Health services and suicide prevention

Kapur, Navneet

doi:10.1080/09638230802370704

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…This study confirms that a significant proportion of Irish prisoners present with a current psychotic or major affective disorder, which are potentially treatable mental illnesses. From a clinical view point, effective treatment of mental illness may reduce morbidity as well as potentially reduce mortality through suicide (Kapur, 2009), and potentially impact recidivism rates (Lovell et al 2002). This finding strengthens the argument for the development of diversion services which, to date, are geographically variable and still evolving in Ireland (Gulati & Kelly, 2018).…”

Section: Discussionmentioning

confidence: 61%

The prevalence of major mental illness, substance misuse and homelessness in Irish prisoners: systematic review and meta-analyses

Gulati

Keating

O’Neill

et al. 2018

Ir. j. psychol. Med.

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AimsTo systematically review studies from Irish prisons that estimate the prevalence of major mental illness, alcohol and substance misuse, and homelessness at the time of committal.MethodsHealthcare databases were searched for studies quantifying the point prevalence for each outcome of interest. Searches were augmented by scanning of bibliographies and searches of governmental and non-governmental websites. Proportional meta-analyses were completed for each outcome.ResultsWe found eight, six and five studies quantifying the point prevalence of major mental illness, substance misuse, and homelessness respectively. Considerable heterogeneity was found for each subgroup (except psychosis where substantial heterogeneity was observed) and random effects models were used to calculate pooled percentages. The pooled percentage for psychotic disorder was 3.6% [95% confidence interval (CI) 3.0–4.2%], for affective disorder 4.3% (95% CI 2.1–7.1%), for alcohol use disorder 28.3% (95% CI 19.9–37.4%), for substance use disorder 50.9% (95% CI 37.6–64.2%) and for those who were homeless on committal 17.4% (95% CI 8.7–28.4%).ConclusionsEstimates for the prevalence of psychotic illness and substance abuse amongst Irish prisoners are in keeping with international estimates of morbidity in prisons, whilst those for affective disorders are lower. The prevalence of homelessness in committal to Irish prisons is higher than some international estimates. Rates for psychoses, alcohol and substance misuse as well as homelessness in Irish prisons are significantly higher than the general population prevalence of these vulnerabilities. A need for service development is discussed.

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Section: Discussionmentioning

confidence: 61%

The prevalence of major mental illness, substance misuse and homelessness in Irish prisoners: systematic review and meta-analyses

Gulati

Keating

O’Neill

et al. 2018

Ir. j. psychol. Med.

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“…An estimated 220,000 emergency department presentations of self-harm occur annually in England [ 1 ], which places considerable pressure on hospital services. However, because self-harm is the strongest risk factor for subsequent suicide [ 2 ], these episodes also represent an important opportunity for prevention [ 3 ]. Self-harm also places a heavy burden on primary care services.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of self-harm in a UK-wide primary care patient cohort, 2001–2013

et al. 2016

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BackgroundMost of the research conducted on people who harm themselves has been undertaken in secondary healthcare settings. Little is known about the frequency of self-harm in primary care patient populations. This is the first study to describe the epidemiology of self-harm presentations to primary care using broadly representative national data from across the United Kingdom (UK).MethodsUsing the Clinical Practice Research Datalink (CPRD), we calculated directly standardised rates of incidence and annual presentation during 2001–2013. Rates were compared by gender and age and across the nations of the UK, and also by degree of socioeconomic deprivation measured ecologically at general practice level.ResultsWe found significantly elevated rates in females vs. males for incidence (rate ratio - RR, 1.45, 95 % confidence interval - CI, 1.42-1.47) and for annual presentation (RR 1.56, CI 1.54–1.58). An increasing trend over time in incidence was apparent for males (P < 0.001) but not females (P = 0.08), and both genders exhibited rising temporal trends in presentation rates (P < 0.001). We observed a decreasing gradient of risk with increasing age and markedly elevated risk for females in the youngest age group (aged 15–24 years vs. all other females: RR 3.75, CI 3.67–3.83). Increasing presentation rates over time were observed for males across all age bands (P < 0.001). We found higher rates when comparing Northern Ireland, Scotland, and Wales with England, and increasing rates of presentation over time for all four nations. We also observed higher rates with increasing levels of deprivation - most vs. least deprived male patients: RR 2.17, CI 2.10–2.25.ConclusionsIncorporating data from primary care yields a more comprehensive quantification of the health burden of self-harm. These novel findings may be useful in informing public health programmes and the targeting of high-risk groups toward the ultimate goal of lowering risk of self-harm repetition and premature death in this population.

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“…[4][5][6] However, psychological, biological, and clinical factors are also important. 7,8 In this context, what role do health services have in suicide prevention?…”

Section: Introductionmentioning

confidence: 99%

Mental health service changes, organisational factors, and patient suicide in England in 1997–2012: a before-and-after study

Kapur

Ibrahim

While

et al. 2016

The Lancet Psychiatry

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The Healthcare Quality Improvement Partnership commissions the Mental Health Clinical Outcome Review Programme, National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, on behalf of NHS England, NHS Wales, the Scottish Government Health and Social Care Directorate, the Northern Ireland Department of Health, Social Services and Public Safety, and the States of Jersey and Guernsey.

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Health services and suicide prevention

Cited by 14 publications

References 21 publications

The prevalence of major mental illness, substance misuse and homelessness in Irish prisoners: systematic review and meta-analyses

The prevalence of major mental illness, substance misuse and homelessness in Irish prisoners: systematic review and meta-analyses

The epidemiology of self-harm in a UK-wide primary care patient cohort, 2001–2013

Mental health service changes, organisational factors, and patient suicide in England in 1997–2012: a before-and-after study

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