-5.09); HPFS HR = 1.74 (95% CI = 1.08-2.81). Greater MWI was associated with worse mental HRQOL 8 years later across all scales and the mental component summary (MCS) in a dose-response manner. This association was attenuated but persisted after adjustment for baseline mental HRQOL and other covariates. Adults with the highest quartile MWI had lower MCS in adjusted models compared with those with the lowest quartile MWI: NHS ß = -0.61 (95% CI = -0.78 to -0.44); NHS II ß = -1.25 (95% CI = -1.44 to -1.06).ConclusionMultimorbidity is associated with substantially higher suicide mortality risk and worse mental HRQOL across all available scales, even when indexed to physical functioning. These results highlight the substantial mental health burden imposed by multimorbidity at all ages and sexes. J Am Geriatr Soc 67:511-519, 2019.
| S-EPMC6402970 | biostudies-literature
Project description:People who suffer from mental illness, the professionals who treat them, and indeed the actual concept of mental illness are all stigmatised in public perception and often receive very negative publicity. This paper looks at Iraq, which has a population of 30 million who are mainly Moslem. Mental health services and professionals have historically been sparse in Iraq with 1 psychiatrist per 300,000 before 2003 falling to 1 per million until recently and 1 primary care centre (40 Healthcare Workers including 4 General Practitioners) to 35,000 population, compared with 1 GP per 1700 population in the UK.We aimed to assess public attitudes and perceptions to mental illness. Participants were asked to complete a questionnaire (additional file 1), which was designed specifically for Iraqi contexts and was made available in 2 languages. The survey was carried out in 500 participants' homes across 2 districts of Baghdad.The response rate of the survey was 86.4%. The paper shows respondents views on the aetiology of mental illness, perceptions of people with mental illness and attitudes towards care and treatment of people with mental illness.This survey of public attitudes towards mental illness in Iraq has shown that community opinion about the aetiology of mental illness is broadly compatible with scientific evidence, but understanding of the nature of mental illness, its implications for social participation and management remains negative in general.
| S-EPMC2964529 | biostudies-other
Project description:ImportanceUnderstanding the extent to which population-level suicide risk screening facilities follow-up and engagement in mental health treatment is important as engaging at-risk individuals in treatment is critical to reducing suicidal behaviors.ObjectiveTo evaluate mental health follow-up and treatment engagement in the Veterans Health Administration (VHA) following administration of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen, a component of the VHA's universal suicide risk screening program.DesignThis cross-sectional study used data from VA's Corporate Data Warehouse.Settings140 VHA Medical Centers.ParticipantsPatients who completed the C-SSRS screen in ambulatory care between October 1, 2018-September 30, 2020.ExposureStandardized suicide risk screening.Main outcomes and measuresMental health follow-up (one or more visits within 30 days of C-SSRS screening) and treatment engagement (two or more visits within 90 days of C-SSRS screening) were examined.Results97,224 Veterans in Fiscal Year 2019 (FY19) (mean age 51.4 years; 86.8% male; 64.8% white, 22.4% African-American) and 58,693 Veterans in FY20 (mean age 49.6 years; 85.5% male; 63.4% white, 21.9% African-American) received the C-SSRS screen. Across FYs, a positive C-SSRS screen was associated with increased probability of mental health follow-up and treatment engagement. Patients who were not seen in mental health in the year prior to screening had the greatest increase in probability of mental health follow-up and engagement following a positive screen (P<0.001). For FY19, a positive C-SSRS screen in non-mental health connected patients was associated with an increased probability of follow-up from 49.8% to 79.5% (relative risk = 1.60) and engagement from 39.5% to 63.6% (relative risk = 1.61). For mental health-connected patients, a positive C-SSRS screen was associated with a smaller increase in probability of follow-up from 75.8% to 87.6% (relative risk = 1.16) and engagement from 63.3% to 76.4% (relative risk = 1.21). Results for FY20 were similar.Conclusions and relevanceIdentification of suicide risk through population-level screening was associated with increased mental health follow-up and engagement, particularly for non-mental health connected patients. Findings support the use of a standardized, comprehensive suicide risk screening program for managing elevated suicide risk in a large healthcare system.
