Child and adolescent suicide: contributing risk factors and new evidence-based interventions

Rufino, Katrina A.; Patriquin, Michelle A.

doi:10.1080/02739615.2019.1666009

Cited by 13 publications

(7 citation statements)

References 20 publications

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“…34 The increased risk for suicide associated with anxiety disorders, depressive disorders, and substance abuse is well known. 35,36 Because many individuals do not respond optimally to first-line treatments, which often include psychiatric medications, 37 children at end of life should be assessed and managed by a psychiatric specialty provider with expertise in selecting from available treatment options. We urge hospice and palliative care nurses to familiarize themselves with local psychiatric treatment resources and colleagues, to facilitate the process of psychiatric referral or ideally, to add a psychiatric clinician as a permanent part of the pediatric hospice and palliative care team.…”

Section: Discussionmentioning

confidence: 99%

Identifying Patterns of Pediatric Mental and Behavioral Health at End of Life

Svynarenko¹,

Beebe²,

Lindley³

2021

J Hosp Palliat Nurs

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Children, who enroll in hospice, have complex mental and behavioral health (MHBH) problems. There is limited literature on patterns of these problems among children at their end of life. Using the national database of 6195 children enrolled in hospice between January 1, 2011, and December 31, 2013, and latent class analysis, this study identified 4 distinctive classes of children. Neurodevelopment and anxiety class (26.5% of the sample) had 41.3% of children of 15 years or older, who had an average of 1.4 MHBH comorbidities and took 17 medications; 29.1% had physical health comorbidities, and 23% were dependent on technology. In the Behavior and Neurodevelopment class (20%), 53.1% of the children were between ages 6 and 14 years, who had an average of 2 MHBH comorbidities and took 17 medications. In the Physiology class (43.4%), 65.5% of children were younger than 5 years, had 1 MHBH comorbidity, and took 19 medications. In the Mood, Behaviors, and Anxiety class (10.2%), more than 90% of children were older than 6 years, had 4 MHBH comorbidities, and took 30 medications. In the latter 3 classes, approximately half of the children either had physical health comorbidities or were technology dependent. These findings highlight the importance of end-of-life care that accounts for the likely presence of complicated patterns of MHBH conditions.

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Section: Discussionmentioning

confidence: 99%

Identifying Patterns of Pediatric Mental and Behavioral Health at End of Life

Svynarenko¹,

Beebe²,

Lindley³

2021

J Hosp Palliat Nurs

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“…This study reported that early therapeutic contact and completing a safety plan may be warranted for CYP (Brent et al, 2009). More recently safety planning for CYP has been identified as a promising new approach (Rufino & Patriquin, 2019), but more research is required about this specific intervention and its impact on CYP (Drapeau, 2019). There is also a particular need for a systematic scoping review of the effectiveness of safety planning for CYP to better identify the complexities and/or challenges involved in the use of this intervention.…”

Section: Introductionmentioning

confidence: 97%

Suicide prevention: What does the evidence show for the effectiveness of safety planning for children and young people? – A systematic scoping review

