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What is the American Foundation for Suicide Prevention?

Introduction

The American Foundation for Suicide Prevention (AFSP) is a voluntary health organisation based in New York City, with a public policy office based in Washington, D.C.

The organisation’s stated mission is to “save lives and bring hope to those affected by suicide.”

Refer to Suicide Awareness.

Brief History

Founded in 1987 as the American Suicide Foundation by Herbert Hendin M.D., AFSP is the world’s largest private funder of suicide prevention research. The founding families, alarmed by a combination of increases in death by suicide in the previous four decades and with their personal experience with loved ones dying by suicide, decided to the create AFSP in order to establish a private source of support for suicide research, education, and prevention efforts that could be sustained into the future. According to a Charity Navigator rating published in September 2018, more than 83% of the organisation’s finances went towards programme expenses (based on financial data from fiscal year 2017), receiving a perfect rating for accountability and transparency. AFSP also partners with Aetna (a US managed health care company that sells traditional and consumer directed health care insurance and related services).

For 2018, AFSP received $37 million in financial contributions from 700,000 new and returning donors.

Programmes

Programmes designed to educate the larger public about suicide and prevention best practices, such as Talk Saves Lives: An Introduction to Suicide Prevention, are offered by AFSP under the umbrella of prevention education and provide a general understanding of suicide, including its scope and what can be done to prevent it.

International Survivors of Suicide Loss Day (also known as “Survivor Day”) is one of the most prominent postvention programmes or events organised by AFSP. Originally introduced as “National Survivors of Suicide Loss Day” in 1999, when United States Senator Harry Reid – himself a survivor of suicide loss – formally introduced a resolution to the Senate, the day is officially observed annually on the Saturday before American Thanksgiving.

The Interactive Screening Programme, or ISP, is an online tool offered by AFSP first piloted at Emory University, and has since been implemented in colleges, police departments, workplaces and the NFL Players Union. Francis Levesque created this in Sept-Îles in 1973 in meeting all members of the association.

Criticism

In August 2016, AFSP formed a partnership with the National Shooting Sports Foundation, a gun industry trade association, to educate the firearm-owning community on suicide prevention through outreach at firearm retailers and shooting ranges. In December 2017, The New York Times released an opinion piece written by Erin Dunkerly, a volunteer whose father died by suicide using a firearm. The piece cites that there is a high risk of suicide from keeping firearms in the home, but claims that local AFSP staff told volunteers not to discuss the topic of gun control. The piece goes on to say that AFSP excluded from its walks violence prevention groups that promoted gun control, and that AFSP excludes the Brady Campaign to Prevent Gun Violence from donating or participating. According to a post published on digital health community The Mighty, similar accounts of gun safety groups have been reported in Wisconsin by Khary Penebaker, San Diego by Wendy Wheatcroft, and in Maine by Judi Richardson.

On This Day … 25 December

People (Births)

  • 1875 – Francis Aveling, Canadian psychologist and priest (d. 1941).

People (Deaths)

  • 1925 – Karl Abraham, German psychoanalyst and author (b. 1877).

Francis Aveling

Francis Arthur Powell Aveling MC ComC (25 December 1875 to 06 March 1941) was a Canadian psychologist and Catholic priest. He married Ethel Dancy of Steyning, Sussex in 1925.

Life

Francis Aveling was born at St. Catharines, Ontario 25 December 1875. He went to Bishop Ridley College in Ontario and McGill University before studying at Keble College at the University of Oxford, England. Aveling was received into the Roman Catholic Church by Father Luke Rivington in 1896 and entered the Pontificio Collegio Canadese in Rome. There he earned his doctor of divinity degree. He was ordained to the priesthood in 1899, and served as a curate in Tottenham, before becoming first rector of Westminster Cathedral Choir School. He was also a chaplain at the Cathedral, and to St. Wilfrid’s Convent, Chelsea.

