A Review of: “Losing a Parent to Death in the Early Years: Guidelines for the Treatment of Traumatic Bereavement in Infancy and Early Childhood by Alicia F. Lieberman,Nancy C. Compton,Patricia Van Horn,and Chandra Ghosh Ippen”

Abstract

This article addresses the need for improved clergy-mental health professional collaboration in the assessment and treatment of elderly suicide. Millions of older adults with personal problems seek the counsel of clergy. A recent Gallup survey found that elders are more willing to turn to their clergy than their medical doctor or a mental health specialist for help when a friend is contemplating suicide (Gallup Organization, 1992). Elder suicide prevention presents the mental health and religious communities with unique opportunities to work together in the best interests of those they serve.     

Attitudes toward suicide among mental health professionals

The Suicide Opinion Questionnaire (SOQ) and the Recognition of Suicide Lethality (RSL) scale were administered to 141 mental health professionals representing seven groups: family practice physicians, psychiatrists, psychologists, psychiatric nurses and aides, social workers, crisis line workers, and clergy. The results indicate significant differences among groups on 5 of the 15 SOQ factors, on a clinically derived empathic understanding scale, and on the RSL. Major findings of the study include: (a.) the complexity of attitudes towards suicide; (b) substantial differences between clergy and other mental health professionals; (c) differences between physicians and psychologists on attribution of manipulative motivation to suicide attempts; (d) a relationship between attitudes and personal familiarity with suicide; (t) an ordering of professional groups on the Empathic Understanding Scale reflecting psychological, medical, or religious training; (i) group differences on the recognition of suicide lethality signs; and (g) a relationship between knowledge of lethality and several attitudinal factors.     

Attitudes toward suicide among mental health professionals

Abstract

The Suicide Opinion Questionnaire (SOQ) and the Recognition of Suicide Lethality (RSL) scale were administered to 141 mental health professionals representing seven groups: family practice physicians, psychiatrists, psychologists, psychiatric nurses and aides, social workers, crisis line workers, and clergy. The results indicate significant differences among groups on 5 of the 15 SOQ factors, on a clinically derived empathic understanding scale, and on the RSL. Major findings of the study include: (a.) the complexity of attitudes towards suicide; (b) substantial differences between clergy and other mental health professionals; (c) differences between physicians and psychologists on attribution of manipulative motivation to suicide attempts; (d) a relationship between attitudes and personal familiarity with suicide; (t) an ordering of professional groups on the Empathic Understanding Scale reflecting psychological, medical, or religious training; (i) group differences on the recognition of suicide lethality signs; and (g) a relationship between knowledge of lethality and several attitudinal factors.     

Perceived suicide stigma,secrecy about suicide loss and mental health outcomes

Abstract

Perceived suicide stigma and consequent secrecy about suicide loss could contribute to impaired mental health among suicide loss survivors. Using online survey data from 195 suicide loss survivors, higher perceived suicide stigma was associated with more grief difficulties, higher suicidality, and less personal growth. Secrecy partly mediated the association between perceived suicide stigma and grief difficulties as well as suicidality and completely mediated the association between perceived suicide stigma and personal growth. Our findings suggest that supporting suicide loss survivors in coping with perceived suicide stigma could reduce secrecy about suicide loss and by this improve their mental health outcomes.     

American Academy of Nursing Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health,substance use disorders,and nurse suicide

Rates of nurse mental health and substance use disorders are high. Heightened by the COVID-19 pandemic, nurses are challenged to care for patients in ways that often jeopardize their own health and increase risks for their families. These trends exacerbate the epidemic of suicide in nursing underscored by several professional organization clarion calls to nurses’ risk. Principles of health equity and trauma-informed care dictate urgent action. The purpose of this paper is to establish consensus among clinical and policy leaders from Expert Panels of the American Academy of Nursing about actions to address risks to mental health and factors contributing to nurse suicide. Recommendations for mitigating barriers drew from the CDC's 2022 Suicide Prevention Resource for Action strategies to guide the nursing community to inform policy, education, research, and clinical practice with the goals of greater health promotion, risk reduction, and sustainment of nurses’ health and well-being are provided.     