| S-EPMC8929551 | biostudies-literature
Project description:BACKGROUND: Common mental health problems are mainly treated in primary care settings and collaboration with mental health services is needed. Prior to re-organisation of the mental health care offer in a geographical area, a study was organized: 1) to evaluate GPs' opinions on their day-to-day practice with Patients with Mental Health Problems (PMHP) and on relationships with Mental Health Professionals (MHPro); 2) to identify factors associated with perceived need for collaboration with MHPro and with actual collaboration. METHODS: All GPs in the South Yvelines area in France (n = 492) were informed of the implementation of a local mental health program. GPs interested in taking part (n = 180) were invited to complete a satisfaction questionnaire on their practice in the field of Mental Health and to include prospectively all PMHP consultants over an 8-day period (n = 1519). For each PMHP, data was collected on demographic and clinical profile, and on needs (met v. unmet) for collaboration with MHPro. RESULTS: A majority of GPs rated PMHP as requiring more care (83.4%), more time (92.3%), more frequent consultations (64.0%) and as being more difficult to refer (87.7%) than other patients. A minority of GPs had a satisfactory relationship with private psychiatrists (49.5%), public psychiatrists (35%) and social workers (27.8%). 53.9% had a less satisfactory relationship with MHPro than with other physicians. Needs for collaboration with a MHPro were more often felt in caring for PMHP who were young, not in employment, with mental health problems lasting for more than one year, with a history of psychiatric hospitalization, and showing reluctance to talk of psychological problems and to consult a MHPro. Needs for collaboration were more often met among PMHP with past psychiatric consultation or hospitalization and when the patient was not reluctant to consult a MHPro. Where needs were not met, GP would opt for the classic procedure of mental health referral for only 31.3% of their PMHP. CONCLUSION: GPs need targeted collaboration with MHPro to support their management of PMHP, whom they are willing to care for without systematic referral to specialists as the major therapeutic option.
| S-EPMC1131897 | biostudies-other
Project description:ObjectivesThe aim of this study was to explore health professionals' perception of risk factors related to child maltreatment in China.DesignQualitative research.SettingThe study was conducted in November and December 2014 in Hunan, Zhejiang, Shaanxi and Guangdong provinces in China.ParticipantsFive urban communities and five rural communities were randomly selected in each province, and interviews were conducted in maternal and child health hospitals, children's hospitals, community health service centres and township hospitals in the selected areas. Doctors, nurses and administrators involved in child healthcare services were selected for in-depth-interview.ResultsA total of 102 health professionals were approached but 95 completed the interview. From their perspective, risk factors causing child maltreatment were categorised into four domains: (1) cultural factors, including parents' absolute authority over their children and son preference; (2) social factors, including a fast-paced and stressful lifestyle, children left behind by migrant worker parents and lack of quality child care and education; (3) family factors, including economic status, family structure, parents' inability to provide parental care, experience of maltreatment and parents' illnesses; (4) children's factors, including gender, temper, disabilities and poor awareness of self-protection.ConclusionsThe results indicate that health professionals in China are aware of certain risk factors for child maltreatment; however, some views are outdated and wrong. Based on the perception of health professionals, targeted training courses are needed to enable them to correctly identify and deal with suspected cases of child maltreatment.
| S-EPMC6561447 | biostudies-literature
Project description:ObjectiveThe majority of suicide decedents have had contact with health services in the months before their death. Contacts for mental health services present potential suicide prevention opportunities. This study aims to compare contact-based characteristics among suicide decedents and living controls in the year subsequent to clinical mental health contact with the public health system in Victoria, Australia.MethodsA population-based nested case-control study of those who had mental health-related hospital and community contacts with the public health system was conducted. Cases (suicide decedents) were age and gender-matched to living controls (suicide non-decedents). These records were linked to records of suicides that occurred in the 12 months following the health service contact, between January 1, 2011, and December 31, 2016. Victorian residents aged 10 years and above were selected at the time of contact (483,933 clients). In the study population, conditional logistic regression models were used to assess the relationship between contact-based characteristics and suicide. Socio-demographics and mental health-related hospital and community contact data was retrieved from the Victorian Admitted Episodes Dataset, the Victorian Emergency Minimum Dataset and the Public Clinical Mental Health database and suicide data from the Victorian Suicide Register.ResultsDuring a six-year period, 1,091 suicide decedents had at least one mental health contact with the public health system in the 12 months preceding the suicide. Overall, controls used more mental health services than cases; however, cases used more mental health services near the event. The relationship between the type of service and suicide differed by service type: hospital admissions and emergency department presentations had a significant positive association with suicide with an OR of 2.09 (95% CI 1.82-2.40) and OR of 1.13 (95% CI 1.05-1.22), and the effect size increased as the event approached, whereas community contacts had a significant negative association with an OR of 0.93 (95% CI 0.92-0.94), this negative association diminished in magnitude as the event approached (OR∼1).ConclusionSuicide decedents had less contact with mental health services than non-decedents; however, evidence suggests suicide decedents reach out to mental health services proximal to suicide. An increase in mental health service contact by an individual could be an indication of suicide risk and therefore an opportunity for intervention. Further, community level contact should be further explored as a possible prevention mechanism considering the majority of suicide decedents do not access the public clinical mental health services.
| S-EPMC9772269 | biostudies-literature