In 1910, Aveling obtained a doctor of philosophy degree at the age of 35 from the University of Louvain (his advisor was Albert Michotte), and in 1912 he was recipient of a doctor of science degree from the University of London, and received the Carpenter Medal following his work On the Consciousness of the Universal and the Individual: A Contribution to the Phenomenology of the Thought Process. Subsequently, Aveling received his doctor of letters degree from the University of London.

Career

Aveling taught at University College, London from 1912 as a Lecturer (Assistant Professor), under the leadership of Charles Spearman, until the First World War. During that war he served in France as a chaplain in the British Army, after which he returned to the University of London. In 1922, he transferred to King’s College, London where he was promoted to reader (associate professor), and later to professor of psychology. He was an extern examiner in philosophy at the National University of Ireland; and a lecturer in pedagogical methods for the London County Council.

Aveling authored several books. He was the doctoral advisor of Raymond Cattell From 1926 until 1929, Aveling was also a president of the British Psychological Society. Aveling was a member of the Council of the International Congresses, of the Aristotelian Society, of the council and advisory board of the National Institute of Industrial Psychology, of the council of the British Institute of Philosophical Studies and of the Child Guidance Council.

He was a contributor to the Dublin Review, The American Catholic Quarterly Review, Catholic World, The nineteenth Century, The Journal of Psychology, and the Catholic Encyclopaedia.

Karl Abraham

Karl Abraham (03 May 1877 to 25 December 1925) was an influential German psychoanalyst, and a collaborator of Sigmund Freud, who called him his ‘best pupil’.

Abraham was born in Bremen, Germany. His parents were Nathan Abraham, a Jewish religion teacher (1842-1915), and his wife (and cousin) Ida (1847-1929). His studies in medicine enabled him to take a position at the Burghölzli Swiss Mental Hospital, where Eugen Bleuler practiced. The setting of this hospital initially introduced him to the psychoanalysis of Carl Gustav Jung.

In 1907, he had his first contact with Sigmund Freud, with whom he developed a lifetime relationship. Returning to Germany, he founded the Berliner Society of Psychoanalysis in 1910. He was the president of the International Psychoanalytical Association from 1914 to 1918 and again in 1925.

Karl Abraham collaborated with Freud on the understanding of manic-depressive illness, leading to Freud’s paper on ‘Mourning and Melancholia’ in 1917. He was the analyst of Melanie Klein during the years 1924-1925, and of a number of other British psychoanalysts, including Edward Glover and Alix Strachey. He was a mentor for an influential group of German analysts, including Karen Horney, Helene Deutsch, and Franz Alexander.

Karl Abraham studied the role of infant sexuality in character development and mental illness and, like Freud, suggested that if psychosexual development is fixated at some point, mental disorders will likely emerge. He described the personality traits and psychopathology that result from the oral and anal stages of development (1921).

Abraham observed his only daughter, Hilda, reporting on her reaction to enemas and infantile masturbation by her brother. He asked that secrets be shared with him but he was careful to respect her privacy and some reports were not published until after Hilda’s death. Hilda was later to become a psychoanalyst.

In the oral stage of development, the first relationships children have with objects (caretakers) determine their subsequent relationship to reality. Oral satisfaction can result in self-assurance and optimism, whereas oral fixation can lead to pessimism and depression. Moreover, a person with an oral fixation will present a disinclination to take care of him/herself and will require others to look after him/her. This may be expressed through extreme passivity (corresponding to the oral benign suckling substage) or through a highly active oral-sadistic behaviour (corresponding to the later sadistic biting substage).

In the anal stage, when the training in cleanliness starts too early, conflicts may result between a conscious attitude of obedience and an unconscious desire for resistance. This can lead to traits such as frugality, orderliness and obstinacy, as well as to obsessional neurosis as a result of anal fixation (Abraham, 1921). In addition, Abraham based his understanding of manic-depressive illness on the study of the painter Segantini: an actual event of loss is not itself sufficient to bring the psychological disturbance involved in melancholic depression. This disturbance is linked with disappointing incidents of early childhood; in the case of men always with the mother (Abraham, 1911). This concept of the prooedipal “bad” mother was a new development in contrast to Freud’s oedipal mother and paved the way for the theories of Melanie Klein (May-Tolzmann, 1997).