Clergy's attitudes toward suicide and recognition of suicide lethality

Five groups of clergy (Protestant ministers, Catholic priests, Jewish rabbi, Eastern religious leaders, and nontraditional ministers; N = 112) were administered a scale to assess their knowledge of suicide lethality (the Recognition of Suicide Lethality) and a suicide attitudinal questionnaire (the Suicide Opinion Questionnaire), scored on 15 factors. Significant group differences were obtained for the RSL scale and seven of the SOQ factors, and significant correlations were obtained between RSL scores and ten SOQ factors. The results indicate that clergy as a group are not able to recognize signs of suicide lethality any better than educated laypersons, and that such recognition is related to a cluster of attitudes, including that suicide is more reflective of personal dynamics rather than external factors.     

'They first killed his heart (then) he took his own life'. Part 1: a review of the context and literature on mental health issues for refugees and asylum seekers

This is the first in a two-part series of papers examining mental health issues for refugees and asylum seekers. Beginning with the suicide of an asylum seeker in Scotland, the paper emphasizes mental health issues for adult and child asylum seekers, stress and memory, suicide, self-harm, risk and protective factors, compulsory health treatments and the prevention of mental illness. It sets the scene for the second paper by drawing implications for nursing practice in the community. Although most literature on refugee and asylum seeker mental health exists outside of nursing scholarship, a majority of the issues reviewed in this paper are mutual challenges for all in the health and helping professions. Nurses interested in refugee and migration issues face two intertwined challenges: that of how to assist migrants with their diverse mental health needs and how, at the same time, to contribute to a society that can promote mental health for all by taking on both the difficulties and opportunities posed by cultural diversity.     

Clergy's attitudes toward suicide and recognition of suicide lethality

Abstract

Five groups of clergy (Protestant ministers, Catholic priests, Jewish rabbi, Eastern religious leaders, and nontraditional ministers; N = 112) were administered a scale to assess their knowledge of suicide lethality (the Recognition of Suicide Lethality) and a suicide attitudinal questionnaire (the Suicide Opinion Questionnaire), scored on 15 factors. Significant group differences were obtained for the RSL scale and seven of the SOQ factors, and significant correlations were obtained between RSL scores and ten SOQ factors. The results indicate that clergy as a group are not able to recognize signs of suicide lethality any better than educated laypersons, and that such recognition is related to a cluster of attitudes, including that suicide is more reflective of personal dynamics rather than external factors.     

Rebuilding post-suicide interventions from a caring ethics perspective

Suicide has become a critical mental health problem in Taiwan. Most studies on the issue are related to suicide rates and risk factors, and their relationships with mental illnesses. These findings help health professionals to understand what life might have been like for a suicide victim before the suicide, but not what life is like after a suicide attempt; how to detect the possibility of a subsequent suicide attempt, rather than how to help people who have attempted suicide to construct a good life. The purpose of this article is to encourage nurses to engage in dialogue with suicidal patients by understanding their explanatory models and by self-reflection. This not only enables suicidal patients to move from shame toward taking responsibility for themselves and others, but also enables nurses to rebuild their experiential knowledge.     

Relationships between suicide attitudes and indicators of mental health among adolescents

A growing body of research literature suggests a relationship between mental health status and attitudes toward suicide among adolescents. This paper reports two studies which explored opposite ends of the mental health continuum as they relate to suicide attitudes among young people. The first study compared attitudes toward suicide between a group of institutionalized 15-24 year olds and a group of college students. The second study assessed suicide attitudes among a group of college students with differing levels of mental health. Two major findings of these studies were that (a) young women with mental health problems severe enough to require institutionalization agree more with all reasons for suicide than do institutionalized males or males and females in a non-institutionalized group, and (b) students who score higher on one measure of self-actualization (inner-directedness) sympathize, empathize, and agree less with all reasons for suicide than do students who score lower on the same measure. Gender, and, to some extent, sex roles were found to be influential in determining sympathetic attitudes toward suicide. Females and feminine males sympathize more than other groups with all reasons for suicide, while males and masculine females sympathize less. The findings are discussed from mental health and sex roles perspectives.     

