A Leader Suicide Risk Assessment Tool for Mitigating Risk Factors

Research Paper Title

Development of a Leader Tool for Assessing and Mitigating Suicide Risk Factors.

Background

Despite efforts in prevention, suicide rates in the US military remain unchanged. This article describes the development of a tool for leaders to identify and mitigate suicide risk factors.

Methods

A seven-item measure, the Leader Suicide Risk Assessment Tool (LSRAT), was constructed to allow leaders to assess and mitigate suicide drivers. During a 6-month pilot, unit leaders completed the LSRAT for 161 at-risk soldiers. The LSRAT data were compared to clinical data from a subset of these soldiers.

Results

The LSRAT showed good test-retest reliability. The LSRAT scores showed significant correlations with both clinical and screening measures of suicidality. Command actions mitigated or partially mitigated 89% of risk factors identified on the LSRAT.

Conclusions

This study provides initial psychometric data on a tool that prescribes concrete responses to mitigate risk. The LSRAT may be a valid and feasible tool to assist front-line commanders in identifying potential area’s risk mitigation. Synchronisation efforts between commanders, clinicians, and support services are crucial to ensure effective intervention to prevent suicide behaviour.

Reference

Hoyt, T., Repke, D., Barry, D., Baisley, M., Jervis, S., Black, R., McCreight, S., Prendergast, D., Brinton, C. & Amin, R. (2020) Development of a Leader Tool for Assessing and Mitigating Suicide Risk Factors. Military Medicine. 185(Suppl 1), pp.334-341. doi: 10.1093/milmed/usz194.

Dosed (2019)

Introduction

An award-winning documentary film about treating anxiety, depression and addiction with psychedelic medicine.

Outline

After years of prescription medications failed her a suicidal woman, Adrianne, turns to underground healers to try and overcome her depression, anxiety, and opioid addiction with illegal psychedelic medicine like magic mushrooms and iboga.

Production & Filming Details

  • Director(s): Tyler Chandler.
  • Producer(s): Robert J. Barnhart, Tyler Chandler, Jason Hodges, Kelley Hodges, Chris Mayerson, Nicholas Meyers, and Nick Soares.
  • Writer(s): Tyler Chandler, Nicholas Meyers, and Jessie Deeter (Story consultant).
  • Music: Jayme McDonald.
  • Cinematography: Nicholas Meyers.
  • Editor(s): Tyler Chandler and Nicholas Meyers.
  • Production: Golden Teacher Films.
  • Release Date: 20 March 2019 (US).
  • Running Time: 82 minutes.

What Haunts Us (2018)

Introduction

The 1979 class of Porter Gaud School in Charleston, South Carolina graduated 49 boys. Within the last 35 years, six of them have died by suicide.

Outline

When Paige Goldberg Tolmach gets word that another former student from her beloved high school has killed himself, she decides to take a deep dive into her past in order to uncover the surprising truth and finally release the ghosts that haunt her hometown to this day.

Production & Filming Details

  • Director(s): Paige Tolmach.
  • Producer(s): Sarah Gibson, James Huntsman, Andreas Olavarria, and Told Slater.
  • Music: Nathan Halpern.
  • Cinematography: Adam Dubrowa.
  • Editor(s): Derek Doneen and Allan Duso.
  • Production: Diamond Docs, Matt Tolmach Productions, and The Kennedy/Marshall Company.
  • Distributor(s): Blue Fox Entertainment.
  • Release Date: 24 February 2018 (Boulder International Film Festival) and 11 May 2018 (US, general release).
  • Running Time: 72 minutes.

Linking Risk of Suicidal Behaviour with Mental Disorders & Work Disability

Research Paper Title

Mental disorders and suicidal behavior in refugees and Swedish-born individuals: is the association affected by work disability?

Background

Among potential pathways to suicidal behavior in individuals with mental disorders (MD), work disability (WD) may play an important role.

The Researchers examined the role of WD in the relationship between MD and suicidal behaviour in Swedish-born individuals and refugees.

Methods

The study cohort consisted of 4,195,058 individuals aged 16-64, residing in Sweden in 2004-2005, whereof 163,160 refugees were followed during 2006-2013 with respect to suicidal behaviour.

Risk estimates were calculated as hazard ratios (HR) with 95% confidence intervals (CI).