Another important contribution is his work “A short study of the Development of the Libido”, where he elaborated on Freud’s “Mourning and Melancholia” (1917) and demonstrated the vicissitudes of normal and pathological object relations and reactions to object loss.

Moreover, Abraham investigated child sexual trauma and, like Freud, proposed that sexual abuse was common among psychotic and neurotic patients. Furthermore, he argued (1907) that dementia praecox is associated with child sexual trauma, based on the relationship between hysteria and child sexual trauma demonstrated by Freud.

Abraham (1920) also showed interest in cultural issues. He analysed various myths suggesting their relation to dreams (1909) and wrote an interpretation of the spiritual activities of the Egyptian monotheistic Pharaoh Amenhotep IV (1912).

Abraham died prematurely on 25 December 1925, from complications of a lung infection and may have suffered from lung cancer.

On This Day … 22 December

People (Deaths)

  • 1902 – Richard von Krafft-Ebing, German-Austrian psychiatrist and author (b. 1840).

Richard von Kraft-Ebing

Richard Freiherr von Krafft-Ebing (full name Richard Fridolin Joseph Freiherr Krafft von Festenberg auf Frohnberg, genannt von Ebing; 1840-1902) was a German psychiatrist and author of the foundational work Psychopathia Sexualis (1886).

Krafft-Ebing was born in 1840 in Mannheim, Germany. He studied medicine at the University of Heidelberg, where he specialised in psychiatry. He later practiced in psychiatric asylums. After leaving his work in asylums, he pursued a career in psychiatry, forensics, and hypnosis.

He died in Graz in 1902. He was recognised as an authority on deviant sexual behaviour and its medicolegal aspects.

What is Pyridotriazolodiazepine?

Introduction

A pyridotriazolodiazepine is a heterocyclic compound containing pyridine and triazole rings fused to a diazepine ring.

Background

Pyridotriazolodiazepines forms the central structure of zapizolam. Zapizolam is poorly researched, but probably it is a sedative and/or anxiolytic, like other benzodiazepine derivatives, especially triazolobenzodiazepines (such as alprazolam).

What is the World Health Organisation Collaborating Centre?

Introduction

World Health Organisation collaborating centres are institutions that work with the World Health Organisation (WHO) in disciplines such as occupational health, food safety, and communicable disease prevention.

Overview

There are over 700 such centres across 80 countries. Collaborating centres may be research institutes, parts of universities, or academies. The participating institutions partner with WHO to perform research, provide training, or offer other services in furthering the WHO health agenda. These partners are designated by the WHO director-general as a part of a collaborative network. By using networks of established organisations, WHO is able to strengthen the scientific validity of its work and lower the costs of research.

Centres Worldwide

The WHO has established networks related to a variety of health topics. For example, WHO has put in place centres focused on organ transplants, hearing loss prevention, hepatitis, leprosy, medical ethics, and maternal health. To move the work forward, WHO has numerous designated centres in each inhabited continent. The network of centres for reference and research on influenza draws upon resources from Japan, the United States, the United Kingdom, and Australia. The network of WHO collaborating centres in occupational health is chaired by Dr. John Howard, director of the US National Institute for Occupational Safety and Health, and contains more than 60 designated organisations from across the globe.

The WHO Collaborating Centre on Global Governance of Antimicrobial Resistance has been working on the Coronavirus disease 2019 and is directed by Steven Hoffman.

What was the National Survey of Mental Health and Wellbeing?

Introduction

The 2007 National Survey of Mental Health and Wellbeing (NSMHWB) was designed to provide lifetime prevalence estimates for mental disorders.

