Restricting youth suicide

Rogers, Steven C.; DiVietro, Susan; Borrup, Kevin; Brinkley, Ashika; Kaminer, Yifrah; Lapidus, Garry

doi:10.1097/ta.0000000000000320

Cited by 15 publications

(11 citation statements)

References 24 publications

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“…In that chart review of 298 pediatric (age <18 years) ED patients with behavioral or psychiatric complaints, only 4% had documented assessment of lethal means access, even though 37% of those deemed high risk by a social worker were also identified as having access to lethal means. [16] Similar work in an adult population has not been reported.…”

Section: Introductionmentioning

confidence: 63%

Lethal Means Access and Assessment Among Suicidal Emergency Department Patients

et al. 2016

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Background Reducing access to lethal means (especially firearms) might prevent suicide, but counseling of at-risk individuals about this strategy may not be routine. Among emergency department (ED) patients with suicidal ideation or attempts (SI/SA), we sought to describe home firearm access and examine ED provider assessment of access to lethal means. Methods This secondary analysis used data from the Emergency Department Safety Assessment and Follow-up Evaluation, a 3-phase, 8-center study of adult ED patients with SI/SA (2010-2013). Research staff surveyed participants about suicide-related factors (including home firearms) and later reviewed the ED chart (including documented assessment of lethal means access). Results Among 1358 patients with SI/SA, 11% (95%CI 10-13%) reported ≥1 firearm at home; rates varied across sites (range: 6% to 26%) but not over time. On chart review, 50% (95%CI 47-52%) of patients had documentation of lethal means access assessment. Frequency of documented assessment increased over study phases (40% to 60%, p<0.001) but was not associated with state firearm ownership rates. Among the 337 (25%, 95%CI 23-27%) patients discharged to home, 55% (95%CI 49-60%) had no documentation of lethal means assessment; of these, 13% (95%CI 8-19; n=24) actually had ≥1 firearm at home. Among all those reporting ≥1 home firearm to study staff, only half (50%, 95%CI 42-59) had provider documentation of assessment of lethal means access. Conclusions Among these ED patients with SI/SA, many did not have documented assessment of home access to lethal means, including patients who were discharged home and had ≥1 firearm at home.

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Section: Introductionmentioning

confidence: 63%

Lethal Means Access and Assessment Among Suicidal Emergency Department Patients

et al. 2016

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“… 8 However, surveys of ED personnel and retrospective chart reviews indicate that many do not routinely engage in lethal means counseling with suicidal patients, suggesting that the dissemination and implementation of this intervention warrants more concerted attention. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality

Runyan¹,

Becker²,

Brandspigel³

et al. 2016

WestJEM

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IntroductionA youth’s emergency department (ED) visit for suicidal behaviors or ideation provides an opportunity to counsel families about securing medications and firearms (i.e., lethal means counseling).MethodsIn this quality improvement project drawing on the Counseling on Access to Lethal Means (CALM) model, we trained 16 psychiatric emergency clinicians to provide lethal means counseling with parents of patients under age 18 receiving care for suicidality and discharged home from a large children’s hospital. Through chart reviews and follow-up interviews of parents who received the counseling, we examined what parents recalled, their reactions to the counseling session, and actions taken after discharge.ResultsBetween March and July 2014, staff counseled 209 of the 236 (89%) parents of eligible patients. We conducted follow-up interviews with 114 parents, or 55% of those receiving the intervention; 48% of those eligible. Parents had favorable impressions of the counseling and good recall of the main messages. Among the parents contacted at follow up, 76% reported all medications in the home were locked as compared to fewer than 10% at the time of the visit. All who had indicated there were guns in the home at the time of the visit reported at follow up that all were currently locked, compared to 67% reporting this at the time of the visit.ConclusionThough a small project in just one hospital, our findings demonstrate the feasibility of adding a counseling protocol to the discharge process within a pediatric psychiatric emergency service. Our positive findings suggest that further study, including a randomized control trial in more facilities, is warranted.

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“…A oitava diretriz aborda a necessidade de considerar os atendimentos relacionados ao comportamento suicida na emergência hospitalar como uma oportunidade de implementar estratégias eficazes para prevenção do suicídio daqueles que estão em risco de cometê-lo. Vários estudos enfatizaram a importância e a possibilidade de uma abordagem preventiva já no ambiente da emergência, oferecendo intervenções terapêuticas breves que impactarão positivamente na adesão ao tratamento e consequentemente na prevenção do suicídio 22,26,28,30,32,35,36,[38][39][40][41][42][43][44] . Dentre estas intervenções, destacam-se o plano de segurança, a orientação dos familiares e a contrarreferência corresponsável aos serviços ambulatoriais de saúde mental 21,22,26,28,30,32,36,38,39,[41][42][43] .…”

Section: Categoria Subcategoriasunclassified

Elaboração de diretrizes para atendimento hospitalar de tentativas de suicídio na adolescência

Scheibe

Luna

2023

Ciênc. saúde coletiva

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Resumo Este artigo visa descrever um estudo qualitativo e quantitativo de construção e validação de diretrizes para atendimento hospitalar de adolescentes com tentativa de suicídio O percurso metodológico implicou a realização de revisão integrativa de literatura com análise temática de conteúdo de 27 artigos, o qual gerou 3 categorias: avaliação do comportamento suicida em contexto de urgência e emergência hospitalar; intervenção diante do comportamento suicida e equipe multiprofissional hospitalar. O conteúdo destas categorias fundamentou a construção de um instrumento com 15 afirmativas sobre a atuação com adolescentes em crise suicida atendidos no contexto hospitalar. Este instrumento foi aplicado com 20 profissionais de saúde selecionados em duas instituições hospitalares do sul do Brasil, os quais atuaram como juízes/avaliadores das afirmativas propostas. O conteúdo das 15 afirmativas foi validado como diretrizes através do Cálculo de Porcentagem de Concordância e do Cálculo do Escore. As diretrizes construídas podem auxiliar as equipes multiprofissionais hospitalares, diante dos adolescentes com tentativas de suicídio, a fundamentarem suas condutas a partir de critérios que norteiam ações de acolhimento, avaliação, intervenção e encaminhamento.

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Restricting youth suicide

Cited by 15 publications

References 24 publications

Lethal Means Access and Assessment Among Suicidal Emergency Department Patients

Lethal Means Access and Assessment Among Suicidal Emergency Department Patients

Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality

Elaboração de diretrizes para atendimento hospitalar de tentativas de suicídio na adolescência

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