Implementation of mental health service recommendations in England and Wales and suicide rates, 1997–2006: a cross-sectional and before-and-after observational study

While, David; Bickley, Harriet; Roscoe, Alison; Windfuhr, Kirsten; Rahman, Shaiyan; Shaw, Jenny; Appleby, Louis; Kapur, Navneet

doi:10.1016/s0140-6736(11)61712-1

Cited by 260 publications

(234 citation statements)

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“…12 This study and others point to the importance of outreach efforts, especially to men and younger/middle age groups, while taking advantage of existing visits to identify risk. 28 The results have other important implications for targeting suicide prevention. While the highest risk for suicide is following a psychiatric hospitalization, 29 the attributable risk is smaller since few individuals have a psychiatric hospitalization before death.…”

Section: Discussionmentioning

confidence: 99%

“…This process may be among the greatest challenges to optimizing suicide prevention efforts. Mental health services systems may be modeled after those developed by While et al, Coffey, and Knox et al 28,46,47 Each of these systems demonstrated reductions in suicide rates after implementing mental health and suicide prevention strategies. Hallmark characteristics of these systems include using assessment and clinical information to provide clinical decision support, using suicide surveillance systems, integrated care across providers, improved access to care, and a culture in which providers are committed to suicide prevention.…”

Section: Discussionmentioning

confidence: 99%

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Health Care Contacts in the Year Before Suicide Death

et al. 2014

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. Medical record, insurance claim, and mortality records were linked via the Virtual Data Warehouse, a federated data system at each site. KEY RESULTS: Nearly all individuals received health care in the year prior to death (83 %), but half did not have a mental health diagnosis. Only 24 % had a mental health diagnosis in the 4-week period prior to death. Medical specialty and primary care visits without a mental health diagnosis were the most common visit types. The individuals more likely to make a visit in the year prior to death (p<0.05) tended to be women, individuals of older age (65+ years), those where the neighborhood income was over $40,000 and 25 % were college graduates, and those who died by non-violent means. CONCLUSIONS: This study indicates that opportunities for suicide prevention exist in primary care and medical settings, where most individuals receive services prior to death. Efforts may target improved identification of mental illness and suicidal ideation, as a large proportion may remain undiagnosed at death.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Health Care Contacts in the Year Before Suicide Death

et al. 2014

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“…However, subsequent reports continue to demonstrate effectiveness of the USAF program in preventing suicide and other mental health problems [5,48]. While and colleagues [6] have reported a ten year follow-up study in the United Kingdom, where suicide rates in those with mental illness were significantly reduced in clinical services adopting nine clear recommendations, compared to services that did not. Both studies report progress over 10 years or more.…”

Section: Discussionmentioning

confidence: 99%

“…The WHO suggests this may relate to improved global health but, in acknowledging emerging evidence for national strategies [2,3], they recommend a range of specific program strategies from which countries may choose. For the first time, they also acknowledge multicomponent strategies as leading to positive outcomes [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Mates in Construction Suicide Prevention Program: A Five Year Review

Martin¹,

Swannell²

2016

J Community Med Health Educ

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Abstract'Mates in Construction' (MATES) is a large-scale multi-component suicide prevention program for construction workers, initiated in Queensland in February 2008, and now disseminated to three additional Australian states. MATES uses on-site universal psychoeducation to encourage help-seeking and early intervention through 'Connectors' trained in suicide first aid and supported by outreach, case management, a 24-hour telephone response line, and online counseling. This review of the first five years in Queensland demonstrates broad program acceptability by workers, unions and construction companies. However, funding constraints and the size and geography of the State limited the overall reach to 35,761 workers from 476 building sites completing the first step in the program -General Awareness Training. Despite this, we compared suicide rates in Queensland male construction workers for the five years of the program (2008)(2009)(2010)(2011)(2012) with the five years prior (2003)(2004)(2005)(2006)(2007), in the context of general male suicide rates for Queensland and Australia for the two time periods.Against a relatively stable male suicide rate for Australia as a whole, the overall male suicide rate (ages 15-64) for Queensland rose during the five years 2008-2012. In contrast, the age-adjusted male suicide rate in the Queensland Construction Industry decreased 7.9% for the years 2008-2012 compared with 2003-2007. Despite small numbers, we attempted statistical analysis using Negative Binomial Regression. The apparent reduction was not statistically significant (95% CI [-0.4, 15.6]), (p=0.386 NS). The decrease for lesser skilled workers (machine operators/ labourers) was 22.5% (95% CI [-6.9, 43.8]), (p=0.121), relative risk 0.80 [CI 0.60, 1.08], again not statistically significant. For skilled trades, the relative risk was 1.04 [CI 0.81, 1.34, NS], a point increase in chance of suicide of 4.1% 33.7, NS]. The complexity of the program and our results are discussed.

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“…A United Kingdom study examined the effect of nine components of health-service reform on suicide outcomes (130), showing that health trusts that implemented more service reforms showed larger reductions in suicides. Three programmes were particularly associated with suicide reductions: a 24-hour crisis response, dual diagnosis policies, and a multidisciplinary review after a suicide death.…”

Section: Multicomponent Interventionsmentioning

confidence: 99%