Purpose

To gain statistics on key mental health issues including the prevalence of mental disorders, the associated disability, and the use of services.

As such the NSMHWB was a national epidemiological survey of mental disorders that used similar methodology to the NCS. It aimed to answer three main questions:

  1. How many people meet DSM-IV and ICD-10 diagnostic criteria for the major mental disorders?
  2. How disabled are they by their mental disorders? and
  3. How many have seen a health professional for their mental disorder?

Background

Respondents were asked about experiences throughout their lifetime. In this survey, 12-month diagnoses were derived based on lifetime diagnosis and the presence of symptoms of that disorder in the 12 months prior to the survey interview. Assessment of mental disorders presented in this publication are based on the definitions and criteria of the World Health Organisation’s (WHO) International Classification of Diseases, Tenth Revision (ICD-10). Prevalence rates are presented with hierarchy rules applied (i.e. a person will not meet the criteria for particular disorders because the symptoms are believed to be accounted for by the presence of another disorder).

Results

  • Among the 16,015,300 people aged 16-85 years, 45% (or 7,286,600 people) had a lifetime mental disorder (i.e. a mental disorder at some point in their life).
  • More than half (55% or 8,728,700 people) of people had no lifetime mental disorders.
  • Of people who had a lifetime mental disorder:
    • 20% (or 3,197,800 people) had a 12-month mental disorder and had symptoms in the 12 months prior to the survey interview; and
    • 25% (or 4,088,800 people) had experienced a lifetime mental disorder but did not have symptoms in the 12 months prior to the survey interview.

Prevalence of 12-Month Mental Health Disorders

Prevalence of mental disorders is the proportion of people in a given population who met the criteria for diagnosis of a mental disorder at a point in time

  • Among the 3,197,800 people (or 20% of people) who had a 12-month mental disorder and had symptoms in the 12 months prior to interview:
    • 14.4% had a 12-month Anxiety disorder (includes Panic disorder (2.6%); Agoraphobia (2.8%); Social Phobia (4.7%); Generalised Anxiety Disorder (2.7%); Obsessive-Compulsive Disorder (1.9%); and Post-Traumatic Stress Disorder (6.4%))
    • 6.2% had a 12-month Affective disorder (includes Depressive Episode (4.1%) (includes severe, moderate and mild depressive episodes); Dysthymia (1.3%); and Bipolar Affective Disorder (1.8%)), and
    • 5.1% had a 12-month Substance Use Disorder (includes Alcohol Harmful Use (2.9%); Alcohol Dependence (1.4%); and Drug Use Disorders (includes harmful use and dependence) (1.4%)).
  • Note that a person may have had more than one mental disorder.
    • The components when added may therefore not add to the total shown.
    • Includes Severe Depressive Episode, Moderate Depressive Episode, and Mild Depressive Episode.
    • Includes Harmful Use and Dependence.

There were 3.2 million people who had a 12-month mental disorder. In total, 14.4% (2.3 million) of Australians aged 16-85 years had a 12-month Anxiety disorder, 6.2% (995,900) had a 12-month Affective disorder and 5.1% (819,800) had a 12-month Substance Use disorder.

Women experienced higher rates of 12-month mental disorders than men (22% compared with 18%). Women experienced higher rates than men of Anxiety (18% and 11% respectively) and Affective disorders (7.1% and 5.3% respectively). However, men had twice the rate of Substance Use disorders (7.0% compared with 3.3% for women).

The prevalence of 12-month mental disorders varies across age groups, with people in younger age groups experiencing higher rates of disorder. More than a quarter (26%) of people aged 16-24 years and a similar proportion (25%) of people aged 25-34 years had a 12-month mental disorder compared with 5.9% of those aged 75-85 years old.

You can read the full survey results here and a shorter analysis can be found here.

On This Day … 21 December

People (Deaths)

  • 1948 – Władysław Witwicki, Polish psychologist, philosopher, translator, historian (of philosophy and art) and artist (b. 1878).