The reference groups comprised individuals with neither MD nor WD.

WD factors (sickness absence (SA) and disability pension (DP)) were explored as potential modifiers and mediators.

Results

In both Swedish-born and refugees, SA and DP were associated with an elevated risk of suicide attempt regardless of MD. In refugees, HRs for suicide attempt in long-term SA ranged from 2.96 (95% CI: 2.14-4.09) (no MD) to 6.23 (95% CI: 3.21-12.08) (MD).

Similar associations were observed in Swedish-born. Elevated suicide attempt risks were also observed in DP.

In Swedish-born individuals, there was a synergy effect between MD, and SA and DP regarding suicidal behaviour.

Both SA and DP were found to mediate the studied associations in Swedish-born, but not in refugees.

Conclusions

There is an effect modification and a mediating effect between mental disorders and WD for subsequent suicidal behaviour in Swedish-born individuals.

Also for refugees without MD, WD is a risk factor for subsequent suicidal behaviour.

Particularly for Swedish-born individuals with MD, information on WD is vital in a clinical suicide risk assessment.

Reference

Björkenstam, E., Helgesson, M., Amin, R., Lange, T. & Mittendorfer-Rutz, E. (2020) Mental disorders and suicidal behavior in refugees and Swedish-born individuals: is the association affected by work disability? Social Psychiatry and Psychiatric Epidemiology. doi: 10.1007/s00127-019-01824-5. [Epub ahead of print].

Do Individuals who are Suicidal have Unusual Patterns of Brain Activity?

Individuals who are suicidal seem to have unusual patterns of brain activity.

The differences are not big enough to identify those who may try to kill themselves, however, the researchers hope it will provide them with more information about what may be happening in terms of brain mechanisms (Schmaal et al., 2019).

The finding comes from a review of 131 brain-scan studies, comprising more than 12,000 people. The study looked to see whether there are distinctive patterns of brain activity in those who had made suicide attempts or had been thinking about suicide.

Most of these studies compared individuals with a certain mental health condition, such as depression, who had a history of suicidal behaviour, with a similar group with that condition who had not become suicidal, or with individuals without mental health problems.

The researchers found that two brain networks appear to function differently:

  • The first of these involves areas at the front of the head known as the medial and lateral ventral prefrontal cortex and their connections to regions involved in emotion. This may lead to difficulties regulating emotions.
  • A second involves regions known as the dorsal prefrontal cortex and inferior frontal gyrus system, which play a role in decision making.

However, the differences in these networks may just reflect that individuals who are suicidal are in more distress, rather than indicating specific thoughts of suicide.

Reference

Wilson, C. (2019) Suicidal Behaviour Linked to Two Brain Networks. New Scientist. 07 December 2019, pp.16.

Schmaal, L>, van Harmelen, A-L., Chatzi, V., Lippard, E.T.C., Toenders, Y.J., Averill, L.A., Mazure, C.M. & Plumberg, H.P. (2019) Imaging suicidal thoughts and behaviors: a comprehensive review of 2 decades of neuroimaging studies. Molecular Psychiatry. 25, pp.408-427. https://www.nature.com/articles/s41380-019-0587-x

Suicide in Older Adults: A Critical Problem

Research Paper Title

Suicide in Older Adults.

Abstract

Suicide in older adults is a critical problem that nurses and other health professionals need to address. Evidence-based interventions for prevention of late-life suicide are urgently needed, as well as increased availability of health care professionals with knowledge and skills to recognise suicide risks and intervene to provide effective care for this vulnerable population.

Reference

Sorrell, J.M. (2020) Suicide in Older Adults. Journal of Psychosocial Nursing and Mental Health Services. 58(1), pp.17-20. doi: 10.3928/02793695-20191218-04.

Suicide in Older Adults: Intervention Required

Research Paper Title

Suicide in Older Adults.

Abstract

Suicide in older adults is a critical problem that nurses and other health professionals need to address.

Evidence-based interventions for prevention of late-life suicide are urgently needed, as well as increased availability of health care professionals with knowledge and skills to recognise suicide risks and intervene to provide effective care for this vulnerable population.

Reference

Sorrell, J.M. (2020) Suicide in Older Adults. Journal of Psychosocial Nursing and Mental Health Services. 58(1), pp.17-20. doi: 10.3928/02793695-20191218-04.