Relationships between suicide attitudes and indicators of mental health among adolescents

Abstract

A growing body of research literature suggests a relationship between mental health status and attitudes toward suicide among adolescents. This paper reports two studies which explored opposite ends of the mental health continuum as they relate to suicide attitudes among young people. The first study compared attitudes toward suicide between a group of institutionalized 15–24 year olds and a group of college students. The second study assessed suicide attitudes among a group of college students with differing levels of mental health. Two major findings of these studies were that (a) young women with mental health problems severe enough to require institutionalization agree more with all reasons for suicide than do institutionalized males or males and females in a non-institutionalized group, and (b) students who score higher on one measure of self-actualization (inner-directedness) sympathize, empathize, and agree less with all reasons for suicide than do students who score lower on the same measure. Gender, and, to some extent, sex roles were found to be influential in determining sympathetic attitudes toward suicide. Females and feminine males sympathize more than other groups with all reasons for suicide, while males and masculine females sympathize less. The findings are discussed from mental health and sex roles perspectives.     

Suicide,mental, and physical health condition stigma in medical students

Abstract

The current study aimed to compare the personal stigma of suicide with the personal stigma for other mental and physical health conditions. 116 Australian medical students (58% women), aged between 20 and 41?years (M?=?25.02, SD?=?3.80), completed an online survey. Suicide was more highly stigmatized than most of the other mental and physical health conditions in both attitudes toward suicide and willingness to disclose. The current study highlights the need for further medical student education in suicide, as ongoing negative attitudes could negatively affect patient care and disclosure.     

Telematic technologies in mental health caring: a web-based psychoeducational program for adolescent suicide survivors

A significant other's completed suicide elicits complex physical, psychological, and social reactions in most suicide survivors. At present, mental health professionals and other caregivers have limited access to clear information and guidelines to meet the postvention needs of these individuals. Telematic technologies offer innovative and creative resources to address their needs by means of a web-based psychoeducational program. The development of a comprehensive web-based program that deals with the lived experiences of adolescent suicide survivors is described. Potential program users include adolescent suicide survivors, social supporters of suicide survivors, mental health professionals and survivor support groups.     

Suicide prevention in mental health services: A qualitative analysis of coroners’ reports

Suicide is a major concern for mental health nurses because of its clear correlation with mental illness. In New Zealand, coroners investigate all deaths that appear to be a result of suicide, and provide reports to mental health services (MHS). The aim of the present study was to investigate coronial recommendations to MHS in relation to suicide prevention and to examine clinical and family responses to these. The present study was a three‐phase design: (i) analysis of coroners’ recommendations related to suicide in MHS; (ii) interviews with clinicians for their response to the recommendations; and (iii) interviews with individuals working with families of consumers of MHS for their responses in relation to family‐related recommendations. A qualitative content analysis was conducted on the recommendations from coroners, the interviews with clinical leaders, and the focus group for family workers. Coroners recommended that MHS should implement suicide‐prevention strategies that would facilitate improved communication, risk containment, service delivery, and family involvement. Clinicians agreed with most recommendations, apart from those related to risk containment. Family workers endorsed the coronial perspective that family inclusion in MHS was suboptimal. Coroners, MHS, and mental health nurses need to consider the latest clinical evidence for suicide prevention. However, given the complexity of factors that influence suicide, it is important to be realistic about MHS role in preventing suicide, but ensure that MHS provide interventions for which there is evidence, including facilitating family participation and providing access to psychotherapies.     

Ignoring the evidence dictating the practice: sexual orientation, suicidality and the dichotomy of the mental health nurse

International epidemiological studies demonstrate that gay and bisexual males are four times more likely to report a serious suicide attempt than their heterosexual counterparts. Data on completed suicides, usually derived from mortality statistics misrepresent the rate of suicides among homosexual populations. However, an increasing number of studies comparing representative samples of gay, lesbian and bisexual youths with heterosexual controls demonstrate increased rates of mental health problems and subsequent suicide among the homosexual population. Homosexual orientation must therefore be considered a risk factor for mental distress and as such should be a focus for any contemporary public health agenda. One of the difficulties of addressing the problem through a public health agenda is the juxtaposition proffered by our political and social environment. The Diagnostic and Statistical Manual of Mental Disorder ceased to define homosexuality as pathological in 1973 replacing it with a new 'illness' of 'gender identity disorder'. Until recently in England, Section 28 of the Local Government Act (1988), forbidding the promotion of homosexuality, further reinforced negativity towards this group of people. This compounded the negative mental health consequences for those developing a gay sexual orientation in a climate of heterosexism. Current health care policy in England concerns itself with the rising number of suicides among young people but fails to acknowledge the importance of the research findings relating to gay people by integrating them into the development of mental health policy. This paper reviews the literature relating to homosexual people and suicidality, and addresses the seriousness of a policy rhetoric which results from ignoring the evidence while dictating mental health nursing practice.     