Wladyslaw Witwicki

Władysław Witwicki (30 April 1878 to 21 December 1948) was a Polish psychologist, philosopher, translator, historian (of philosophy and art) and artist. He is seen as one of the fathers of psychology in Poland.

Witwicki was also the creator of the theory of cratism, theory of feelings, and he dealt with the issues of the psychology of religion, and the creation of secular ethics. He was one of the initiators and co-founders of Polish Philosophical Society. He is one of the thinkers associated with the Lwów-Warsaw school.

What is the WHO Assessment Instrument for Mental Health Systems?

Introduction

The World Health Organisation Assessment Instrument for Mental Health Systems (WHO-AIMS) is a new WHO tool for collecting essential information on the mental health system of a country or region.

Purpose

The goal of collecting this information is to improve mental health systems and to provide a baseline for monitoring the change.

What is WHO-AIMS?

WHO-AIMS is a WHO tool for collecting essential information on the mental health system of a country or region. The goal of collecting this information is to improve mental health systems and to provide a baseline for monitoring the change.

For the purpose of WHO-AIMS, a mental health system is defined as all the activities whose primary purpose is to promote, restore or maintain mental health. WHO-AIMS is primarily intended for assessing mental health systems in low and middle income countries, but is also a valuable assessment tool for high resource countries.

Note: Great care has been taken to ensure the reliability of the data presented in the WHO-AIMS country reports. Data for WHO-AIMS are collected by a team led by a focal point within the country and are, in most cases, approved by the Ministry of Health. However, since WHO is not directly responsible for the data collection, WHO cannot independently verify the accuracy of any of the data presented in these reports.

WHO-AIMS Instrument, Version 2.2

You can find country reports, sub-regional reports, and other reports here (Pan American Health Organisation (PAHO) site).

What is the Mental Health Gap Action Programme (mhGAP)?

Introduction

The World Health Organisation (WHO) Mental Health Gap Action Programme (mhGAP) aims at scaling up services for mental, neurological and substance use disorders for countries especially with low- and middle-income.

Background

Mental, neurological, and substance use disorders are common in all regions of the world, affecting every community and age group across all income countries. While 14% of the global burden of disease is attributed to these disorders, most of the people affected – 75% in many low-income countries – do not have access to the treatment they need.

As such, the programme asserts that with proper care, psychosocial assistance and medication, tens of millions could be treated for depression, schizophrenia, and epilepsy, prevented from suicide and begin to lead normal lives – even where resources are scarce.

The following overview is from the WHO ‘mhGAP Mental Health Gap Programme: Scaling Up Care for Mental, Neurological, and Substance Use Disorders’ published on 01 January 2008:

Mental, neurological and substance use disorders are highly prevalent and burdensome globally. The gap between what is urgently needed and what is available to reduce the burden is still very wide.

WHO recognizes the need for action to reduce the burden, and to enhance the capacity of Member States to respond to this growing challenge. mhGAP is WHO’s action plan to scale up services for mental, neurological and substance use disorders for countries especially with low and lower middle incomes. The priority conditions addressed by mhGAP are: depression, schizophrenia and other psychotic disorders, suicide, epilepsy, dementia, disorders due to use of alcohol, disorders due to use of illicit drugs, and mental disorders in children. The mhGAP package consists of interventions for prevention and management for each of these priority conditions.

Successful scaling up is the joint responsibility of governments, health professionals, civil society, communities, and families, with support from the international community. The essence of mhGAP is building partnerships for collective action. A commitment is needed from all partners to respond to this urgent public health need and the time to act is now!

References/Further Reading

WHO mhGAP Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological, and Substance Use Disorders (WHO site; published 01 January 2008).

Outline of the Mental Health Gap Action Programme (mhGAP) (WHO site).

Clinical Review: WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: A Systematic Review of Evidence from Low and Middle-Income Countries (BMJ Journals: Evidence-Based Mental Health).