Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people

Objectives: Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness.

Method: Single group pre-test–post-test design.

Results: The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up.

Conclusions: The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.     

Knowledge and attitude towards suicide among medical students in Japan: preliminary study

Japan has one of the highest suicide rates in the world. Suicides numbered 32,863 in 1998 and have exceeded 30,000 in every subsequent year. Education of those involved in general and psychosocial patient care can contribute greatly to suicide prevention. The authors administered a brief knowledge and attitude assessment questionnaire concerning suicide to students in their first, third, and fifth years at a Japanese medical school. Participants numbered 160 (94 men with a mean age of 21.8 years, SD = 3.01, and 66 women with a mean age of 21.2 years, SD = 2.64); 59 first year, 52 third year, and 49 in their fifth year. The questionnaire consists of eight multiple-choice questions asking knowledge of suicide and one open-ended question asking attitude. In the knowledge part, only about half of the items were answered correctly (mean score was 4.21, SD = 1.28). A significant difference was observed in prevalence of attitudes as categorical variables between student years (P = 0.001). Sympathetic comments increased along with student years, while critical comments decreased. Given the frequent and interventional opportunities of primary-care medical contacts, poor understanding of suicide from the medical viewpoint was of concern. Moreover, judgmental attitudes were common, especially in earlier school years. Better informed, more understanding physicians and other health professionals could contribute greatly to prevention.     

Increasing rates of suicide in Western Australian psychiatric patients: a record linkage study.

OBJECTIVE: To investigate the risk of suicide following contact with mental health services and whether it has changed over time. METHOD: Record linkage was used to obtain the records of previous hospital admissions and mental health service contacts for deaths due to suicide in the period 1980-98. Standardized incidence rates were calculated for the general population and for users of mental health services. Proportional hazards regression was used to assess risk factors within the cohort of people with mental health service contact. RESULTS: Suicide risk was significantly increased in users of mental health services (rate ratio 6.66 in males and 7.52 in females). Suicide risk was highest in the first 7 days after discharge from in-patient care, and decreased exponentially with time since discharge. Suicide risk in users of mental health services has increased over the study period. CONCLUSION: These results highlight the importance of adequate follow-up of patients discharged from in-patient services, and the need for adequate resources for community-based services.     

Views on suicide among middle-aged and elderly populations in Japan: their association with demographic variables and feeling shame in seeking help

Aims: The purpose of this study was to investigate the relationship between inappropriate views on suicide, such as it being a personal choice, inevitable, unpreventable, and permissible, with demographic variables and the feeling of shame in seeking help among the general population. Methods: A self‐administered questionnaire on mental health and suicide was distributed to all residents aged 40–74 in four areas in Oita Prefecture, Japan, and 4487 responded. The association of seven inappropriate views on suicide with demographic variables was examined by multiple logistic analyses. The association between feeling shame in seeking help with demographic variables and the above views on suicide was similarly analyzed. Results: Inappropriate views on suicide were associated with gender (i.e. men). Some of these views also correlated with age, never having been married, and living in rural areas or areas with high suicide mortality rates. Multivariate analysis revealed that feeling shame in seeking help when distressed was associated with being aged 70–74, living in rural areas or areas with high suicide mortality rates, the view on suicide as a matter of self‐choice, and a pessimistic view toward life. Conclusion: These findings suggest that inappropriate views on suicide adversely affect coping strategies and mental health. Suicide prevention programs aimed at improving mental health literacy in a community should take into consideration the characteristics of elderly male residents.     

Decrease in suicide among the individuals treated with antidepressants: a controlled study of antidepressants in suicide,Sweden 1995–2005

Objective: Ecological studies have demonstrated a substantial decrease in suicide in parallel with an increase in the use of antidepressants. Causality cannot, however, be inferred from such studies. The aim of this study was to test on the individual level the hypothesis that treatment with antidepressant medication has been a substantially contributing cause of the decrease in suicide. Method: Time trends in the detection of antidepressants and five ‘control medications’ in the forensic toxicological screening of 16 937 suicides and 33 426 controls in Sweden 1995–2005. Results: The expected number of antidepressant‐positive suicides in 2005 was 409 if the hypothesis was true and 603 if it was false. The observed number in 2005 was 420. The control medications were detected to the extent that was expected if not preventing suicide. Conclusion: The observed trend in the number of suicides with antidepressants was well predicted by the hypothesis that the increased use of antidepressants has been a substantially contributing cause of the decrease in suicide.     

The use and perceived helpfulness of self‐help interventions for depressive symptoms and sub‐threshold depression: comparisons among the general population,patients with depression,and psychiatrists

The aim of this study was to examine the patterns of use and perceived helpfulness of self‐help interventions for depressive symptoms and sub‐threshold depression in Korean samples drawn from the general population, patients with depression, and psychiatrists. A total of 1000 adults from the community, 114 patients with sub‐threshold or mild depression, and 201 psychiatrists were asked to complete questionnaires about the use and helpfulness of 20 self‐help interventions for depression chosen via the Delphi method. Psychiatrists (82.6%) and the general population (67.2%) were more likely to prefer self‐help methods than were patients with depressive disorders (28.4%). Lifestyle change and psychological approaches were the preferred interventions among those with depressive disorders. Although the general population was more likely to prefer to use health supplements and dietary interventions, the perceived helpfulness of these approaches was generally lower than that of the other interventions. Although self‐help strategies have been widely used, psychiatrists, patients with depression, and the general population differ with respect to their preferred intervention. Members of the general population were more likely than were psychiatrists and patients to use not consensually accepted interventions. The evidence‐based use of self‐help strategies for depression should be promoted by providing information about their effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.