Impact of suicide on health professionals in psychiatric care mental healthcare professionals' perceptions of suicide during ongoing psychiatric care and its impacts on their continued care work

People who attempt suicide as well as those who actually take their own life often have communicated their suicidal thoughts and feelings to healthcare professionals in some form. Suicidality is one of the most challenging caring situations and the impacts of suicide care affect both the professional and personal lives of healthcare professionals. This study investigates how mental health professionals perceive suicide while providing psychiatric care and how this perception impacts their continued care work. This qualitative exploratory study includes 19 mental health professionals in psychiatry who had provided care for patients who had taken their own life. Analysis followed the principle of phenomenography. The findings reveal that these healthcare professionals experienced an internal conflict that affected them both personally and professionally. In response to these conflicts, the healthcare professionals developed strategies that involved a safety zone and increased vigilance. Those who were able to commute and balance a safe spot and learning to be more vigilant seem to have developed as a result of patient's suicide. These findings have the potential to help establish a post‐suicide caring process where healthcare professionals learn to make better suicide assessments, become more open to talking about death with patients, and develop a humbler approach to understanding a patient's suicide.     

If I was going to kill myself, I wouldn't be calling you. I am asking for help: challenges influencing immigrant and refugee women's mental health

It is estimated that 37% of Canadians experience some types of mental health problem. As a result of the migration process, many immigrant and refugee women suffer serious mental illness such as depression, schizophrenia, posttraumatic stress disorder, suicide, and psychosis. The purpose of this exploratory qualitative study, informed by the ecological conceptual framework and postcolonial feminist perspectives, was to increase understanding of the mental health care experiences of immigrant and refugee women by acquiring information regarding factors that either support or inhibit coping. Ten women (five born in China and five born in Sudan) who were living with mental illness were interviewed. Analysis revealed that (a) women's personal experience with biomedicine, fear, and lack of awareness about mental health issues influences how they seek help to manage mental illness; (b) lack of appropriate services that suit their needs are barriers for these women to access mental health care; and (c) the women often draw upon informal support systems and practices and self-care strategies to cope with their mental illnesses and its related problems. The authors discuss implications for practice and make recommendations for intervention strategies that will facilitate women's mental health care and future research.     

Whose life is it anyway? An exploration of five contemporary ethical issues that pertain to the psychiatric nursing care of the person who is suicidal: Part two

ABSTRACT: This is the second of a two‐part paper which focuses on five principal issues/questions which can inform mental health nurses’ ethical discourse around the matter of suicide. This second part focuses on the questions: is there such a phenomenon as a rational or appropriate suicide? And what role, if any, should mental health nurses occupy in assisted suicide? We find that the relevant theoretical and ethical literature in this area suggests, at least for some, that there may very well be such a phenomenon as a rationale suicide, especially if the often cited myth that all people who complete suicide must ipso facto have a mental health problem, is scrutinized. Furthermore, the extant literature indicates that while for the majority of suicidal acts, mental disorders may be a necessary but not sufficient element; the suicidal process is not, however, synonymous with mental disorder phenomenology. Lastly, whether or not there is a role(s) for mental health nurses in assisted suicide is difficult to say because there is almost no indication in the literature that such views have been solicited and considered. Given mental health nurses’ often ‘front‐line’ involvement in care of the person who is suicidal, there is an urgent need to canvass these views and include them in the debate. Lastly, given the content of current mental health nurses Codes of Ethics and Professional Codes of Conduct, there may be a need to revisit these codes in light of contemporary and changing views of assisted suicide.     

急诊医护人员接诊自杀未遂患者心理体验的质性研究

目的 分析综合医院急诊医护人员接诊自杀未遂患者的心理体验,为临床制订相应的干预措施,完善自杀未遂患者心理健康服务提供参考与依据.方法 采用描述性现象学研究方法,于2019年12月1日—10日对湖北省2所综合医院有接诊自杀未遂患者经历的急诊医护人员进行半结构化深度访谈,采用Colaizzi 7步分析法分析资料.结果 急诊...