Abbott-Smith

Ring

Dougall

et al. 2023

Psychiatric Ment Health Nurs

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Accessible SummaryWhat is known on the subject? Suicide prevention is an international healthcare priority. There is an urgent need to use approaches that are helpful and follow research evidence. Safety planning is now widely used in suicide prevention; however, it was developed for use with adults, and little is known about its effectiveness for children/young people. What the paper adds to existing knowledge? This systematic scoping review brings together all research evidence since 2008 that reported how effective safety planning is for children/young people. Findings highlight that when healthcare professionals help children/young people who are suicidal, they need to ensure that the safety plan is completed collaboratively with healthcare professionals and children/young people and that it is appropriate for their age and development. There is also need for healthcare professionals to better recognize and respond to the needs of parents/carers who are caring for a child/young person with suicidal ideations/behaviours. What are the implications for practice? There is some research indicating that safety planning is effective for use with children/young people, but such evidence has primarily been obtained from females and there is need for more evidence from male study populations. Further research on its use is needed for certain groups of children/young people including those who are care experienced, or identify as lesbian, gay, bisexual and transgender. This review highlighted that healthcare professionals need specific training before they deliver safety planning for children/young people. It was identified that parents/carers have additional needs and should be involved in safety planning. An additional resource specifically for parents/carers should be developed. AbstractIntroductionSuicide is a leading cause of death for children and young people and its prevention is a global priority. Many Mental Health Services employ safety planning as a brief intervention. There is some evidence of safety planning effectiveness for adults, but little is known about its effectiveness with young people.AimTo synthesize research reporting safety planning effectiveness for children/young people with suicidal ideation and identify good practice recommendations.Inclusion criteriaThe review relates to safety planning around suicide prevention for children/young people aged less than 18 years, even if it was within a wider intervention. The review was inclusive of all clinical areas (including mental health, primary care, etc), any geographical location or social economic status and inclusivity around the method of delivery.MethodsA systematic scoping review of literature reporting effectiveness data for the use of safety planning with children/young people with suicidal ideation. The systematic scoping review protocol (pre‐registered with Open Science Framework) followed Joanna Briggs Institute conduct guidance and PRISMA‐ScR checklist.Data analysis and presentationFifteen studies were reported during 2008–2021. Overall, there is promising, but limited, evidence of effectiveness for safety planning for children/young people but with complete evidence gaps for some demographic sub‐groups. Evidence determined that healthcare professionals should deliver a safety planning intervention that is completed collaboratively, developmentally appropriate, and recognizes parental/carer involvement.Discussion and implications for practiceFurther research is needed but current evidence suggests safety planning should be a routine part of care packages for children/young people with suicidal ideation proportionate to their needs. Developing/implementing these plans needs bespoke health professional training and additional support and resources for parents/carers should be developed.

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“…12 Specifically, in children and adolescents, general anxiety disorder was shown to be a risk factor for suicidal behavior. 13 In addition, people with anxiety disorders frequently have more difficulty regulating their emotions than those without such disorders. 14,15 Emotions promote behavioral responses, guide thinking in different situations, aid decision-making, facilitate motor responses, and govern interpersonal interactions, making them a prominent factor in psychological research.…”

mentioning

confidence: 99%

“…A study of over 7000 adults from The Netherlands showed that anxiety disorders were very common among those who reported suicidal behavior and that, after adjusting for comorbid mental health disorders, anxiety disorders were a risk factor for suicidal ideation and suicide attempts 12. Specifically, in children and adolescents, general anxiety disorder was shown to be a risk factor for suicidal behavior 13. In addition, people with anxiety disorders frequently have more difficulty regulating their emotions than those without such disorders 14,15…”

mentioning

confidence: 99%

Emotion Regulation Mediates the Relationship Between Therapeutic Alliance and Anxiety in Emerging Adults During Inpatient Psychiatric Treatment

Shepard

Rufino

Daza

et al. 2022

Journal of Psychiatric Practice

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Emerging adulthood is a critical developmental period characterized by emotional growth and unstructured living. To date, there is little research on emerging adults-defined as those 18 to 25 years old-with serious mental illnesses and even less on emerging adults in psychiatric hospitals. This study analyzed therapeutic alliance with the clinical team and change in anxiety symptoms in emerging adult psychiatric inpatients with the goal of establishing whether emotion regulation could serve as a mediator between these 2 constructs. Participants were 913 emerging adults (46.7% female; 18 to 25 y of age) who were voluntarily admitted to an intermediate length-of-stay (6 to 8 wk) inpatient psychiatric hospital. Each patient completed measures assessing anxiety symptoms, emotion regulation strategies, and working alliance as an assessment of therapeutic alliance. The results indicated that working alliance had significant indirect effects on change in anxiety symptoms through emotion dysregulation and lack of awareness, limited access to emotion regulation strategies, and lack of emotional clarity. This study emphasizes the need to understand emerging adults and the difficulties characteristic of this developmental period, and that clinicians should be aware that cognitive factors involved in emotion regulation may impact anxiety symptoms in emerging adult populations.

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Child and adolescent suicide: contributing risk factors and new evidence-based interventions

Cited by 13 publications

References 20 publications

Identifying Patterns of Pediatric Mental and Behavioral Health at End of Life

Identifying Patterns of Pediatric Mental and Behavioral Health at End of Life

Suicide prevention: What does the evidence show for the effectiveness of safety planning for children and young people? – A systematic scoping review

Emotion Regulation Mediates the Relationship Between Therapeutic Alliance and Anxiety in Emerging Adults During Inpatient Psychiatric Treatment

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